Infectious diseases Flashcards
TB treatment
I-REP
Isoniazid,Rifampicin,Ethambutol,
Pyrazinamide
For Pulmonary TB , 2 months IREP and 4 months EP.
For Meningeal TB, 2 months IREP and 10 months EP.
For Pericardial TB, 2 months IREP and 4 months EP.
MDR TB
Resistance to Isoniazid and Rifampicin.
XMDR TB
Resistance to Isoniazid, rifampicin, quinolone, and a second line injectable agent.
Side Effects of TB Drugs
Hepatitis-IRP
Optic Neuritis, Ototoxicity- Ethambutol
Peripheral Neuropathy- Isoniazid
Red/orange color urine- Rifampicin
Latent TB chemoprophylaxis
3 months of Isoniazid and rifampicin
or 6 months of Isoniazid
Leishmaniasis
Caused by Leishmania, transmitted by sandflies.
For cutaneous leishmaniasis sodium stibogluconate.
For Visceral leishmaniasis, liposomal Amphotericin B.
Cat scratch Fever
- Transmitted to humans by a bite or scratch from cat.
- Bartonella Hensalae
- Tender Lymphadenopathy
Hepatitis E
Hepatitis E is viral hepatitis transmitted via the faeco-oral route, and is not protected against by the current vaccination program.
Diphtheria
Fever, Sore throat, Cervical lymphadenopathy, Grayish pharyngeal membrane
Reactive Arthritis
Reactive arthritis classically presents with the combination of urethritis, conjunctivitis and arthritis, with NSAIDs the initial treatment of choice.
Cerebral Malaria
Plasmodium falciparum invades the central nervous system, causing cerebral malaria.
Splenectomy
- Patients should be vaccinated with an appropriate pneumococcal vaccination at latest two weeks prior to surgery to allow the maximal humoral immune response
HIV
Acute human immunodeficiency virus (HIV) presents two weeks to three months after exposure to the virus; the illness typically consists of:
- fever
- arthritis
- rash, and
- lymphadenopathy.
Bronchiectasis
Postural drainage is the cornerstone to treating bronchiectasis and should be undertaken at least once per day and more frequently during exacerbations.
Behçet’s disease
- Oral and Genital Ulceration
- Colitis
- Scleritis
Clindamycin
Clindamycin is a lincosamide antibiotic that has good activity against gram-positive cocci, including methicillin-resistant Staphylococcus aureus (MRSA),
Eron Classification
I There are no signs of systemic toxicity and the person has no uncontrolled co-morbidities
II The person is either systemically unwell or systemically well but with a co-morbidity (for example peripheral arterial disease, chronic venous insufficiency, or morbid obesity) which may complicate or delay resolution of infection
III The person has significant systemic upset such as acute confusion, tachycardia, tachypnoea, hypotension, or unstable co-morbidities that may interfere with a response to treatment, or a limb-threatening infection due to vascular compromize
IV The person has sepsis syndrome or a severe life-threatening infection such as necrotizing fasciitis
Henoch-Schonlein purpura (HSP)
Henoch-Schonlein purpura (HSP) is an IgA mediated small vessel vasculitis. There is a degree of overlap with IgA nephropathy (Berger’s disease). HSP is usually seen in children following an infection.
Features
palpable purpuric rash (with localized oedema) over buttocks and extensor surfaces of arms and legs
abdominal pain
polyarthritis
features of IgA nephropathy may occur e.g. haematuria, renal failure
Treatment
analgesia for arthralgia
treatment of nephropathy is generally supportive. There is inconsistent evidence for the use of steroids and immunosuppressants
Behcet syndrome
Features
-HLA-B51
- classically: 1) oral ulcers 2) genital ulcers 3) anterior uveitis
- thrombophlebitis and deep vein thrombosis
- arthritis
- neurological involvement (e.g. aseptic meningitis)
- GI: abdo pain, diarrhoea, colitis
erythema nodosum
SYPHILIS
Management
intramuscular benzathine penicillin is the first-line management
alternatives: doxycycline
nontreponemal (rapid plasma reagin [RPR] or Venereal Disease Research Laboratory [VDRL]) titres should be monitored after treatment to assess the response
a fourfold decline in titres (e.g. 1:16 → 1:4 or 1:32 → 1:8)is often considered an adequate response to treatment
The Jarisch-Herxheimer reaction is sometimes seen following treatment
fever, rash, tachycardia after the first dose of antibiotic
in contrast to anaphylaxis, there is no wheeze or hypotension
it is thought to be due to the release of endotoxins following bacterial death and typically occurs within a few hours of treatment
no treatment is needed other than antipyretics if required.
