Infectious Flashcards
(219 cards)
1
Q
What is the cause of Alice in Wonderland syndrome
A
EBV
metamorphosia, perceptual distortions of sizes, spatial relationships may be presenting symptoms
2
Q
Malaria chemoprophylaxis
A
Doxycycline (100mg/tablet): 2mg/kg
start 2-3 days prior to travel up to 4 weeks upon leaving area
Mefloquine tab: >45kg = 250mg; <45kg=5mg/kg
1 week prior to travel up to 4 weeks
Chloroquine and Mefloquine: 1-2 weeks to 4 wks after
Doxycyline: 1-2 days prior to 4 weeks; not for <8yo
Atovaquone/Proguanil (malarone): 1-2 days to 7 days after
3
Q
rectal temperature of 38C or higher as sole presenting feature
A
Fever without a focus
- neonates or infants to 1 month: fever who does not appear ill have 7% risk of having serious bacterial infection
- infants >1month to 3 months of age: pyelonephritis most common
- children >3moths to 3yrs: viral infections
4
Q
What is fever of unknown origin
A
fever documented for which cause could not be identified after 3 weeks evaluation as outpatient or
after 1 week of evaluation in the hospital
5
Q
connective tissue disease most commonly associated with FUO
A
SLE and JIA
6
Q
most common cause of pyogenic infection of skin and soft tissue
A
Staphylococcus aureus
7
Q
associated with invasive skin disease
A
PVL
8
Q
most common cause of osteomyelitis and suppurative arthritis in children
A
Staphylococcus aureus
9
Q
fever, hypotension, an erythematous rash with subsequent desquamation on the hands and feet, multisystem involvement including vomiting, diarrhea, myalgia, conjunctival hyperemia and strawberry tongue
A
Toxic shock syndrome
*many cases occur in women 15-25yo who use tampons
10
Q
primary toxin is TSST-1
A
Toxic Shock syndrome
11
Q
what are the major and minor criteria of Toxic Shock Syndrome
A
Major (all required):
Fever >38C
hypotension
rash (erythroderma with convalescent desquamation)
MInor (3 or more): mucuous membrane inflammation vomiting, diarrhea liver abnormalities renal abnormalities muscle abnormalities CNS abnormalities Thrombocytopenia
12
Q
Treatment for toxic shock syndrome
A
Beta lactamase antistphyloccocal: Nafcillin and Oxacillin or 1st Gen Cephalosporins
MRSA: Vancomycin
13
Q
What are coagulase negative staphyloccoci?
A
S. epidermidis
S. pyogenes
S. saphrophyticus
14
Q
Treatment of choice for CONS
A
Vancomycin
15
Q
most common cause of nosocomial bacteremia associated with central venous catheters
A
S. epidermidis
16
Q
associated with CSF shunt meningitis
A
CONS
17
Q
What is true bacteremia
A
blood cultures grow rapidly (within 24hr)
>/= 2 blood cultures are positive with same CONS
clinical signs and symptoms compatible with CONS sepsis
18
Q
most common cause of bacteremia, bacterial pneumonia and otitis media
A
Streptococcus pneumoniae
19
Q
when do we use a D test?
A
in cases where pneumococcus is resistant to erythromycin but sensitive to clindamycin
D test should be performed to determine whether clindamycin resistance can be induced
If positive D test, clindamycin should not be used
20
Q
Drug of choice for Streptococcus pyogenes
A
Penicillin G
21
Q
virulence of Group A Strep
A
M protein
22
Q
gold standard for documentation of presence of GAS
A
throat culture
23
Q
in patients who do not fulfill Jones criteria but had acute onset of arthritis following episode of GAS infection
A
Poststreptococcal reactive arthritis
Not migratory
does not respond dramatically to therapy with Aspirin and other NSAIDS
role of secondary prophylaxis not established
24
Q
PANDAS is associated with
A
GAS infection
25
most common form of acquired heart disease in all age groups
Rheumatic Fever
26
pathogenesis of ARF and RHD
Cytotoxic theory: GAS toxin may be involved
| Immunologic theory
27
what are the manifestations of chorea in Rheumatic fever
```
emotional lability
incoordination
poor school performance
uncontrollable movements
facial grimacing
exacerbated by stress and disappearing with sleep
```
Milkman's grip
Spooning and pronation of hands
Wormian darting movements
examination of handwriting
28
what are the 4 minor criteria of Jones Criteria
arthralgia
fever
elevated ESR and CRP
Prolonged PR interval
Absolute requirement for evidence of recent GAS infection:
positive throat culture or rapid antibody titer
elevated or increasing
29
3 circumstances in which diagnosis of ARF can be made without strict adherence to Jones Criteria
Chorea as the only manifestation
Indolent carditis as the only manifestation
recurrent ARF
30
treatment for ARF
10 days oral Penicillin or erythromycin
| or a single IM injection of Benzathine penicillin then long term prophylaxis
31
drug of choice for Sydenham chorea
Phenobarbital
32
Antibiotic prophylaxis for RF without carditis
5 years or until 21 years of age whichever is longer
33
Antibiotic prophylaxis for RF with carditis but without residual heart disease
10 yr or until 21 years of age whichever is longer
34
Antibiotic prophylaxis for RF with carditis and residual heart disease
10 years or until 41 years old whichever is longer sometimes lifelong
35
what are the manifestations of Diphtheria infection?
