W05_10 Infectious diseases in the ER Flashcards
what are the two rare but very serious and rapidly progressing infections seen in the ER?
bacterial meningitis,
necrotizing fasciitis
for meningitis, what are the 3 classical symptoms?
fever, neck stiffness, and altered mental status. note these three come together in less than half the cases
lift which body part for brudzinski’s sign?
head/neck
lift which body part for the kernig’s sign?
hip/knee
what are each of the 4 tubes for in CSF analysis (adults)?
cell count/differential;
glucose + protein;
gram stain, culture, ID studies;
cell count/differential + xanthrochromia
how to treat for bacterial meningitis?
IV dexamethosone to blunt immune response (neuroedema);
antibiotics like ampicillin, vanco, cephs, meropenem, etc.
what’s the most common cause of neonatal bacterial meningitis?
group b strep.
can check for this by swabbing the vagina at 37 weeks, and Rx antibiotics
risk factors for necrotizing fasciitis?
drug use, DM, obesity, immunosuppression, PVD
systemic findings of nec. fasc.?
fever, tachycardia, hypotension
signs and symptoms of nec fasc?
local tense edema, disproportionate pain, blisters, crepitus, subQ gas, necrosis
what are the 2 types of nec fasc?
type 1 - polymicrobial (anO2 + O2)
type 2 - monomicrobial (like strep pyogenes)
what anO2 bacteria do you expect in nec fasc type 1?
bacteroides, clostridium, peptostreptococcus
what’s fournier’s gangrene?
gangrene of genitals. facultative + anO2
what causes type II nec fasc?
group A strep.
what do you look for on imaging for nec fasc?
abnormal gas in soft tissues
