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Infectious diseases > rare infections > Flashcards

rare infections Flashcards

1
Q

Bartonella - disease

A
  1. cat scratch disease

2. bacillary angiomatosis

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2
Q

cat scratch disease?

A

cutaneous lesion at the site of cat scratch/bute with regional lymphadenopathy with fever and malaise
GRANOULOMAS

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3
Q

cat scratch disease - clinical manifesrtation

A

papule at scratch/bite site
regional adenomapty
+/- fever

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4
Q

cat scratch disease - diagnosis + treatment

A

usually clinical
+/- serology
treatment: self limited, azythomycin

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5
Q

cat bite - management / microbiology

A
  1. copious irrigation + cleaning
  2. prophylactic augmentin
  3. tetanus as indicated (5 years)
  4. avoid closure
    - paster multocida, anaerobic
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6
Q

ixode tick is the vector of

A
  1. Borrelia burdorferi
  2. Anaplasma
  3. protozoa Babesia
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7
Q

early sign of Lyme disease - next step

A

oral doxacycline
no serology: serology only if nervous or Cardiac disease
clinical diagnosis

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8
Q

Lyme disease - stage 1 manifestation

A

1st month

  • erythema migrans
  • fatique / headache
  • myalgias, arthralgias
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9
Q

Lyme disease - stage 2 manifestation

A

early disseminated (weeks - months)

  • Multiple erythema migrans
  • Unilateral/bilateral CN palsy (CN 7)
  • Meningitis
  • Carditis (AV block)
  • Migratory arthralgias
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10
Q

Lyme disease - stage 3 manifestation

A

months to years

  • arthritis
  • encephalitis
  • periphearl neuropathy
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11
Q

treatment of early localized lyme in pregnant and lactating women

A

amoxicillin

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12
Q

prophylaxis criteria for lyme

A

must meet all 5

  1. attached tick in an adult or nymphal ixodes scapularis
  2. tick attached for 36 h or engorged
  3. prophyxis started within 72 hours of tick removal
  4. local infection rate 20% or more
  5. no condraindications to doxycycline (younger than age, pregnant, lactating)
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13
Q

how to remove a tick from the body

A

tweezers

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14
Q

Franciella tularencis - disease / transmission and source

A

Tularemia
ticks
rabbits, deer fly (handling of infected animals, aerosolization)

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15
Q

Tularemia - forms (and proportions)

A
  1. Ulcerroglandular form (80%)

2. typhoidal form (10-15%) (pneumonia and bacteremia)

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16
Q

Pasteruella multocida - disease / transmission and source

A
  1. Cellulitis
  2. Osteomyelitis
    animal bite, cat, dog
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17
Q

Yesrinia pestis - disease / source and transmission (and resevoirs)

A

PLAQUE

  1. fleas (rats and prairie are dogs reservoirs)
  2. contact with infected animals
  3. aerosol
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18
Q

Rickettsia rickettsi - disease / transmission and source

A

Rocky mountain spotted fever

Dermacentor (dog tick)

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19
Q

vector-borne illness - rash common and rash rare diseases

A

Rash rare: 1. Ehrlichiosis 2. Anaplasmosis 3. Q fever

Rash common: 1. Rocky Mountain spotted fever 2. Typhus

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20
Q

Rickettssia rickettsii - area (map)

A

despite its name –> occurs primarily in:

SOUTH ATLANTIC STATES (NORTH CAROLINA)

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21
Q

Rocky Mountain spotted fever - symptoms

A

classic triad:

  1. headache
  2. fever
  3. rash (vasculitis)
22
Q

Rocky Mountain spotted fever - rash

A

typically starts at wrists and ankles and then spreads to trunk, palms and soles

23
Q

Typhus is caused by

A

Rickettssia typhi –> Endemic typhus

Rickettssia prowazekii –> epidemic typhis

24
Q

Rickettssia typhi - transmission and source

A

rodent fleas

25
Q

Rickettssia prowazekii - transmission and source

A

human body louse

26
Q

typhus - rash

A

starts centrally and spreads out, SPARING palms and soles

27
Q

Rocky Mountain spotted fever vs typus according to rash

A

Rocky Mountain spotted fever –> typically starts at wrists and ankles and then spreads to trunk, palms and soles
Typhus –> starts centrally and spreads out, sparing palms and soles

