Infx Dz JB Flashcards
anthrax sx
F w/ nonproductive cough, myalgia, fatigue, retrosternal chest pain –> improvement –> rapid deterioration (high F, severe dyspnea, tachypnea, hypoxemia, hematemesis, hemoptysis, chest pain, meningismus, coma)
ascariasis tx
mebendazole
albendazole, pyrantel if pregnant
tx whole family
ascariasis sx
large worm load: vague abdominal sx
can migrate to pancreatic duct, bile duct, appendix, diverticula
cough, wheezing, hemoptysis, abd pain, diarrhea
ascariasis dx
eggs in feces or large worm may be coughed, vomited
worms can leave nose, anus, or mouth
stool O&P
eosinophilia
asplenia immunizations needed
pneumoncoccal (strep pneumo)
meningococcal (neisseria/H.flu)
Virus: HPV/influenza/zoster
bacteremia labs
F, elevated WBC, blood culture + (unless HACEK)
bartonellosis (cat scratch dz) sx
gradual regional lymph nose enlargement (axilla, groin, neck) lasts 2-3mo or longer
distal scratch and/or red-brown papules on skin
bartonellosis (cat scratch dz) tx
azithromycin 1st line
doxycycline preferred if optic neuritis or neurologic dz
candidal balanitis tx
topical imidazole
clotrimazole 1%
miconazole 2%
catheter associated infx tx
BS B lactase and MRSA coverage
very ill: imipenem + vancomycin
Pre-op abx prophylaxis C-section
cefazolin within 60m before
decrease risk of endometritis
cryptococcosis presentation
HIV pt + patient w/ meningitis
cryptococcosis dx
LP: fungal CSF pattern
india ink: encapsulated budding round yeast
cryptococcosis tx
amphotericin B + flucytosine ==> PO fluconazole
pneumonia if immunocomp: fluconazole or itraconazole
cryptococcus prophylaxis in HIV
fluconazole if CD4<100
CMV retinitis presentation
immunocomp w/ decompensating vision
diphtheria sx
gray and white patches on tonsils and back of throat, bleeds if scraped
sore throat, F, swollen lymph nodes, bullock, myocarditis
diphtheria dx
clinical
PCR to confirm
diphtheria tx
antitoxin (horse) supplied by CDC + erythromycin or PCN
clindamycin or rifampin alternatives
PCN + ahminoglycosides for endocarditis
diphtheria prophylaxis and prevention
close contact: erythromycin or PCN benzathine G
prevention DTap
dengue staphylococcus prevention
permethrin on clothes
DEET on body
HSV2 genital/penis tx
acyclovir (IV for encephalitis)
valacyclovir
famciclovir
herpes zoster opthalmicus sx
shingles involving 1st division of trigeminal nerve
hutchinson sign: lesion on nose
dendritic lesions on slit lamp if keratoconjunctivitis
herpes zoster opthalmicus tx
PO antiviral
may add trifluridine, acyclovir, or vidarabine ophthalmic
histoplasmosis tx
mild/mod: itraconazole 1st line
severe: amphotericin B
HIV dx
screening: ELISA (blood or saliva)
confirm: western blot
HIV RNA viral load: monitor infectivity and tx effectiveness
AIDS defined as CD4 count of?
