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Infectious Disease 1

Infectious Disease

“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