Organisms

Question 0

Enterococci species

Answer 0

E faecium: vancomycin, imipenem, zosyn, moxifloxacin
VRE: linezolid, quinupristin/dalfopristin
E faecalis: vancomycin, imipenem, zosyn, moxifloxacin
also meropenem, levofloxacin
VRE: linezolid
E gallinarum: ampicillin
E casseliflavus: ampicillin

Question 1

Cryptosporidium

Answer 1

Spread person-person, from contaminated water/food, calves
Immuno-competent: self-limited profuse watery diarrhea x10-14d
Immunodeficient: prolonged debilitating dz (chronic diarrhea, FTT), biliary tract dz
Tx: usually supportive; Nitazoxanide

Question 2

Enterococci/VRE

Answer 2

Usually E faecalis, E faecium
Usually live in GI tract, low-grade pathogens
Inf: bacteremia in neonates, multi-org intra-abd inf, device-associated, UTI
Prev Tx: ampicillin, vancomycin, syngery w/gent
VRE: linezolid
Risk: hospital setting, recent vanco/cephalo’s

Question 4

Pseudomonas

Answer 4

Gram - Rod
Immunocompetent: hot tub folliculitis, contact lens solution contamination, puncture wound osteomyelitis
Immunocompromised: sepsis, ecthyma gangrenosum, VAP, burn pts
CF: intermittent > persistent mucoid infection

Abx:
Zosyn/gent
Carbapenems
Ceftazidime
Cipro

Question 5

Mumps

Answer 5

Paramyxovirus
Spread via resp secretions
B/l or unilateral parotid swelling
Complications: CNS (meningitis, encephalitis), orchitis, arthritis, pancreatitis, thyroiditis, myocarditis, oophoritis
Contagious: 1-2d before swelling until 5+ days after swelling developed
Incubation: 12-25d

Question 5

Non-typhoidal Salmonella

Answer 5

GNR from food (chicken, egg, vegetables), reptiles, chickens
Can be asx or gastroenteritis, bacteremia, osteomyelitis, meningitis
*short incubation (6-72hrs)
*common in 1-4yo
*blood, mucus, wbc’s in stool
Tx only if <3mos, invasive (osteo/meningitis), immunosuppressed, hemoglobinopathy

Question 6

Campylobacter

Answer 6

Abd pain mimics appendicitis/intussusception
Incubation- days
Tx: macrolides: azithro/erythro
fq’s (cipro), ext-spectrum cephalos, carbapenems

Question 7

Yersinia

Answer 7

Incubation 4-6d

Question 8

Shigella

Answer 8

spread person-person

Incubation 2-4d

Question 9

Head Lice

Answer 9

Pediculosis Capitis
Closer to scalp = newer eggs
More visible = empty egg cases
Tx:  ovicidal and insecticidal
     Permethrin topical >> 2 doses, 7-10d apart
     Malathion more expensive
     Lindane neurotoxicity
Prophylactically tx household contacts
* Can return to school after first dose despite empty egg cases visible