Emergency And Zoonotic Flashcards
(31 cards)
What are the bugs from human bites?
Which anitboiotic is used
Two types of bites: Clenched Fist injuries (CFI) or Occulsive Bites
Eikinella corrodens: culture negative endocarditis
Staph
Strep
Augmenten to treat. Will need IV antibiotics for fight bites.
Cat bites
Look for pieces of cat tooth with xrays
80% of cat bites end up infected
Pasturella Multosida
Staph and strep
Can cause tinnosynovitis, osteomyelitis, FASCIITIS or abscess. Very raised bite
Cat Scratch Fever from Bartenella. Get lymphanopathy. Give antibiotics (won’t help). Don’t cut into abscess!
Dog Bites problems
Tissue damage: Kids is face, head and neck.
Bugs: Pastueurlla, staph/strep
Other tinnosynovitis, and osteomyelitis.
Use X-ray to find foreign body. Don’t use CT. MRI for soft Tissue suspicions
Captocytophagia Cytomorphous: High mortality rate from endocarditis.
Snake bites
Not high mortality in US (8 total bites in Idaho). Morbidity data does not exist.
Elapid (cobras) have neurotoxin (paranthesia, respiratory failure) Pit vipers (crotalids) die from shock) are local venom.
Venom spreads through lymph. Affects the superficial cells and tissues. Gives DIC, shock
Don’t use a tourniquet
Most envenomation shows within 6 hrs.
Gram negative infections.
Use Antivenin
Other Reptiles
Helamonster
Helamonsters have neurotoxin, with grinding teeth.
They can cause MI, with gram negative infection
Spider bites
Brown recluse (hobo spider) -Raised bites, painless at onset. Have volcano lesion
Cause ischemia so NO ICE
Can use hypobaric chamber
No antivenin
Black Widow
- Aggressive
- Letrodotoxin: Neurotoxins to destabilize membranes and release ACh to cause cramps, abdominal cramping, and nausea
Can use ice and benzodiazepem. Can also use antivenin for old and young.
Will give you cardiac arrhythmia.
Scorpion stings
Neurotoxins and local tissue damage with hemorrhage.
Neurotoxins causes repetitive sodium channels opening. Kids get really severe pain from touching the redness around the sting
Antivenin for young and old
Just supportive care for most.
Hymenoptera
Fire ants and Bees
Local skin reactions (itching and pain)
Cause allergic reactions like anaphylaxis within 30 minutes. Can get serum sickness.
You can get systemic problems when you are stung by lots of the little guys and it can cause DIC
Marine Animals
Jellyfish: Box-jellyfish can cause respiratory distress. Must remove the stinger by plucking! Don’t scrub.
Immerse the stung appendage in hot water.
Gives vibrio infections and gram negative. Vibrio cause necrotizing fasciitis (will give pain out of proportion POOP). Treated with *****
Scabies
Burrow into the skin to lay eggs.
Can see them with a magnifying glass.
Often confused with impetigo.
Can use lindane or ***
Bed Bugs
Fumigate but hard to get rid of.
Will leave little red patches.
Mites
Recetchial pox
It looks almost like chicken pox. And causes swollen lymph nodes.
Will need to fumigate.
Carpet beetles
Causes carpet beetle rash from just walking on you.
Much more close bumps in the rash.
Need to fumigate the home.
Fleas
See the bites around the socks and around the waist.
They don’t cause any infections, but the infection comes from scratching them.
Lice
Don’t have to fumigate the house.
Treat all your linen and use the special shampoo.
Which zoonotic infections are Tick vectored?
Erlichia Borrelia Rickettsia Anaplasma Babesia (protozoan)
Bartonella
5 species:
B. Quintana: Bacillary angiomatosis, trench fever
B. Bacilliformis: bartonellosis
B. Henselae: cat-scratch disease
Most prevalent
Gram negative, intracellular pathogen
The bartonella comes from different vectors:
- Bacilliformis: Sandfly
- Quintana: Body louse
- Henselae: cat flea
Bartonellosis due to bacilliformis from Sandfly. Oroya fever first and then verruga. Gives fever and malaise, headache and will worsen to anemia.
Verruga: recurs for months to years. Wart-like things.
B. Quintana Infection
Bartonella Infection
Trench fever from body lice
More in urban areas and found in WWl
Presents with severe and sudden onset headache, weakness, rash, and pain in long bones. 5 day fever recurrence (ungilating)
B. Henselae Infection
From Bartonella
Cat scratch disease
From cat scratch or bite. Much less severe in kids most of the time.
Can get very swollen lymph nodes that last for months. Will form hyperplasia and granuloma formation. Can get septic shock.
Bacillary Angiomatosis
Infection from B. Henselae or B. Quintana seen in immunocompromised patients.
Will involve the skins, and also the liver and spleen with hensalae.
Will involve skin, and bone in Quintana, not as bad***
Can Bartonella be cultured?
No, it is very difficult, but serology can be useful.
Pasteurella multocida
Dog and Cat bite wounds
Cellulitis, osteomyelitis.
Shows acute onset redness, pain, swelling, and fever.
Gram neg, aerobic, oxidase + and catalase +
Leptospirosis Interrogans
Animal Urine
Causes Leptospirosis: more in dog, but causes fever chills, vomiting.
Weil Disease: from pet rats. Cause jaundice, conjunctival injection, liver and kidney failure.
Spirochete: spiral bacteria
Ixodes Tick
Western version doesn’t have as much disease
Carries Lyme, anaplasmosis, and babesiosis. Can all be transferred at the same time.
