Microbiology - Symptoms Differentials

Question 1

What are the SX for Bacterial Sinusitis?

Answer 1

Inflammed sinuses. Thick, purulent nasal discharge, congestion, facial pain, headache.

Less common SX - toothache, halitosis (bad breath)

Question 2

What are the SX for otitis media? When does it usually occur?

Answer 2

Inflammation of middle ear, Otalgia (ear pain), otorrhea (discharge), diminished hearing, fever. Usually occurs after a viral URTI.

Question 3

What are the general SX for oral cavity infections?

Answer 3

Swelling of soft tissue along angle of jaw and neck or in oral cavity. May develop draining sinus tract with yellow granules pus (sulfur granules) and infection may spread to adjoining tissue.

Question 4

What are the SX of Pharyngitis? What is absent?

Answer 4

Sore throat, fever, chills, abdominal pain, inflamed uvula, pharynx; enlarged tonsils with grayish-white patchy exudate (NO COUGH OR CONGESTION)

Question 5

What are the SX of epiglottitis?

Answer 5

Inflamed epiglottis, SEVERE sore throat, fever, dysphagia (difficulty swallowing) and muffle voice.

Question 6

What are the SX of pneumonia? (general)

Answer 6

Infection of lung parenchyma, cough, fever, tachycardia, dyspnea, chest pain, increased RR and use of accessory muscles.

Question 7

What are the SX of CA-Pneumonia (with gram stainable bacteria)?

Answer 7

Fever, dyspnea, productive cough, chest pain.

Question 8

What are the SX of CA-Pneumonia (with atypical bacteria)?

Answer 8

Fever, dyspnea, chest pain and NON PRODUCTIVE COUGH, extra pulmonary findings are common.

Question 9

What are the SX of Legionaire’s disease?

Answer 9

HIGH FEVER, chills, SLIGHT productive cough (SPUTUM MAY HAVE BLOOD), diarrhea, abdominal pain, headache, confusion, changes in mental status

Question 10

What are the SX of Pontiac Fever?

Answer 10

Malaise, fatigue, myalgias, fever and headache (mild and self limiting disease)

Question 11

What are the SX of mycoplasma pneumoniae pnemonia?

Answer 11

Fever, malaise, headache, sore throat, nasal congestion, non-productive cough

Question 12

What are the SX of chamydophila pneumonia? - atypical pneumonia

Answer 12

Fever, malaise, headache, sore throat, nasal congestion, non-productive cough

Question 13

What are the SX of chlamydophila psittaci (psittacosis)? - atypical pneumonia

Answer 13

HIGH FEVER, chest pain, muscle aches, non productive cough, can produce severe pneumonia

Question 14

What are the SX of francisella tularensis penumonia?

Answer 14

Non productive cough, dyspnea, chest pain

Question 15

What is an important differential for hospital acquired pneumonia regarding the patients cough?

Answer 15

Likely unable to cough enough to provide a sputum sample for culture

Question 16

What are the general SX of VAP?

Answer 16

Fever, PURULENT SECRETIONS, leukocytosis (increased WBC)

Question 17

What are the SX of aspiration pneumonia?

Answer 17

Cough w/ purulent sputum, fever, chills, malaise, myalgias, dyspnea and chest pain

Question 18

What are the SX of lung abscesses?

Answer 18

Cough w/ purulent sputum, fever, chest pain, night sweats, fatigue and anemia (common)

Question 19

What are the SX of active TB?

Answer 19

PRODUCTIVE COUGH, fever, weight loss, night sweats, hemoptysis (cough up blood), chest pain and fatigue (remember that TB can infect pulmonary or extrapulmonary or both)

Question 20

What are the SX of inhalation anthrax?

Answer 20

Fever, chills, dyspnea, cough, headache, vomiting, chest and abdominal pain, progresses to HIGH FEVER, EDEMA, ENLARGED MEDIASTINAL LYMPH NODES and meningitis

Question 21

What are the SX of diptheria?

Answer 21

Sudden sore throat, malaise, LOW GRADE FEVER, EXUDATE THAT FORMS A PSEUDOMEMBRANE, Severe cardiac and neurological complications caused by toxin

Question 22

What are the SX of pertussis (whooping cough)?