respiratory tract and cutaneous
36
complications of diphtheria infection
Toxic cardiomyopathy 50-60% of death
| Neurologic complication- oculomotor and ciliary paralysis
37
mainstay of therapy in Diphtheria
Specific antitoxin
* role of antibiotic therapy is to halt toxin production, treat localized infection, prevent transmission of the organism
* only erythromycin and Penicillin recommended
38
what should be given to people who had contact with a patient with Diphtheria?
antimicrobial prophylaxis using erythromycin or Benzathine Pen G
39
most frequent neurologic sequela of meningitis
Deafness
40
poor prognostic factors for N. meningitides
```
hypothermia or extreme hyperpyrexia
hypotension or shock
purpura fulminans
seizures
leukopenia
thrombocytopenia
acidosis
high levels of endotoxin and TNF-alpha
presence of petechiae <12hour before admission
absence of meningitis
low or normal ESR
```
41
When is prophylaxis indicated in patients with exposure to Hib?
all members of the household or close contact group if the group includes >1 child <48 months of age who are not fully vaccinated
42
When is prophylaxis indicated in patients with exposure to Hib?
all members of the household or close contact group if the group includes >1 child <48 months of age who are not fully vaccinated
43
what are the stages of Pertussis
* catarrhal stage (1-2wks)
* paroxysmal stage
* Convalescent
*infants less than 3yo do not display the classic stages
44
typical paroxysms that are not life threatening
```
duration less than 45sec
red but not blue color change
tachycardia, bradycardia
whooping or strength for self-rescue
self-expectorated
```
45
classic triad of Botulism
acute onset of symmetric, descending paralysis with clear sensorium
no fever
no paresthesia
46
symmetric descending paralysis
Botulism
47
treatment for infant botulism
Human Botulism Immunoglobulin
single IV infusion 50-100mg/kg
*antibiotic therapy is not part of treatment of uncomplicated infant or foodborne botulism
48
acute spastic paralysis
Tetanus
49
presenting symptom of generalized tetanus
trismus
50
true or false
| Tetanus affects sensory nerves and cortical function
False
| Tetanus does not affect sensory nerves or cortical function
51
treatment for tetanus
wound debridement to remove foreign body
Human tetanus IG single IM 500 units TIG to neutralize
Total doses 3000-6000 units
Oral or IV metronidazole -DOC; dec vegetative state
Pen G-alternative treatment
52
what are the 2 phases of Leptospirosis
Initial/Septicemic phase
| Immune/Leptosperic/Icteric
53
What phase of leptospirosis:
| recurrence of fever, aseptic meningitis, increased ICP, pleocytosis, encephalitis, cranial and peripheral neuropathies
immune phase
54
Icteric leptospirosis
Weil Syndrome
55
What phase of leptospirosis:
| jaundice, acute renal dysfunction, thrombocytopenia, abnormal ECG, acute kidney failure
Immune phase
56
Leptospires recovered in blood or CSF during
1st 10 days
| Urine on 2nd week
57
treatment for Lepto
Pen G
Cefotaxime
Ceftriaxone
Doxycycline
Allergic to Pen G: Doxycycline
58
After a live vaccine, when can we give Immunoglobulin
2 weeks after
59
poor prognosis for meningococcemia
petechiae <12hrs before admission
absence of meningitis
low or normal ESR
60
Drug of choice for meningococcemia
Ceftriaxone
61
duration of droplet precaution for patients with meningococcemia
24 hours after effective antibiotic treatment
62
most common cause of respiratory infections in school age and young adults
Mycoplasma pneumoniae
63
eschar formation
Pseudomonas
64
saber shins, Hutchinson teeth, saddle nose and 8th nerve deafness
Congenital syphilis
65
most important preventable cause of blindness in the world
Trachoma
66
Ekiri syndrome or toxic encephalopathy is caused by
Shigella
