Infectious Diseases Flashcards
Roseola Infantum
-Caused by HHV-6 (Known as Sixth Disease)
-Transmission: respiratory droplets
-Symptoms: high fever and LAD. Child appears well and alert during febrile phase. Fever resolves and rash occurs. Rose pink, macular, blanch able rash beginning on trunk and neck and spreading to face. Nagayama Spots (papules on soft palate and uvula)
-Treatment: Supportive, self-limited, hand-washing
What is unique about Roseola Infantum?
It is the only viral exanthema that starts on the trunk!
Rubella (German Measles)
-Caused by Rubella virus (part of the Togavirus family)
-Transmission: respiratory droplets
-Symptoms: Prodrome of fever, LAD (posterior cervical or posterior auricular). Rash: pink or light-red non confluent maculopapular rash starts on face and spreads to trunk and extremities. Lasts 3 days. Spreads more rapidly and doesn’t darken. Forchheimer Spots (small red petechiae on soft palate). Transient photosensitivity and joint pains.
Treatment: Supportive, oral hydration
What is true about the complications associated with Rubella?
Teratogenic in the first trimester (congenital Rubella Syndrome)
Mumps
-Parotid gland enlargement caused by Paramyxovirus
-Transmission: respiratory droplets
-Symptoms: low fever, malaise, headache, earache, then bilateral parotitis, parotid swelling and tenderness
-Treatment: Supportive is mainstay. Droplet precaution if hospitalized.
_______ is the most common complication of Mumps, especially in post pubertal males
Mumps is the MC infectious cause of __________ in children
Epididymo-orchitis is the MC complication of Mumps
Acute Pancreatitis in children
MMR vaccine (2 doses) schedule
-Can it be given to pregnant women?
-given at 12-15 months and then at 4-6 years old
It is a live attenuated vaccine. Do not give to pregnant women. They should wait 4 weeks after getting the vaccine before becoming pregnant.
Dengue Fever
-Febrile infection causes by dengue virus transmitted from Aedes mosquito
-Symptoms
–Biphasic Fever: high fever, remission, second fever, severe myalgia, headache, ocular pain
–Biphasic Rash: flushed skin, mottling, fever resolves, maculopapular rash and petechiae on extensor surfaces.
–Hemorrhagic Fever: epistaxis, menorrhagia, ecchymosis. Positive Tourniquet Test (purpura from where tourniquet was), hepatitis.
-Hemorrhagic Shock: rapid weak pulse, narrow pulse pressure, hypotension, cold clammy skin
-Treatment: Supportive, Acetaminophen (NO ASPIRIN)
Rabies
-What is it?
-Transmission?
-Pathophysiology?
-Life-threatening Rhabdovirus infection of the grey matter in the CNS
-Transmission: saliva from infected animal bites (BATS MC, raccoons, skunks, foxes).
-Pathophysiology: virus goes from peripheral to central nervous system via acetylcholine receptors
Rabies
-Symptoms (phases)
-Prodrome Phase: pain, paresthesias, itching at bite site
-CNS Phase: encephalitis, hydrophobia, acrophobia, rabid rage, hyper salivation, thick sputum.
-Respiratory Phase: respiratory muscle paralysis –> death
Rabies
-Diagnostics
-Management
-Immunofluorescence: Negri bodies in the brain of euthanized animals
-Animal observation for 7-10 days
-No effective management once symptoms occur (these patients rarely survive)
Rabies
-Post Exposure Vaccine Schedule (first episode)
-Post Exposure Vaccine Schedule (subsequent exposures)
-First Episode
–Immunocompetent: HDCV (Rabies Vaccine) on days 0, 3, 7, 14 + RIG
–Immunocompromised: Days 0, 3, 7, 14, 28 + RIG
-Subsequent Exposures: Rabies vaccine day 0 and 3. no RIG
Herpes Simplex Virus 1
-Transmission
-Diagnostic
–Test of choice
–Gold Standard
-Management
-Transmission: direct contact with contaminated saliva or infected body secretion.
-PCR (most sensitive and specific)
-HSV-1 serology (GOLD)
-Management: Oral Valacyclovir or Acyclovir
What does a Tzank Smear show for Herpes?
Multinucleated Giant cells (but this is nonspecific)
Herpes Simplex Virus 1
-Symptoms (primary vs secondary)
-Primary: may cause tonsillopharyngitis in adults and gingivostomatitis in children. Herpetic Whitlow (dentists and health care workers, lesion on the finger.)
-Secondary: Herpes Labialis (cold sore): prodromal symptoms (burning, numbness, tingling) and then grouped vesicles on erythematous base that crusts before healing.
Genital Herpes
-Caused by HSV-2 virus
-Painful genital ulcers often preceded by prodromal symptoms.
-Multiple, shallow, tender ulcers. Grouped vesicles on an erythematous base.
-PCR is test of choice, HSV-1 serology is GOLD standard.
-Management
–Acyclovir, Valacyclovir, Famciclovir
Tetanus
-Treatment
Metronidazole + IM Tetanus Immuneglobulin (5,000 units)
Benzodiazepines to reduce spasms (Diazepam)
Respiratory support if needed
Tetanus Prophylaxis If:
-Previously Vaccinated
-Never Vaccinated
-Tdap preferred or Td vaccine booster every 10 years (also for major wounds > 5 years since last booster)
-TIG 250u + tetanus toxoid vaccine (three doses)
Tetanus Vaccine Schedule with Booster
-DTap (5 doses): 2, 4, 6 months, 15-18 months, and 4-6 years old
-Tdap Booster: at 11-12 years of age
True or False: Tetanus vaccine is recommended for every pregnancy?
True!
_______ is the MC overall bacterial cause of STI in the US
Chlamydia trachomatis
Symptoms of Chlamydia (think of the different conditions it can cause)
-Urethritis: purulent discharge, pruritus, dysuria, dyspareunia, hematuria. Asymptomatic in men.
-PID: abdominal pain, cervical motion tenderness.
-Reactive arthritis: urethritis, uveitis, arthritis. HLA-B27
-Lymphogranuloma venereum: genital/rectal lesion with softening, suppuration, and lymphadenopathy.
Chlamydia
-Management
Azithromycin 1 dose OR Doxycycline 100mg BID x 10 days
Also treat for Gonorrhea: Ceftriaxone IM x 1 dose
Lymphogranuloma Venereum
-Genital ulcer disease caused by Chlamydia trachomatis
-Painless genital ulcer at site of inoculation.
-Secondary stage (2-6 weeks later): painful inguinal and/or femoral LAD (buboes)
-May develop proctocolitis (rectal discharge, anal pain, constipation, fever)
-Doxycycline 100mg BID x 21 days OR Azithromycin 1g orally once weekly x 3 weeks
