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