Toxoplasmosis And Others Flashcards
……………………
raising strong suspicion for toxoplasmosis.
This patient with HIV has neurologic symptoms (headache, confusion, focal deficits), fever, and evidence of ring-enhancing lesions on MRI,
HIV undergo laboratory evaluation (T gondii lgG testing) for exposure; those with positive serology who have a CD4 count <100/mm3 require primary prophylaxis with…………… which reduces the risk of toxoplasmosis to 0%-2%.
trimethoprim-sulfamethoxazole (TMP-SMX),
Toxoplasma encephalitis symptoms
• Headache
• Confusion
• Fever
• Focal neurologic deficits/seizures
Toxoplasma encephalitis diagnosis
• AIDS with CD4 count <100/mm3
• Positive Toxop/asma gondii lgG
• Multiple ring-enhancing brain lesions (MRI)
• Sulfadiazine & pyrimethamine (plus leucovorin
Treatment of Toxoplasma encephalitis
• Sulfadiazine & pyrimethamine (plus leucovorin)
• Antiretroviral initiation within 2 weeks
• Prophylaxis TMP-SMX (CD4 count <100/mm3)
Risk factors for cellulitis
Immune suppression include
• Diabetes mellitus
• HIV infection
• Chronic glucocorticoid therapy
Risk factors for cellulitis
Breaches in skin barrier include
• Dry skin
• Chronic inflammation (eg, eczema, radiation therapy)
• Chronic wounds (eg, pressure ulcer, venous ulcer)
• Dermatophyte infection (eg, tinea pedis)
Risk factors for cellulitis Immune suppression
Chronic edema include
• Postsurgical lymphedema (eg, lymph node
dissection)
• Chronic venous insufficiency
• Congestive heart failure, chronic kidney disease
• Prior cellulitis with lymphatic scarring
Risk factors for cellulitis
Immune suppression
Breaches in skin barrier
Chronic edema
Obesity
This patient with erythema, warmth, and swelling of the foot associated with fever and lymphadenopathy has ………
cellulitis
Cellulitis typically occurs when …………… gain access to the subcutaneous space via breaks in the skin
gram-positive skin flora (eg, beta-hemolytic Streptococcus, Staphylococcus aureus)
…………… is one of the most common risk factors for lower extremity cellulitis
tinea pedis
fissuring, erosions, and ulceration that allow bacterial entry into the tissue,
tinea pedis
tinea pedis caused by
Trichophy/on rubrum
characteristic triad of trichinellosis are
periorbital edema, myositis, and eosinophilia.
Laboratory studies show………… , the hallmark of trichinellosis
eosinophilia (usually >20°/o)
Treatment of trichinellosis
Mild infections are typically self-limited; severe infections require antiparasitic therapy (eg, mebendazole, albendazole) with corticosteroids.
Clinical presentation of trichinellosis / Intestinal stage (within 1 week of ingestion)
Can be asymptomatic or include abdominal pain, nausea, vomiting & diarrhea
Clinical presentation of trichinellosis / Muscle stage (up to 4 weeks after ingestion)
• Myositis
• Fever, subungual splinter hemorrhages
• Periorbital edema
• Eosinophilia (usually >20° /o) with possible elevated creatinine kinase & leukocytosis
The patient will receive Tetanus toxoid-
containing vaccine PLUS TIG
Dirty or severe wound / Unimmunized , uncertain, or <3 toxoid doses
is an anaerobic, spore-forming, gram-positive bacillus that is found in soil
C/ostlidium tetani
Following traumatic tissue inoculation, it can release a neurotoxin (tetanus toxin), leading to symptomatic tetanus.
Clvostlidium tetani
Current recommendations are for children to receive a primary ………… dose vaccine series at ages………… months, with additional doses recommended at 15-18 months and
years.
3 , 2, 4, and 6 , 4-6
Adults should receive a single dose of tetanus-diphtheria-acellular pertussis (Tdap), followed by revaccination (booster) for tetanus and diphtheria (Td) every……… years thereafter.
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