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Infectious Disease 2

Infectious Disease

Meningitis and rash Meningiococcal; petechial rash: N. meningitidis
Agents of Viral Meningitis (aseptic): Enterovirus (ECHO, Coxsackie A & B), HSV-2; possibly mumps
granulomatous meningitis bugs M. tuberculosis, fungi (crypto, coccidioides, Histoplasma), spirochetes; dz more common in immunocompromised pts; poss also sarcoid
brain abscess etio usu direct spread of infxn from sinus, ear, soft tissue; hematogenous spread to brain is RARE
dermatophytosis orgs Trichophyton, Microsporum, Epidermophyton spp; most common = Trichophyton rubrum
in PCP pts, recurrent PTX is related to: prior pentamidine use
Hutchinson triad: interstitial keratitis, Hutchinson incisors, 8th nerve deafness; 2/2 congenital syphilis
Acrodermatitis chronicum atrophicans = bluish-red discoloration of distal extremitis w/atrophy (in Euro, not US); 2/2 Stage 3 Lyme dz
toxic shock syndrome: violaceous vesicular/bullous rash is: ominous sx
botulinum toxin MOA inhibits Ach release at NM junction
botulism S/S 12-36 post-ingestion: diplopia, loss of accommodation/EOMs; CN palsy; resp paralysis; normal mental status
GPR, vesicular papule w/blue-black ctr 2 wks post-exp => painless necrotic eschar => sepsis/ meningitis = anthrax
tetanus MOA spores in wound => bac produce tetanospasmin: interferes w/neurotransmission at spinal synapses of inhibitory neurons => uncontrolled spasm & hyperreflexia
tetanus incubation period is: 5d - 15 wks
diphtheria complications myocarditis; CN neuropathy 2/2 exotoxin
pertussis stages catarrhal; paroxysmal; convalescent
EBV is what kind of virus HHV 4
EBV S/S F, ST; posterior LAD; 50% splenomegaly
non-enveloped icosahedral virions: HPV
HPV serotypes 1-4 skin warts; 11 laryngeal; 6 & 11 anogenital; 16 & 18 assoc w/CIN
HSV remains latent within: dorsal root ganglia; HSV-1 in trigeminal n.; HSV-2 in sacral root ganglia
Orthomyxovirus = influenza (strains A, B, C)
Reye syndrome fatty liver w/encephalopathy; may dev 2-3 wks post flu A onset, usu kids; jaundice, sz, hypoglycemia, inc LFTs; supportive tx
VZV incubation = 10-20 days; esp contagious day before rash appears
HIV MOA infect cells w/T4 Ag (esp CD4 helper inducer lymphs)
AIDS defn = CD4 <200 or indicator dz; 4 stages
infant w/jaundice, HSM, low plt, periventricular CNS calcifications, MR, purpura = CMV
CMV comps include: retinitis (if CD4 <50), esophagitis, odynophagia, pulmo in BMT (85% fatal), encephalitis
Lyme dz: stage 1: 7-10d post bite; erythema migrans (groin, thigh, axilla); 50% flu-like illness
Lyme dz: stage 2: skin, CNS, MS; HA, stiff neck; cardiac (pericard, block) or neuro (Bell, meningitis, encephalitis)
Lyme dz: stage 3: (mos - yrs later); arthritis, chronic synovitis; CNS: encephalopathy, axonal polyneuropathy, leukoencephalitis
College student with ST; enlarged tonsils, anterior cervical LAD, splenomegaly; elevated atypical lymphocytes EBV (mononucleosis)
Acute joint pain; swollen, warm, erythema = Septic arthritis (synovial fluid = leukocytosis, low glucose)
Bac meningitis agents in Neonates: GBS (S agalactiae); Enterococci; Enterobacteriaceae/ Listeria
Bac meningitis agents: <2 mo: GBS (S agalactiae); E. coli (tx < 1yo = Vanco + Rocephin)
Bac meningitis agents: 3 mos - 6 yrs Strep pneumo (DRSP); N. meningitidis; H flu
Bac meningitis agents: 7-50 yrs Strep pneumo (DRSP) (No. 1 cause); N. meningitidis; L. monocytogenes
Bac meningitis agents: Adults >50 yrs usually Strep pneumo (DRSP)
Pertussis: catarrhal stage s/s sneezing, coryza, hacking cough
Pertussis: paroxysmal stage s/s whooping cough fits
Pertussis: convalescent stage s/s til 4 wks post onset
Created by: Adam Barnard Adam Barnard