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Bacterial Infections Flashcards

(59 cards)

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1
Q

Botulism is cause by clostridium botulinum. This naturally occurs in 3 forms:

A
  1. FOOD BORNE: contaminated canned, smoked, or vacuum packed food
  2. HONEY: infants
  3. WOUND: usually associated with IV drug use
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2
Q

Symptoms of botulism

A

12-36 hours after ingestion: starts with visual changes (diplopia)

  • descending paralysis
  • sensory is normal and sensorium remains clear
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3
Q

Diagnosis of botulism

A

Toxin in serum and food

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4
Q

Treatment of botulism

A

Equine antitoxin given within 24 hours, IV Fluids, alert the CDC

  • can give guanidine hydrochloride to increase muscle strength
  • intubate and manage airway
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5
Q

Chlamydia pneumonia pneumonia is a common cause of atypical PNA. What is the dx and treatment?

A

Dx: serology with macroimmunoflorescene MIF/ or PCR
Tx: tetracycline or erythrocycline 500mg QID for 10-14 days.

Sulfa drugs wont work due to resistance

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6
Q

C. Psittaci PNA risk factors and treatment

A

Risk factors: Exposure to birds

Tx: tetracycline or doxycycline, isolate the suspected birds

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7
Q

Cholera diarrhea is often described how?

A

Explosive Rice water stools: Voluminous, liquid, gray, turbid

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8
Q

Cholera treatment

A
  • fluids, fluids, fluids . Can do PO solution of 1/2 tsp salt: 4 tsp sugar : 1L water or IV LR if cant tolerate PO
  • empiric antibiotics with tetracyclines. 2nd line azithro, flouroquinolones, Bactria, ampicillin
  • vaccine available for short-lived limited protection
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9
Q

Clostridium myonecrosis (gas gangrene) is caused by what process?

A

Toxins produced in tissues under anaerobic conditions leading to shock -> hemolysis -> and myonecrosis

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10
Q

2 Risk factors for gas gangrene

A
  1. Trauma

2. IVDU

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11
Q

Systemic symptoms of gas gangrene

A

Sudden onset rapidly increasing pain in affected area, hypotension, tachycardia, fever, stupor, delirium, coma

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12
Q

Describe the skin color change of wounds with gas gangrene

A

Swollen with surrounding skin that goes from pale -> dusky -> deeply discolored coalescent red vesicles
- wound will be draining foul, brown tinged drainage

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13
Q

Dx of clostridium myonecrosis

A

Anaerobic culture -> gram positive rods

- don’t wait, just treat

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14
Q

Tx of clostridium myonecrosis

A
  • IV PCN 2 million units q3h + clindamycin + surgical debridement
  • +/- hyperbaric O2
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15
Q

What is clostridium sordellii known to cause?

A
  • TSS and endometriosis after childbirth or medical abortion with mifepristone
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16
Q

Clostridium sordellii TSS treatment

A

IMMEDIATE surgical debridement via hysterectomy

- PCN antibiotics, macrolides

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17
Q

MC site of Corynebacterium diphtheria infection

A
  • pharyngeal with the tenacious gray membrane, sore throat, hoarseness, malaise and fever
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18
Q

Two major complications of diphtheria

A

Myocarditis: arrhythmias, heart block, HF
Neuropathy: CN palsy

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19
Q

Treatment for unvaccinated patients exposed to diphtheria

A
  • vaccinate, antitoxin from CDC, remove membrane surgically
  • treat with PCN or erythro 4x a day for 14 days
  • isolate pt until 3 consecutive negative cultures
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20
Q

Treatment for those in contact with people exposed to diphtheria

A

Erythromycin x7 days

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21
Q

Three types of salmonella infections and their buzzwords

A
  1. S. Enterica typhi -Typhoid fever with pea soup diarrhea
  2. S. Enterica typhimurium: dysentery
  3. S. Enterica choleraesuis: disseminated infection of bone/joints/pleura/pericardium often in immunocompromised
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22
Q

Incubation period for typhoid fever

A

5-14 days

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23
Q

Clinical presentation of typhoid fever

A
  • gradual onset with progressive fever over 7-10 days
  • malaise, HA,N/V, abdominal pain, sore throat, cough
  • PEA SOUP DIARRHEA
  • pink papular rash on trunk during week 2 (ROSE SPOTS)
  • bradycardia, splenomegaly
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24
Q

Typhoid fever diagnosis: Blood culture or stool culture?

