Microbio - infection CPC Flashcards
68M
SOB, reduced ETT
productive cough w green sputum + lethargy
complex PMH, deaf, heavy smoker and drinker
Afebrile. Tachypneic, high RR, hypoxic, normal ECG. CXR - patchy consolidation, groundless opacity in upper and lower lobes.
Causative organism?
Ground glass appearance =
= PNEUMOCYSTIS JIROVECII –> pneumonia
Histology of pneumocystis pneumonia
Cysts
Neutrophil defects –> name 4 infections which are more common
Staph
Pseudomonas
Candida
Aspergillus
T cell defects –> name 5 infections more likely?
Fungal - PCP, candida
Viral - CMV, EBV, VZV
B cell defects –> name 5 infections more likely?
Strep, staph, Haemophilus
- Enterovirus
- Tetanus, diptheria
Complement defect – which infections are more likely?
Neisserial
Encapsulated: meningococcal, TB
Alcoholics –> infection w Gram + rod?
Actinomyces
Actinomyces pneumonia in alcoholics = how does this tend to present?
Slow growing, abscess formation
Histology shows sulphur granules + branching gram+ rods ..what do you suspect?
actinomyces
Mx of prosthetic joint infection
1: Removal of prosthesis + adequate debridement
Abx = secondary role
Name an Abx which can be used against pseudomonas
ceftriaxone
Name an Abx which can be used against MRSA
Vancomycin
5 steps to take in pt who is C Diff +ve
1) Isolate
2) assess severity
3) Stop offending Abx
4) wash hands with soap and water + use gloves/aprons
5) commence C diff care pathway, fluid balance + bristol stool chart
Mx of non-severe C Diff?
If severe C Diff?
If colonic dilatation?
ribotype 027Non-severe: Metronidazole PO
Severe: Vancomycin PO QDS 2/52 + consider IV metronidazole
Colonic dilatation: as above, + refer to surgeons
which ribotype of C Diff –> severe disease in 2005?
RIbotype 027