28
Q

vector-borne illness - rash rare diseases / caused by

A
  1. Ehrlichiosis (Ehrlichia chaffensis)
  2. Anaplasmosis (Anaplasma)
  3. Q fever (Coxiella burnetii)
29
Q

human monocytic ehrlichiosis - epidimiology

A

lone star tick

- southeastern south central US

30
Q

Human momocytic ehrlichiosis - diagnosis

A

intracytoplasmic morulae in momnocytes

- PCR

31
Q

human monocytic ehrlichiosis - clinical manfestation

A

flu like
- neurologicc symptoms (conffusion)
- rash is uncommon (less than 30% in adults)
like Rocky mountain spotted fever without the sopots

32
Q

human monocytic ehrlichiosis - labs

A

leukopenia + thrombocytopenia

- elevated liver enzymes + LDH

33
Q

Humanmonocytic ehrlichiosis - treatment

A

empiric doxocycline while awaiting confirmatory testing

34
Q

anaplasma vs Ehrlichia chaffensis according to cells

A

Mnemonic EMAN:
Ehrlichia –> Monocytes
Anaplsma –> granulocytosis

35
Q

Q fever - transmission / presentation

A

spores inhaled as aerosol from cattle/sheep amniotic fluid

- presents as pneumornia, MCC of culture (-) endocarditis)

36
Q

high risk wild animals for rabies … (and next step)

A

bat, racoon, skunk, fox, coyote –> start prophylaxis if animal unavailable
if available –> euthanize and test, start prophylaxis if test is (+)

37
Q

low risk wild animals for rabies … (and next step)

A

squirrel, chipmunk, mouse/rat, rabbit –> no prophylaxis

38
Q

pet - rabies … (and next step)

A

available for quarantine?
NO: start prophylaxis
yes: observe 10 days –> if healthy animal, no prophylaxis

39
Q

livestock or unknown wild animal - rabies … (and next step)

A

contact public health department

40
Q

Rocket mountain spotted fecer - CSF

A

like viral mening

41
Q

human bite - treatment

A

polymicrobial (aerobic and anaerobic) –> augmentin

+ Tetanus vaccination

42
Q

nocardia - duration of treatment

A

TMP-SXM for 6-12 months

43
Q

vibrio vulnificus - epidimiology

A

gram (-) free living in marine environment
ingestion (oysters) or wound infection
risk with liver disease

44
Q

vibrio vulnificus - manifestation

A
  1. rapidly progressive (often less than 12h)
  2. septicemia: septic shock, bullous lesions
  3. cellulitis: hemorr bullae, necrotizing fascitis
45
Q

vibrio vulnificus - diagnosis

A

blood + wound cultures

46
Q

vibrio vulnificus - treatment

A

empiric in those with likely illness as highly fatal

IV ceftriaxone + doxycycline

47
Q

Legionella - clinical clues

A
  • fever (higher than 39)
  • Bradycardia relative to high fever
  • neurological symptoms (esp confusion)
  • GI symptoms (esp diarrhea)
  • Uneresponsive to beta lactam + aminoglycoside
48
Q

Legionella - Labs

A
  • low Na+
  • hepatic dysfunction
  • hematuria + proteinuria
  • Sputum gram stain showing many neutrophils, but few or no organisms
49
Q

legionella - diagnosis + treatment

A

diagnosis: urine antigen testing
treatment: resp quinolone (fluoroquinolone) or newer macrolide

50
Q

chronic slow growing non-tender mass near mandibular - after teeth extraction - organism , diagnosis, treatment

A 
actinomyces 
RF: low immune, DM, malnutrition 
sulfur granules 
diagnosis: fine needle aspiration, culture for 2 weeks
penicillin 2-6 months, surgery if severe

Infectious diseases (13 decks)

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