67
Loeffler syndrome is associated with
Ascaris lumbricoides
68
Parasitic infection with pulmonary disease, obstruction of intestinal or biliary tract
fever and urticaria
Ascariasis
69
Treatment fo GI ascariasis
Albendazole 400mg OD
| Mebendazole 100mg BID x 3 days
70
most common cause of human hookworm infection
Necator americanus
71
what are the blood findings in patients with hookworm infection
anemia and IDA
| *microcytic hypochromic anemia
72
may cause ground itch when they penetrate human skin
Necator americanus
Ancylostoma
Hookworm
73
May cause cutaneous larva migrans
Ancylostoma brazilienze
74
eosinophilia conincides with entry to GI tract ; may cause chlorosis (yellow-green pallor)
Necator americanus
Ancylostoma
Hookworm
75
drug of choice for cutaneous larva migrans
Ivermectin
76
parasitic infection that causes rectal prolapse, anemia a, poor growth, development and cognitive deficits
Trichuris trichiura
(whipworm)
DOC: Albendazole
77
causes perineal pruritus
Enterobius vermicularis
(pinworm)
DOC: Albendazole
78
barrel-shaped eggs
Trichuris trichiura
(whipworm)
DOC: Albendazole
79
manifestation is larva currens; allergic reaction to filariform larvae
Strongyloides stercoralis
DOC: Ivermectin
80
Katayama syndrome; febrile illness represents immune complex disease associated with early infection and oviposition
Schistosoma spp
(flukes)
DOC: Praziquantel
81
causes swimmer's itch
Schistosoma spp
(flukes)
DOC: Praziquantel
82
most prevalent helminthiasis
Ascariasis
83
diagnostic for ascariasis
examination of fresh stool sample for characteristic eggs
84
pinworm
Enterobius vermicularis
85
Invasive amebiasis is treated with
Metronizadole or Tinidazole and then luminal amebicide
86
what are the 2 common forms of disease caused by
| E. hystolitica
amebic colitis
| amebic liver abscess
87
patient with profuse, watery greasy stools and foul smelling what is the causative agent?
Giardia lamblia
88
test of choice for Giardia lamblia infection
stool enzyme immunoassay (EIA) or
| direct fluorescent antibody
89
treatment for Giardia
Tinidazole, Nitazoxanide or Metronidazole
90
what are the two major phases in life cycle of malaria
```
asexual phase (schizogony) in humans
sexual phase (sporogony) in mosquitoes
```
91
life cycle of Plasmodium
erthrocytic phase (asexual) begins when merozoites released from exoerythtocytic schizonts in the liver penetrate erythrocytes -->parasite transforms into ring form --> enlarge to become trophozoite
92
vector of malaria
female Anopheles mosquitoes
93
rupture of schizonts that occur every 48 hours
P. vivax
| P. ovale
94
rupture of schizonts that occur every 48 hours
P. malariae
95
long term relapse occurs in
P. vivax and ovale because of persistence in liver
| P. malariae persists in the erythrocyte
96
complication of P. falciparum infection
cerebral malaria
97
chemoprophylaxis when traveling to chloroquine-resistant P. falciparum exists
Mefloquine
98
Pathognomonic for Measles
Warthin-Finkeldey cells
99
measles also known as
Rubeola
100
measles is infectious
3 days before onset of rash up to 4-6 days after onset of rash
101
most common cause of death in measles
Pneumonia
102
most common complication of measles
otitis media
103
chronic complication of measles
Subacute sclerosing panencephalitis
104
stages of SSPE
1. mild
2. massive myoclonus; basal ganglia
3. involuntary movements disappear --> choreoathetosis
4. loss of breathing, heart rate and BP --> death
105
treatment for SSPE
supportive
Isoprinosine
Carbamazepine
106
also known as 3 day measles and German measles
Rubella
107
highest communicability of Rubella
5 days before to 6 days after onset of rash
108
most important risk factor for severe congenital defects in Rubella
age of gestation (18 weeks age of gestation)
