Microbiology Flashcards
Complications of sore throat (4)
1) Otitis media
2) Quinsy
3) Abscess
4) Mastoiditis
What is Lemierre’s Syndrome?
Infection of posterior compartment of pharyngeal space with jugular vein involvement
T/F: Throat swabs are routine in general practice for sore throat.
False - isolation yield is poor and most are viral
What are the Centor criteria (4)
1) Tonsilar exudate
2) Tender anterior cervical nodes
3) History of fever
4) Absence of cough
Higher = more likely to be bacterial
How should viral sore throat initially be managed (no red flags)
Fluid intake, hot drinks, warm-salty water mouthwash
Most common bacterial cause of sore throat
S. pyogenes (Group A beta haemolytic strep)
A patient has a Centor criteria of 4, how should they be treated?
Penicillin
What infection controls need to be taken in confirmed S. pyogenes throat infections?
SICPs, contact and droplet
S. pyogenes Gram stain.
Haemolysis pattern
Gram positive cocci in chains
Beta haemolytic
Complications of strep throat
Rheumatic fever, glomerulonephritis
A patient comes in with a severe sore throat and a grey-white pseudomembrane across the pharynx. Spot diagnosis?
C. diptherhiae infection
C. diphtheriae produces exotoxin/ endotoxin?
Exotoxin (very cardio and neurotoxic)
The diptherhia vaccine is what type?
Toxoid
How is diphtheria treated?
Antitoxin + penicillin or erythromycin
A patient comes in with sore throat and white patches on their mouth/throat, which have become red and raw, spot diagnosis?
Thrush (C. albicans)
How is oral thrush treated?
Nystatin
AOM is a common secondary infection to what
URTI
AOM is commonly due to what organism type?
Virus
Most common bacteria isolated from AOM?
S. pneumoniae, H. influenzae, S. pyogenes.
Can swabs be taken in AOM?
Yes, if the ear-drum has ruptured and there is discharge.
When should AOM be given antibiotics?
If infection >4 days, or if they are systemically unwell.
What antibiotics should be given in AOM?
Amoxicillin (1st)
Erythromycin (2nd)
When should antibiotics be given in acute sinusitis?
If infection >10 days
What is the first and second line antibiotic for acute sinusitis?
Penicillin V
2nd line is doxycycline (but NOT in children)
Potential complication of AOE?
Malignant otitis (extension into bone surrounding the ear canal, e.g. mastoid and temporal bones). A fatal condition.
Most common otitis externa bacterial isolates? (2)
S. aureus, P. aeruginosa
Common fungal causes of otitis externa?
Aspergillus niger, C. albicans
How is otitis externa managed, first-line?
Topical aural toilet, acetic acid drops
Mono is caused by what
EBV
How is mono diagnosed?
Atypical lymphocytes in film + IgM EBV test
Spot diagnosis: Patient with lymphadenopathy, palatal petichae?
IM
Splenic rupture can result from what infection?
EBV
EBV belongs to which viral family?
Herpes
T/F: Primary infection with EBV in youth (<10) commonly leads to IM symptoms
False - often only causes symptoms in those >10 years old
How is EBV treated?
Bed rest, paracetamol, avoid sport.
NOT antivirals
Which HSV type causes oral lesions?
HSV1
How is primary gingiviostomatitis treated?
Aciclovir
T/F: Aciclovir eliminates HSV1.
False
How should HSV be diagnosed?
Swab lesion, send in viral medium for PCR
Potential serious complication of HSV?
Herpes Simplex Encephalitis
Hand, Foot and Mouth is caused by which family of viruses?
Coxsackie. Diagnosed with PCR.
Chancre is buzzword for what
Primary syphilis (T. pallidum)
How is genital syphilis treated?
Benzylpenicillin