Answer 22

Catarrhal stage: runny nose, sneezing, low grade fever (1-2 wks)

Paroxysmal stage: Whooping cough, vomiting, exhaustion

Covalescent stage (several weeks)

Question 23

What are the signs/SX for osteomyelitis?

Answer 23

Pain, low grade fever, markers of inflammation (increased ESR, CRP)

Question 24

What are the SX of brucellosis?

Answer 24

Fever, night sweats, chills, musculoskeletal SX (arthralgia, low back pain, hip pain), fatigue, myalgia, headache, ENDOCARDITIS (RARE)

Question 25

What are the SX of meningitis?

Answer 25

Headache, fever, nuchal rigidity, altered mental status

Sometimes…nausea, vomiting, photophobia

Question 26

What are the SX of meningitis (early onset in neonates) by listeria?

Answer 26

Severe form - granulomatosis infantiseptica - abscesses and granulomas

Question 27

What are the SX of meningitis (late onset in neonates) by listeria?

Answer 27

Meningitis or meningoexephalitis with septicemia

Question 28

What is the major differentiating symptom of neisseria meningitis when patient presents with meningitis?

Answer 28

Nonblanching petechial or purpuric rash

Question 29

What are the SX of mild leptospirosis?

Answer 29

Flu like illness (fever, chills, headache, nausea, vomiting, abdominal pain - may have rash)

Immune phase results in fever and myalgia (may lead to meningitis)

Question 30

What are the SX of severe leptospirosis (Weil’s syndrome)

Answer 30

Hemorrhage, jaundice and acute kidney injury (death due to septic shock)

Question 31

What are the SX of brain abscesses?

Answer 31

Heache, fever, local neurologic defect

Question 32

What are the SX of peptic ulcer disease?

Answer 32

Epigastric pain after eating, gnawing or burning sensation

Question 33

What are the SX of s. aureus diarrhea?

Answer 33

Watery diarrhea, vomiting, abdominal pain

Incubation: 2-6
Duration: <24

Question 34

What are the SX of B. cereus diarrhea?

Answer 34

Watery diarrhea, abdominal cramps

Incubation: 8-12
Duration: <24

Question 35

What are the SX of of B cereus vomiting?

Answer 35

Vomiting, nausea, abdominal cramps

Incubation: Within 6 hours
Duration: <24 hours

Question 36

What are the SX of C. perfringens?

Answer 36

Watery diarrhea, abdominal cramps

Incubation: 8-24 hours
Duration: <24 hours

Question 37

What are the SX of ETEC diarrhea?

Answer 37

Watery diarrhea, nausea, vomiting, abdominal cramps

Incubation: 12-72 hours
Duration: 3-5 hours

Question 38

What are the SX of EPEC diarrhea?

Answer 38

Watery diarrhea, nausea, vomiting, abdominal cramps

Incubation: 1-2 days
Duration: 5-15 days

Question 39

What are the SX of EAEC diarrhea?

Answer 39

Watery diarrhea, nausea, vomiting, fever, abdominal cramps

Question 40

What are the SX of V. cholera?

Answer 40

Watery diarrhea, vomiting, muscle cramps, NO WATER, rice water appearance and fishy odor of diarrhea

Incubation: 1-2 days

Question 41

What are the SX of V. parahaemolyticus diarrhea?

Answer 41

Watery diarrhea, abdominal cramps, nausea, vomiting, fever

Incubation: 4 hours-4 days

Question 42

What are the SX of Listeria monocytogenes diarrhea?

Answer 42

Mild watery diarrhea, headache, nausea, vomiting, fever

Incubation: 24 hours + cold environment

Question 43

What are the SX of nontyphoidal salmnella diarrhea?

Answer 43

Nausea, vomit, H20 diarrhea, FEVER, ab. cramps

Question 44

What are the SX of enteric (typhoid) fever?

Answer 44

Gradually increasing fever, headache, ab pain, diarrhea, constipation

RASH rose spots (fade 2-5 days)

Question 45

What are the SX of diverticulitis?

Answer 45

Severe localized ab pain, FEVER, constipation or diarrhea –> could lead to abscess formation and peritonitis

Question 46

What are the SX of appendicitis?

Answer 46

Severe ab pain RLQ, nausea, vomit, constipation or diarrhea

Question 47

What are the SX of peritonitis?

Answer 47

Severe ab pain, FEVER