109
tiny rose colored lesions on oropharynx
Forchheimer spots
110
What are the manifestations of Congenital Rubella syndrome
```
nerve deafness
salt and pepper retinopathy
unilateral or bilateral cataracts
PDA
meningoencephalitis
```
111
single most common finding among infants with congenital rubella syndrome
Nerve deafness
112
most common ocular abnormality among infants with congenital rubella syndrome
salt and pepper retinopathy
113
most serious eye finding among infants with congenital rubella syndrome
unilateral or bilateral cataracts
114
what to do in pregnant patients with exposure to Rubella
obtain blood specimen (IgG antibody)
If Rubella (-): obtain second specimen after 2-3 weeks
if both samples (-): obtain 3rd specimen
If 2nd and 3rd samples are (-) --> no infection
If 1st specimen (-), 2nd and 3rd (+): seroconversion
115
In mumps, when do virus appear
appear in saliva 7 days before to 7 days after onset of swelling
116
confirmatory of mumps
elevated serum amylase
117
complications of mumps infection
meningitis with or without encephalitis
gonadal (orchitis, oophoritis)
maternal infection during 1st trimester --> increase fetal wastage
118
mumps vaccine are given
1st dose: 12-15 months
| 2nd dose: 4-6 years
119
Poliovirus primarily affects
motor neuron cells of spinal cord (anterior horn cells) and medulla oblongata
120
Clinical manifestations of polio:
| no disease; no sequalae; non-specific influenza like symptoms
Inapparent Infection/ abortive
121
Clinical manifestations of polio:
intense headache, nausea/vomiting
nuchal rigidity and spinal rigidity
nonparalytic
| 2nd phase
122
Clinical manifestations of polio:
patient recover then experience severe headache, fever
severe muscle pain, sensory and motor phenomena
asymmetric flaccid paralysis
Spinal paralytic
123
What are the findings in patients with spinal paralytic polio
sensation is intact
sensory disturbances if present suggest another disease
lack of improvement for paralysis within 1st several weeks or month is evident of permanent paralysis
124
associated with nonimmune fetal hydrops and stillbirth
Parvovirus
125
5th disease
erythema infectiosum
prodromal: mild, low grade fever, headache, mild URTI
126
transient arrest of erythropoiesis and absolute reticulocytopenia
transient aplastic crisis
127
what to do if a pregnant patient with varicella
mothers who had varicella 5 days before delivery to 2 days after --> inc risk for neonatal varicella
128
what to do if mother had varicella 5 days before delivery to 2 days after
newborn should receive Varicella Ig asap upon birth
* all premature infants <28wks AOG whose mothr had active varicella should receive VZIg
* if not available, give IVIG
129
what are the manifestations of Congenital Varicella Syndrome
cicatricial skin scarring zoster like distribution
limb hypoplasia
abnormalities in CNS (microcephaly, chorioretinitis)
Low brith weight common
130
triad of EBV
fatigue
pharyngitis
generalized lymphadenopathy
131
what is the most common route of CMV infection
breastfeeding
blood transfusion related
132
hepatosplenomegaly, petechial rashes, jaundice and microcephaly
Congenital infection of CMV
133
most common long term sequalae of congenital CMV
hearing loss
134
Antiviral agent of choice for Influenza A infection
Oseltamivir
135
Highest risk of congenital rubella will manifest if mother had rubella at what age of gestation
11 weeks age of gestation
136
Triad of congenital rubella
PDA
Deafness
Cataract
137
Earliest time to give Rubella vaccine
12 months
138
Most serious complication of 3 day measles
Encephalitis
139
Patient with severe eye pain and photophobia with associated blurred vision, lacrimation, conjunctival erythema, congestion, lid edema. What is most common etiology?