CD4 <200
HIV/AIDS tx
HAART regimen:
NNRTI + 2 NRTI
PI + 2 NRTI
INSTI + 2 NRTI
cytomegalovirus in HIV/AIDS dx
clinical dz only in immunocompromised patients
CD4 <50, colitis if CD4 <100
HPV infection types
cutaneous: verruca (warts)- common (vulgaris), plantar (planteris), flat (plana)
mucosal: genital warts (condyloma acuminata), cervical dysplasia/cancer, and anogenital carcinoma
MMR immunization schedule
1st dose 12-15mo
2nd dose 4-6yo
shigella dysenteriae infection sx
explosive watery diarrhea (mucoid, bloody)
lumbricoides infestation
giant roundworm
from contaminated soil
Cause of liver abscess
entamoeba histolytica
liver abscess tx
metronidazole
lyme dz etiology
borrelia burgdorfery (gr negative sphirochete)
lyme dz dx
clinical dx
ELISA –> western blot
false positive ELISA seen w/ syphilis
lyme dz tx
early: doxycycline (azithromycin or erythromycin if allergic)
amoxicillin TOC in kids or pregnancy
late/severe: IV ceftriaxone
lyme dz prophylaxis
doxycycline w/in 72h of tick removal, if tick present for >36h, and >20% ticks infected in that area
if allergic, no prophylaxis given
malaria etiology
plasmodium falciparum
diseases that are protective against malaria
thalassemia
sickle cell
malaria sx
cyclical fever, leukopenia, hemolytic anemia, thrombocytopenia
HA, myalgia, GI sx, splenomegaly
cerebral malaria w/ P. falciparum
malaria dx
geimsa stain PBS: parasites in RBC
MRSA tx
bactrim
clindamycin, tetracycline (doxycycline or minocycline)
mumps caused by
paramyxovirus
MCC acute pancreatitis in children
Mumps
mumps sx
F, HA, myalgia, fatigue, anorexia –>
salivary gland swelling w/in 48h
parotitis, obscure angle of mandible
mumps dx
serology
increased amylase
often clinical dx
mumps tx
supportive
anti-inflammatories
Mycobacterium avium complex
not from person to person contact
seen in HIV when CD4 <50
mycobacterium avium complex tx
if CD4<50 –> clarithromycin, azithromycin, rifabutin
neurosyphilis sx
Meningitis, dementia, vision/hearing loss, incontinence
tabes dorsalis, ataxia, areflexia, no proprioception
argyll-robertson pupil
rabies tx
vaccine given pre and post exposure
5 IM doses of HDCV days 0, 3, 7, 14
+ rabies IG: 1/2 in wound, 1/2 IM within 6 days of exposure
Ramsay hunt sx
triad: ipsilateral facial paralysis (bells palsy CN7), ear pain, vesicles of auditory canal/auricle
ipsilateral altered taste perception and tongue lesions
decreased hearing, tinnitus
Ramsay hunt tx
oral acyclovir + CS
RMSF etiology
rickettsia ricketsii
RMSF sx
F, HA
Rash: small spots of bleeding and starts on wrist/ankles ==> palms and soles ==> spreads centrally over 2-3d
RMSF dx
clinical dx
do not wait for serologies
RMSF tx
doxycycline (even in children)
chloramphenicol TOC if pregnant
scarlet fever tx
penicillin G or VK 1st line
macrolide if PCN allergic
secondary syphilis sx
maculopapular fase (diffuse, bilateral, involvement of palms and soles) condyloma lata: wart like moist lesions involving mucus membranes (contagious)
Bacterial sepsis sx
fever, hypoTN, AMS, increased RR
syphilis tx
primary, secondary, early-latent: penicillin G berzathine
tertiary, late latent: penicillin G berzathine
PCN allergy: doxycycline or tetracycline, macrolide, or ceftriaxone
Systemic inflammatory response syndrome (SIRS) tx
pan culture before abx zosyn + ceftriaxone or imipenem IV isotonic fluids vasopressor if no response to fluids \+/- IV hydrocortisone goal MAP > 60mmHg
Tetanus etiology
clostridium tetani (gram positive rod)
Toxic shock syndrome etiology
S. aureus or strep pyogenies
Toxic shock syndrome sx
sudden onset high fever >102.2
tachycardia, hypoTN, N/V/D
pharyngitis, rash (diffuse erythematous macular like sunburn. includes palms/soles)
toxoplasmosis sx
primary: mono-like illness
chorioretinitis in immunocompromised (CD4<100)
Triad: chorioretinitis, intracranial calcificaitons, hydrocephalus
toxoplasmosis dx
PCR
head CT/MRI +/- ring enhancing lesions
toxoplasmosis prophylaxis
CD4<100: bactrim
trichomoniasis tx
flagyl, safe in pregnancy
tinidazole
typhoid fever etiology
Salmonella (S. typhi)
typhoid fever sx
pea soup stools (brown/green color)
intractable F, bradycardia, hepatosplenomegaly
blanching rose spots
