Organism and treatment

Question 1

Vibrio vulnificus

Answer 1

aggressive debridement

IV III gen ceph. or tetracycline/gentamicin

Question 2

Mycobacterium marinum

Answer 2

clarithromycin + ethambutol +/- rifabutin

Question 3

What bacteria: cut while in the water, leg is swollen, septic, h/o alcoholic liver dz. Tx?

Answer 3

Aeromonas hydrophilis

Tx = surgery, supportive care, and antibiotics with gram-negative coverage, such as doxycycline plus ciprofloxacin.

Question 4

Sporotrichosis by Sporothrix schenckii

Answer 4

local: itraconazole
disseminated: amphotericin B (DM, transplant pts)

Question 5

empiric tx of ecthyma gangrenosum 2/2 pseudomonas aeruginosa

Answer 5

Meropenem + cefepime until sensitivities are back

Question 6

Respiratory failure, pulmonary edema, increased Hct (from Southwest or after visiting Yosemite National Park)

Answer 6

HANTA virus from rat feces

Question 7

Tx of anthrax?

- CXR shows?

Answer 7

fluoroquinolone or PCN

• Bacillus anthracis, a gram-positive, aerobic organism
• CXR shows mediastinal widening from hemorrhagic lymphadenitis

Question 8

Tx Tularemia

Answer 8

streptomycin 7-10 days

by Francisella tularensis

Question 9

Tx primary pneumonic plague?
isolation type?
by bacteria?

Answer 9

• either streptomycin or gentamicin
• droplet
• caused by the bacteria Yersinia pestis; gram-negative coccobacilli; safety-pin shaped

Question 10

Tx: Q fever, Brucellosis, Leptospirosis, Erysipelothrix

Answer 10

Doxycycline

Question 11

pneumocystis jirovecii pneumonia: treatment
if allergic to Bactrim –>
If PO2 < 70 –>

Answer 11

Trimethoprim-sulfamethoxazole (Bactrim)
if allergic to Bactrim –> clindamycin + primaquine
If PO2 < 70 –> add steroids

Question 12

Cryptococcal meningitis tx

if one week later the pt still has a headache, then?

Answer 12

Amphotericin B + 5 FC induction and then change to long-term fluconazole
one week later: repeat lumbar puncture to relieve pressure

Question 13

1. smallpox exposure within 7 days and close contacts of patients (“ring vaccination”)
2. treatment for outbreak

Answer 13

1. vaccination with vaccinia

2. tecovirimat

Question 14

Tx cyclospora

Answer 14

oral bactrim
Cyclospora protozoan infections are typically acquired after consumption of fecal-contaminated food or water, particularly in countries where the parasite is endemic, such as Peru, Guatemala, Haiti, and Nepal.

Question 15

What protozoa is the most common cause of swimming pool–related outbreaks of diarrhea? Diagnosis is made by?

Answer 15

• Cryptosporidium

- Dx by microscopic examination of the stool or by stool antigen testing

Question 16

What rapidly growing, nontuberculous mycobacteria can produce chronic, nonhealing wounds that do not respond to conventional antimicrobial therapy?

Answer 16

Mycobacterium fortuitum

Question 17

Nontuberculous mycobacteria (NTM), Mycobacterium avium complex (MAC), infection is most common in?

Answer 17

Pulmonary disease.

• MAC is also responsible for most cases of NTM lymphadenitis.
• Disseminated MAC infection develops in patients with HIV who have CD4 cell counts less than 50/μL and are not receiving MAC prophylaxis. –> The clinical presentation often includes fever, night sweats, weight loss, and gastrointestinal symptoms.

Question 18

• Risk factors for invasive or disseminated aspergillosis include?
• clinical pres?
• CXR shows?
• dx?

Answer 18

• Risk factors include profound and prolonged neutropenia and stem cell and solid organ transplantation
• clinical pres: patients have fever, cough, chest pain, and hemoptysis at presentation
• CXR: pulmonary infiltrates, nodules, or wedge-shaped densities
• dx by bronchoscopy with biopsy and bronchoalveolar lavage

Question 19

What virus is a cause of Ramsay Hunt syndrome?

Answer 19

Varicella-zoster
- presents with ear pain, a vesicular rash in the external ear (although the rash may be absent), and ipsilateral peripheral facial palsy.

Question 20

Nonpurulent cellulitis without systemic signs of infection is usually caused by?
- tx?

Answer 20

• streptococci

- tx –> oral clindamycin, penicillin, cephalexin, or dicloxacillin.

Question 21

For purulent skin infections, tx?

- caused by?

Answer 21

• I&D, then trimethoprim-sulfamethoxazole or doxycycline

- Staphylococcus aureus including MRSA

Question 22

What are appropriate therapy for treatment of methicillin-sensitive Staphylococcus aureus (MSSA) osteomyelitis associated with orthopedic hardware?

Answer 22

Cefazolin and rifampin