infectious nelson extra

Question 1

empirical antimicrobial therapy for invasive meningococcal infection

Answer 1

third gen cephalosporin (ceftriaxone, cefotaxime)

Question 2

Drugs of choice in invasive meningococcal disease wherein “prophylaxis” us required at the end of treatment

Answer 2

Penicillin G
Ampicillin

Question 3

Poor prognostic factors in meningococcal disease

Answer 3

Hypo/extreme hyperpyrexia
hypotension or shock,
purpura fulminans,
seizures,
leukopenia,
thrombocytopenia (including DIC),
acidosis,
high circulating levels of endotoxin and TNF-α

Question 4

Antibiotic prophylaxis to prevent n. Meningitidis infection

Answer 4

Rifampin
Ceftriaxone
Ciprofloxacin
Azithromycin (not routinely recommended)

Question 5

Who must be given meningococcal prophylaxis treatment?

Answer 5

Recommended for household and kissing contacts.
In the United States, chemoprophylaxis is recommended for: • Household contact, especially children <2 yr old
• Childcare or preschool contact at any time during 7 days before onset of illness
• Direct exposure to index patient’s secretions through kissing, sharing toothbrushes or eating utensils at any time during 7 days before onset of illness
• Mouth-to-mouth resuscitation, unprotected contact during endotracheal intubation during 7 days before onset of illness • Frequently slept in same dwelling as index patient during 7 days before onset of illness
• Passengers seated directly next to the index case during airline flights lasting >8 hr