Study These Flashcards
A

Blood culture

25
Treatment of typhoid fever
Cipro or Levi x5-7 days (10-14 if severe)
26
Treatment of typhoid fever carriers
Cipro x4 weeks
27
What is the mechanism of action for typhoid fever?
Bacteremia via intestinal lymph system (Peters patches and mesenteric LNs)
28
Incubation for salmonella gastroenteritis
8-48 hours (compared to typhoid fever which is 5-14 days)
29
Clinical symptoms of salmonella gastroenteritis
Fever, N/V, abdominal pain, dysentery
30
Diagnosis of salmonella gastroenteritis : Stool or blood culture?
-Stool! (Blood culture is diagnostic for typhoid fever)
31
Treatment of salmonella gastroenteritis
Usually self limited so treat with supportive measures | - if complicated (HIV, sickle cell, immunocompromised) give cipro X1-2 weeks
32
Shigella is another dysentery causing bacteria. What’s the diagnosis and treatment?
Dx: Stool culture (blood cultures often negative!) Tx: usually none, can give cipro 7-10days
33
Antibiotic choice for an uncomplicated staph infection of the skin
Cephalexin or dicloxacillin
34
Antibiotic choice for possible MRSA infection of the skin
- Clindamycin - Bactria - doxycycline
35
Antibiotic choice for a complicated staph infection (one that is deep and/or extensive)
- IV/IM cefazolin, naficillin, oxacillin
36
Complicated (extensive and or deep) MRSA infection
- Vancomycin, linezolid, or ceftaroline
37
Most sensitive diagnostic imaging to diagnose osteomyelitis?
- Bone scan! then MRI > CT > X-ray in order of sensitivity | - Beware initial X-ray can be WNL
38
Treatment for osteomyelitis
- prolonged antibiotics (4-6 weeks) - Start with IV and step down to PO as appropriate - If MSSA: reach for naficillin/oxacillin or cefazolin -If MRSA: vanco with trough of 15-20 mcg/ml
39
Symptoms and diagnosis of TSS (staphylococcus)
- abrupt HIGH FEVER - watery diarrhea - MORBILLIFORM RASH WITH DESQUAMATION OF THE PALMS AND SOLES - hypotension 3 symptoms above +3 organ systems involved
40
Why would blood cultures often be negative in TSS?
Because the symptoms are caused by a toxin not a systemic infection
41
Treatment for staph TSS
- REHYDRATE - IV naf/vanco/clindamycin - Remove source of infection (tampon, nasal packing, etc.)
42
Types of hemolysis
Alpha: + hemolysis -> classically strep viridans or strep pneumo so look for the source in the heart or lungs Beta: mild hemolysis -> these are your Group A, B, and C strep. Look for skin or soft tissue sources of infection Gamma: No hemolysis -> enterococcus
43
How would you treat someone with a history of rheumatic fever?
Erythromycin or PCN G for a long time
44
Painful superficial cellulitis of the face that is well demarcated. You diagnose facial erysipelas, whats the treatment?
IV ABX: PCN is first choice. Can also use cefazolin/naficillin or vanco/Daptomycin
45
Treatment for strep TSS
PCN with clindamycin
46
Major risk factors for tetanus
Frost bite, burns, IVDU, elderly, Migrant workers
47
Treatment for tetanus
PCN IV 20 million units daily + Tetanus immune globulin within 24 hours - after recovery, give a full course of tetanus immunizations: 2 doses 4-6 weeks apart and then 3rd dose 6-12 months later -> one needs to be Tdap
48
Treatment for active TB
6 months of treatment: 2 months INH, RIF, PZA, ETH + 4 months INH & RIF if susceptible
49
How long should you treat for military TB, TB meningitis, or TB infection of the bone/joints?
9 months
50
Adverse effects of Isoniazide
- hepatotoxicity | - peripheral neuropathy (prevent with vit b6 pyridoxine)
51
Adverse effects of Rifampin
- hepatotoxicity - turns bodily fluids such as sweat and tears orange - increased drug metabolism because it is a cup 450 inducer - flu like symptoms
52
Adverse effects of pyrazinamide
- hepatotoxicity - increased uric acid levels - caution in gout patients - contraindicated in pregnancy
53
Adverse effects of ethambutol
- hepatotoxicity - optic neuritis (red/green vision loss) - nephrotoxicity - ototoxicity
54
Adverse effects of streptomycin
- ototoxicity | - nephrotoxicity
55
The patient has a + PPD but no symptoms. What is the treatment for latent TB?
INH for 9 months
56
Mycobacterium Avium Complex (MAC) is an AIDS defining illness. What are the symptoms?
- Persistent fevers/night sweats - severe weight loss - chronic diarrhea/abdominal cramping - lymphadenopathy, splenomegaly, anemia
57
Diagnosis of MAC
- elevated alk phos - serum culture + for AFB - MAC culture - CD4< 100
58
Treatment for active MAC
1 year of: Azithro/clarithro + ethambutol or clofazmine or rifampin or rifabutin
59
When and how should you prophylaxis HIV+ patients for MAC?
With azithro or clarithromycin when CD4 <100 | - can d/c if CD4 >100 for 6 months

Infectious Disease (7 decks)

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