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Infectious Disease 1
Infectious Disease
| Question | Answer |
|---|---|
| “spider bite” appearing lesion that turns into abscess = | MRSA |
| In toxic shock syndrome, a violaceous vesicular / bullous rash is: | An ominous sign |
| Gram negative intracellular diplococci | Gonorrhea |
| Sexually active, multiple or new partner, urethral discharge, Gram negative intracellular diplococci | Gonorrhea |
| Red cervix w/ mucopurulent discharge in sexually active female | Chlamydia |
| Orbital cellulitis bugs | SP, SA, H flu, GN bac; MRSA in adults; broad spectrum Abx |
| Dacryocystitis bugs | SA, GABHS, staph epi, candida |
| Bacterial conjunctivitis bugs | SA, SP, H aegypticus, M cat; RARE: CT/NG |
| AOM bugs | Big 3, strep pyogenes, SA |
| OE bugs | PA, enterobac, Proteus, fungi |
| Infectious arthritis RFs | DM, EtOH, CRF, AIDS, TB; prosthetic joints / recent surg, trauma, older, immunosupp tx, malig, exp to animals; low SES, IVDU |
| Infectious arthritis: typical sites | Large bones > small bones (usu knee); usu monoarticular (poly <20%) |
| Gono arthritis: 2 presentations | 1. rash, fever, chills, migratory tenosynovitis of knees, ankles, wrists, feet and hands (30-60%) (some = skin lesions: papulovesicular or hemorrhagic, varying size); 2. monoarticular process: KNEE; hip, ankle, wrist or elbow |
| Non-gono arthritis: agents | Usually S. aureus (or strep A/B; SP, coag neg staph) |
| Non-gono arthritis: common hosts | RA, diabetes, immunosuppressive drugs |
| Non-gono arthritis: affected joints | 90% monoarticular; knee>hip>shoulder>wrist>elbow; following bite: small bones / joints of hands / feet; IVDU: spine, SI, sternoclavicular joints |
| Non-gono arthritis: gram neg | Enterobacteriaceae; IVDU; neutropenic (also pseudomonas) |
| Non-gono arthritis non-GN agents | spirochetal (congenital: long bones; secondary: diffuse); Lyme; Myco TB |
| Infxs arthritis: prosthetic joint: late: bug | usually Staph aureus (often indolent presentation) |
| Prosthetic joint infection: rates highest among: | pts w/ RA, h/o prior joint surgery, immunosuppressive therapy |
| Prosthetic joint: prophylaxis? | not recommended (but consider for pts w/ inflammatory arthritis, DM, immunosuppression or within 2 yrs of joint replacement) |
| Post-infectiouss glomerulonephritis bugs | GABHS, SP, MRSA, meningococcus; 1-3 wks; gross hematuria, HTN, edema, ARF |
| Fishy odor, Thin grayish vaginal discharge, clue cells = | Bacterial vaginitis; Gardnerella vaginalis |
| mastitis organism | S. aureus |
| Infxs arthritis: prosthetic joint: early: bug | usually Staph epi |
| Gonorrhea skin lesions | erythematous macules -> painful pustules with central hemorrhage +/- necrosis (hands, fingers, web spaces, feet) |
| Meningitis and rash | Meningiococcal; petechial rash: N. meningitidis |
| granulomatous meningitis bugs | M. tuberculosis, fungi (crypto, coccidioides, Histoplasma), spirochetes; dz more common in immunocompromised pts; poss also sarcoid |
| brain abscess etiology | usu direct spread of infxn from sinus, ear, soft tissue; hematogenous spread to brain is RARE |
| Hutchinson triad: | interstitial keratitis, Hutchinson incisors, 8th nerve deafness; 2/2 congenital syphilis |
| Campylobacter pathology | Comma-shaped GNR in pairs. Contaminated water, raw milk, poultry. C jejuni colonizes jejunum => enterotoxin. Overt dz in 3-5 days. |
| Campylobacter clinical features | Abrupt onset watery +/- bloody diarrhea, abd cramping, fever. Often self limiting; recurs in 5-10% |
| Cholera organism | Vibrio cholera: slightly curved GNR that elaborates an exotoxin (enterotoxin). Serogroups O1 and O139 are associated with cholera. |
| Cholera pathology | Organisms surviving stomach attach to jejunum & ileum microvilli of epithelial cell brush border -> multiply & liberate cholera enterotoxin without invading mucosa |
| Cholera clinical features | Abrupt painless high volume watery diarrhea -> fluid loss & possible shock. Fever is rare. |
| “rice water stools” (gray / odorless) are associated with: | Cholera |
| Diphtheria organism | Corynebacterium diphtheria: small pleomorphic GPR |
| Diphtheria pathology | Potent exotoxin -> inflammatory response & formation of pseudomembrane on respiratory mucosa. Toxin absorbed by circulatory system. Death 2/2 membrane aspiration or toxigenic effect on heart |
| Salmonellosis organism | Salmonella enterica: motile GNR (>2000 serotypes, esp typhi, typhimurium, choleraesuis |
| 7-10 day prodrome, HA, cough, ST, malaise, stepwise fever; then pea-soup diarrhea, abd pain; rose spot rash on abd | Salmonellosis |
| Shigella dysentery causative organisms | S sonnei in most cases (2nd: S flexneri). S dysenteriae in most serious cases |
| Shigellosis clinical featues | 1-4 day incubation. Abrupt diarrhea w/blood & mucus, abd cramping, tenesmus, fever (average 7 days) |
Created by:
Abarnard
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