Infectious diseases II Flashcards
What are the typical pathogens that cause meningitis in the following:
a) neonates,
b) children + teenagers,
c) adults + elderly?
a) Group B strep (long labour, infection in prev. pregnancy), E. Coli (late neonatal infection), Listeria monocytogenes
b) Neisseria meningitides (gram - ve diplococci), H. influenzae (if unvaccinated)
c) Strep. pneumoniae (gram +ve cocci), Listeria monocytogenes (cheese/unpasteurised milk, alcoholics)
Meningitis CSF findings if the following are the cause:
a) bacteria
b) virus
c) TB
a) turbid appearance, high neutrophils, high protein, low glucose, +ve gram stain
b) clear/cloudy appearance, high lymphocytes, high protein, normal glucose, N/A gram stain
c) clear/cloudy appearance, high lymphocytes, high proteins, low glucose, NA gram stain
Causes and RFs of infective endocarditis
Bacterial causes: Streptococci viridans - congenital heart valves Streptococci bovis - GI malignancy Staphylococci aureus Staphylococci epidermis - IVDU Enterococci HACEK
RFs: Abnormal valves Prosthetic heart valves IVDU Turbulent flow; PDA, VSD Recent dental work
Signs + sx of infective endocarditis
Clubbing, pyrexia, tachycardia, signs of anaemia, vasculitic lesions, splenomegaly, new murmur (mitral>aortic>tricuspid>pulmonary)
Fever w/ sweats/chills/rigors, malaise, arthralgia, myalgia, confusion
Mnemonic for infective endocarditis signs
F ever R oth spots O sler nodes M urmur J aneway lesions A naemia N ail-bed haemorrhage E mboli
Ix and mx of infective endocarditis
Ix:
- bloods: FBC (high WCC, normocytic anaemia), ESR + CRP, U&Es, RF +ve
- 3 blood cultures, 1hr apart within 24 hours
- urgent ECHO
- Dukes classification
- broad spectrum Abx until MCS
Mx with Abx for 4-6 weeks:
if native valves
- S. aureus => flucloxacillin
- S. viridans => benzylpenicillin + gentamicin
if prosthetic valves
- Staphylococci => flucloxacillin/vancomycin + rifampicin + gentamicin
Complications of infective endocarditis
Congestive heart failure Valve incompetence Aneurysm formation Systemic embolism Renal failure Glomerulonephritis
Infective endocarditis buzzwords
Prosthetic valve Dental procedure New onset murmur Vegetation on ECHO Right heart-indwelling catheter
Which bacteria has caused the gastroenteritis?
a) Rice water diarrhoea
b) Last thing ate was leafy veg
c) Recent hx of Abx use
d) Low sanitation
e) Uncooked poultry
f) Uncooked eggs
g) Reheated rice
h) Children have recently had gastroenteritis
a) Vibrio cholera
b) E. coli
c) C. dif
d) Entamoeba histolytica
e) Campylobacter
f) Salmonella
g) Bacillus aureus
g) Shigella
Organisms that cause diarrhoea vs dysentery
Diarrhoea
- Campylobacter/C. dif
- Staph. aureus
- Vibrio cholera
- E coli
- Bacillus aureus
- Salmonella
Dysentry (w/ blood)
- C amplyobacter/C dif.
- H aemorrhagic E. coli
- E ntamoeba histolytica
- S higella
- S almonella
Hep A&E summary
A&E => fAEco-oral hepatitis
A: acute (travel hx, shellfish) and asymptomatic (usually)
E: enteric, epidermics (water), expectant mothers, e-immunocompromised
Mx => supportive + avoid alcohol
Hep B(D) + C summary
B: baby-making, blood, birthing (perinatal)
D: co-infection
C: chronic, RF for hepatocellular carcinoma
Hepatitis triad of sx
I. fever
II. jaundice
III. raised ALT + AST
Malaria summary card
Endemic in tropics, infection w/ protozoan Plasmodium (most common is P. falciparum)
= headache, weakness, myalgia/arthralgia, anorexia, fever (severe cold/rigors followed by severe sweating)
= splenomegaly, anaemia, pyrexia
Ix
= Giemsa-stained thick and thin blood smears
= thick to detect which parasite present
= thin to identify species
= FBC, clotting profile, U&Es, FTs, glucose, urinalysis, ABG
A baby girl born 1 day ago born after a long vaginal labour, becomes drowsy. On examination, T: 38.9, HR: 170bpm, RR: 30. Which is the most likely causative agent?
A Neisseria meningitis B Streptococcus pneumonia C Listeria monocytogenes D Group B streptococcus E E. Coli
D Group B streptococcus