Infectious Disease Flashcards
What are the recommendations for administration of the pneumococcal vaccine?
Age >65, 13-valent pneumococcal conjugate vaccine (PCV13), followed by the 23-valent pneumococcal polysaccharide vaccine (PPSV23) in 6-12 months
Age <65 with CHF, lung, liver disease, or DM, current smokers, alcoholics -> PPSV23
Age <65 with CSF leak, cochlear implants, Sickle cell, asplenia, immunocompromised, CKD -> PPSV13 then PPSV23 6 mo later
Advanced imaging findings of TB meningitis?
Basilar meningeal enhancement and choroidal tubercles likely has tuberculous meningitis.
CSF will have decreased glucose and increased protein with elevated WBCs (however, WBCs wont be >1000 like many other bacterial meningitis infx)
Treatment of TB meningitis?
Tuberculous meningitis should be initiated on treatment prior to bacteriologic confirmation. Treatment involves 2 months of 4-drug therapy with isoniazid, rifampin, pyrazinamide, and either a fluoroquinolone or injectable aminoglycoside, followed by 9-12 months of continuation therapy with isoniazid plus rifampin. Patients should also receive adjuvant glucocorticoids to reduce treatment-associated central nervous system inflammation.
