Chapter 156- Miscellaneous Bacterial Infections With Cutaneous Manifestations

Question 1

Presents as an exquisitely painful nodule on distal phalanx of finger that may progress to tenosynovitis or joint destruction

Answer 1

Seal finger

Question 2

Pathogen of seal finger

Answer 2

Mycoplasma

Question 3

Treatment of choice for seal finger

Answer 3

Tetracyclines for 4-6 weeks

Question 4

Most coomin in pregnant women, neonates, patients with AIDS, in foodborne outbreaks

Answer 4

Human listeriosis

Question 5

Listeria monocytogenes is ___ when cultured on blood sheep agar and ___ in broth

Answer 5

Beta hemolytic

Tumbling motility

Question 6

Treatment for neonates with listeriosis

Answer 6

IV penicillin

Question 7

In neonatal listeriosis with septicimeia or with meningitis, mortaity is approximately ___%

Answer 7

50

Question 8

How to prevent listeriosis

Answer 8

Avoid unpasteurized dairy products, unwashed vegetables, and poorly cooked meats

Question 9

Facultative anaerobic, pleomorphic, Gram (-) rods found in marine waters, estuaries, brackish lakes when water is above 20 C

Answer 9

Vibrio

Question 10

Vibrio vulnificus can cause (3) clinical syndromes

Answer 10

Gastroenteritis
Primary sepsis
Primary wound infection

Question 11

There is nearly always a history of contact with ___ or consumption or handling of ___ with Vibrio infection

Answer 11

Saltwater

Shellfish

Question 12

Vibrio sp. that ferments lactose on MacConkey agar

Answer 12

V.vulnificus

Question 13

Wound infections sustained in fresh water suggest infection with ___ than Vibrio

Answer 13

Aeromonas

Question 14

Antibiotics of choice for Vibrio are

Answer 14

Doxycycline
Ceftazidime
Modified Dakin (0.025% NaOCl)

Question 15

Patients with (3) should not eat raw shellfish

Answer 15

Cirrhosis
DM
AIDS

Question 16

Disease with Aeromonas Hydrophila are also associated with

Answer 16

Medical use of leeches

Question 17

MC presentation of Aeromonas hydrophila infection

Answer 17

Cellulitis associated with laceration followed by abscess formation

Question 18

Treatment of Aeromonas hydrophila

Answer 18

Third gen cephalosporins
Fluoroquinolones
Aminoglycoside

Question 19

Meloidosis caused by

Answer 19

Burkholderia pseudomallei

Question 20

Susceptible to Burkholderia pseudomallei

Answer 20

Rice farmers with
DM
Chronic renal failure

Question 21

Common presentation of meloidosis in children

Answer 21

Acute unilateral suppurative parotitis

Question 22

Treatment for meloidosis

Answer 22

2 weeks of IV antibiotics
(Ceftazidime + Carbepenem)
Ff by TMP-SMX, Co-Amxiclav

Question 23

Associated with percutaneous trauma while handling raw fish or poultry

Answer 23

Erysipeloid (Erysipelothrix rhusiopathiae)

Question 24

Volaceous, warm, tender plaque with well defined margins involving the web spaces but spares the terminal phalange and does not progress beyond the wrist

Answer 24

Erysipeloid of Rosenbach

Question 25

Treatment for erysipeloid

Answer 25

High dose penicillin or ampicillin for 7-10 days

Question 26

Complication of erysipeloid

Answer 26

Subacute bacterial endocarditis of aortic valve

Question 27

Most important reservoir of leptospirosis

Answer 27

Leptospira interrogans

Question 28

2 clinical forms of leptospirosis

Answer 28

Mild, anicteric form | Severe icteric form (Weil disease)

Question 29

Prominent jaundice, hepatomegaly, interstitial nephritis

Answer 29

Weil disease

Question 30

Distinctive rash that appears on 4th- 5th day of illness with tender erythematous papules on the shins

Answer 30

Pretibial or Fort Bragg fever

Question 31

Pretibial or Fort Bragg fever is caused by

Answer 31

L. Interrogans serovar autumnalis

Question 32

Treatment for leptospirosis

Answer 32

Doxycycline | Penicillin

Question 33

Untreated Weil disease have mortality rate of ___% due to renal failure

Answer 33

5 to 40%

Question 34

Prophylaxis for leptospirosis

Answer 34

Doxycycline 200mg once weekly

Question 35

Adherent asymmetrical gray leathery membranous pharyngeal lesions along tonsils and soft palate which may cause lethal airway obstruction

Answer 35

Diphtheria

Question 36

Diphtheria exotoxin may cause (2)

Answer 36

``` Latent peripheral neuritis (2 weeks to several months) Lethal cardiomyopathy (1-2 weeks) ```

Question 37

Tender pustules that break down into punched out ulcers covered by gray membranes

Answer 37

Cutaneous diphtheria

Question 38

Culture for diphtheria

Answer 38

Loffler/Tellurite agar

Question 39

Treatment for diphtheria

Answer 39

High dose IV penicillin | Diphtheria antitoxin IV

Question 40

Tetanus and diphtheria toxoid should be given evvery ___ years

Answer 40

10

Question 41

Resembles diphtheria but is caused by drinking raw milk

Answer 41

Corynebacterium ulcerans

Question 42

Resembles diphtheria and can cause SSTIs after exposure to horse manure or cause pulmonary disease in AIDS patients

Answer 42

Rhodococcus equi

Question 43

Colonizes or infects freshwater tilapia

Answer 43

Streptococcus iniae

Question 44

In dolphins, S. Iniae causes slow growing nodular abscesses of skin, subQ giving it name of

Answer 44

Golf ball disease

Question 45

Key element in Streptococcus iniae infection

Answer 45

Rapid onset of hand cellulitis in 1-3 days with ascending lymphangitis and fever

Question 46

Treatment for Streptococcus iniae

Answer 46

Penicillin for 10 days

Question 47

Gram (-) motile flagellated bacillus rarely pathogenic except to people with disorders of neutrophil function

Answer 47

Chromobacterium violaceum

Question 48

Treatment consists of

Answer 48

Oral doxycycline + TMP-SMX

Question 49

Difference od erysipeloid with erysipelase

Answer 49

In erysipeloid, there is central clearing