infectious dz Flashcards
candida
skin, mm, disseminated, GI, vulva, vagina, dentures, balanitis
tx: clinical or biopsy
KOH-pseudo
cutaneous: warm, moist, dark
chronic infections: defect in Tcell response
-possible endocrinopathies
contiguous spread: trauma, burns, surgery
disseminated- on blood culture, high morality rate
endocarditis- infectious drug users, prosthetic valves
chronic disseminated- leukemia
tx:
azoles, capsofungin, amphotericin B( amyphy terrible- a lot of side effects, terbinaine
cyrptococosis
-budding yeast in soil, pigeon feces, inhalation
pull infection: fever, though
dx: cx
tx: difulcan X 10 weeks
meningitis:
s/s: HA, N/V, confusion, lethargy, visual changes
dx: CSF ( inc protein, inc WBC, dec glucose)
CT/MRI-punched out lesions
tx: mild dz: diflucan,
severe dz: induction ( amphotericin B)
maintenance- diflucan- life long
histoplasmosis
social, bird, bat droppings
3 types:
chronic progressive pul dx- apical cavities
progressive disseminated dz- ( HIV CD$
histoplasmosis work up
labs: anemia of chronic dz
diagnostic: bronchoalveolar lavage
- blood cx
tx: mild dz: itraconazole
severe dz: amphotericin witch to itraconable for life
PCP
airborne, premature babies, immunodeficiency states
s//s: abrupt, fever, tachypnea, dyspnea, cough dx: CXR: diffuse infiltrates cysts, nodules, cavities PFTS: dec VC, dec TLC labs: sputum stains
tx: Bactrim, steroids
prophylaxis( CD4
botulism
- gram positive rod, seen in soil
- toxin A and B
transmitted food borne ( canned or smoked), infant botulisms ( honey)
s/s: 12-26–> eyes ( double vision, dry mouth, n/v, dying of respirator paralysis)
tx: report to CDC with botulinum antitoxin
manage respiratory failure
cholera
seen after earthquakes, breaks in sewage
- hypersecretion of watery diarrhea ( rice water)
- pt dye of dehydration
- soil cultures
- diangosed clinical
tx: fluids, abx ( tetracycline, ampicillin, bacterium)
prevention: vaccine, short lived, limited
diphtheria
respiratory droplets
- s/s: nasal d/d
laryngitis
pharyngeal- thick gray membrane
tx: reportable dz
anti-toxicin
remove membrane
abx: pen, erythromycin, zithromax
case: till 3 neg BC
prevention: Dtap, Tdap, Td
pertussis
- respiratory droplets s/s: catarrhal- coryza, cold-like sxs, hacking cough paroxysmal- burts of coughing convalescent- 4 weeks after set
tx: erythromycin X 7d yas
prevention: Dtap, infants
Trap: adolscents
tetanus
soil, local
elderly, migrant workers, IV drug users
s/s: pain and tingling at site, stiffness of jaw/neck, irritability, painful tonic convulsions
-remains conscious
tx: tetanus immun globulin and start immunizations
- sedation, induced paralysis
PCN- eradicate any left o
wound management for tetanus
clean wound
unknown vaccine hx:
dirt wound
- 1 vaccine and immune globulin
clean wound- vaccine and no immune globulin
salmonella
-gram negative
Gastro enteriis s/s: crampy abd pain, diarrhea
tx: fluids
bacteremia: prolonged fever, bacteria go to distant areas
tx: fluids, cipo
enteric fever: malaise, fever, sore throat, pea soup diarrhea,
tx: fluids, cipro
vaccine: poorly effective
shigella
fecal -oral route
diarrhea with blood
tenesmus
30% - reactive arthritis
dx: stool cx ( WBC and RBC) and BC
tx: hydration, bactrim, cipro
lyme
borellia burgdorferi
most common tick born illness
must feed 24-36 hours
drops off in 2-4 hours
stage 1: erythema migrant, flue-like sxs
stage 2: fatigue, malaise, small, multiple, h/a neck pain, migratory arthritis
cardiac: pericarditis
focal : aseptic meningitis
stage 3: months–> years
MSK- variable arthritis synovitis
- encephalopathy
dx: early- should not get lyme titers ( testing wrong)
- diagnosed clinically
tx: doxy 2-3 weeks
peds/pregnancy- amor
prevention: avoid ticks
chemoprevention tx: doxy 200 mg once
rockey mountain spotted fever
wood tick and dog tick
- prevention: avoid ticks
- no chemoprophylaxis
- 1 week ; f/c/n/myalagia
pneumonitis cough
delirium, lethary
rash over ankles and spread to center
labs: low plts and low salt
tx: doxy- all ages
pregnancy- cholaremphenicol
