Workbook1 Flashcards
What bacterial infection presents with sinuses that discharge puss (usually painless) or abcesses?
Actinomyces israeli
How would you treat a facial abcess caused by A. Israelii (actinomycosis) ?
Penicillin G, surgical drainage of abcesses
What does Actinomyces Israelii affect? Why?
abscesses in mouth, lungs, GI and GU tract, draining sinus tracts normal flora -> trauma, surgery, etc disrupts mucosal barrier -> local infection and inflammation -> yellow sulfur granules develop (filamentous bacteria that looks like fungus) -> forms pus-filled abscesses (usually mouth, lungs, GI, GU) expansion without respect of planes -> goes through skin, muscle, bone and organs, like a bullet think “acting mice”, mice penetrate any barrier, mice are easy to get rid of - Penicillin G
Recent surgery (esp. dental) or trauma leading to abscesses or draining sinuses raises suspicion of what bacterial organism?
Actinomyces israelii (actinomycosis)
What are the symptoms of meningitis in infants?
stiff neck, convulsions, irritability, poor eating, fever may be possible
What are CSF results indicative of bacterial meningitis?
low glucose, high PMNs, high protein, Gram + or - bacteria
How does Listeria present?
meningitis and sepsis, especially in neonates and immunocompromised
How does Listeria monocytogenes affect people?
Adults: not properly pasteurized milk -> penetrates GI mucosa, invades phagocytes -> grows -> spreads through blood -> meningitis Neonates: present in vaginal tract -> transmitted to fetus across placenta or during birth -> spread through blood -> disseminated abcesses, meningitis
What are characteristics of Listeria monocytogenes?
Gram +, rod, catalase +
How would you treat Listeria-caused meningitis?
ampicillin +/- gentamicin TMP-SMX
What is the drug that is likely to cause C.difficile infection?
Clindamycin
What is the possible reason why a patient who was recently on antibiotic develops diarrhea, especially in the hospital?
C. difficile - colonizes GI and secretes two toxins - one to interfere with fluid secretion -> diarrhea; second to kill epithelial cells and form a pseudomembrane around them
What are the classic symptoms of C.difficile?
significant diarrhea, but no blood in the stool, recent or current antibiotic use likely, colon may be covered with pseudomembrane
How do you treat C.difficile?
oral metronidazole or vancomycin (want oral to act on GI, think “van + metro”) withdraw causative antibiotic (ex. clindamycin)