Enterovirus
140
Gloves and socks syndrome
Parvovirus B19
141
Stage of 5th disease with appearance of slapped cheek appearance
1st stage
142
Recurrent aseptic meningitis (Mollaret meningitis)
| Is caused by
HSV
143
Gingivostomatitis os treated with
Oral acyclovir
144
Means of preventing HPV infection
Avoid direct contact with lesion
145
Herpes virus associated with convulsions
Human Herpes Virus 6B
146
Enanthem of 6th disease
Nagayama spots
147
Most common complication of exanthem subitum
Convulsions
148
Most common respiratory tract pathogen of early childhood
RSV
149
Most common finding in children with severe viral enteritis
Isotonic dehydration with acidosis
150
Hallmark of amebic liver abscess
Fever
151
Indication for HiB prophylaxis
Unvaccinated children less than 2yo
152
What is the prophylaxis for asymptomatic case contact of patient with diphtheria
Single injection Bezathine Penicillin
600,000 units IM for <6yo
1,200,000 units IM for >6yo
Or Erythromycin 40-50mg/kg/day qid PO x 10d
153
Best specimen for CMV
Sources of viral nucleic acids include saliva, urine and blood
Preferred screening: saliva
Confirmation: urine
154
Drug of choice for uncomplicated falciparum malaria
Atovaquone-proguanil or oral athemeter-lumefantrine( coartem)
Oral quinine plus doxycyline, tetracycline or clindamycin
155
Used for invasive neonatal Candida infections
Fluconazole
156
Mainstay of therapy for systemic candidiasis against both yeast and mycelial forms
Amphotericin B
157
patient complains of abdominal pain associated with high grade fever and rashes on the trunk which became visible on 7th day of illness
Typhoid fever
*Rose spots
158
How to diagnose typhoid fever?
Culture of blood during 1st week
| Culture of urine and stool after 1st week
159
Affected in typhoid fever
Peyer patches in terminal ileum
160
Bloody diarrhea with fever, abdominal cramps, rectal pain and mucoid stools
Dysentery caused by Shigella
161
Rectal prolapse may occur in
Dysentery
162
Extraintestinal manifestations of shigella
Nuerologic: convulsions, headache, lethargy, confusion, nuchal rigidity
Hypocalcemia, hyponatremia —> seizures
Most common: dehydration
DIC
163
Treatment for Shigella
Fluid and electrolyte
High protein and high caloric diet
Vitamin A
zinc supplementation
Ciprofloxacin: DOCp
164
Drug of choice for all patients with bloody diarrhea
Ciprofloxacin
165
Painless purging of profuse, rice water stool with fishy smell
cholera
166
DOC for Cholera
Doxycyline
Alternative: cotrimoxazole and chloramphenicol
167
What is the use of antibiotics in cholera?
Shorten duration
Decrease fecal excretion and
Decrease fluid requirement
168
Drug of choice for campylobacter infection
Azithromycin
169
Prominent sign botulism
Loss of head control
170
Test for Tetanus
Spatula test: bedside test
Touch the oropharynx with spatula
If tetanus present: reflex spasm of masseter will develop and will bite the spatula
171
Drug of choice for tetanus
Metronidazole
Will decrease vegetative state
Alternative: Pen G
172
Drug of choice for Syphilis
Pen G
173
Test to diagnose EBV
Monospot test
| Can remain positive up to 12 months
174
1st human virus associated with malignancies
EBV
175
Fever in which elevated temperature observed over 24hr varies by >0.5C and does not return to normal levels
Remittent fever
176
Elevated temperature observed over 24 hours varies with intervals of normal temperature
Intermittent fever
Ex: malaria; acute pyelonephritis
177
Gradual increase in temp that remains high for a few days then gradually decreses to normal temperature levels
Undulant fever
178
Fever recent onset (<1 week) with no adequate explanation determined by history or examination, without apparent site of infection
Fever without localizing signs
179
Most common bacterial agents in early onset sepsis
GBS and E. Coli
180
Most common bacterial agents in late onset sepsis
GBS and S. Aureus
181
Triad of NEC
Intestinal ischemia
Enteral nutrition
Pathogenic organisms
182
Most commonly involved ares in NEC
Distal ileum and proximal colon
183
Triad of NEC in clinical diagnosis
Feeding intolerance
Abdominal distention
Bloody stools
184
Treatment for NEC
```
Systemic antibiotics for 10-14 days
Cessation of feeding
Bowel decompression
IV fluids
Monitor hemodynamics, coagulation profile, electrolytes, acid-base status
```
185
Triad of Toxoplasmosis
Chorioretinitis
Intracranial calcifications
Hydrocephalus
186
Triad of congenital CMV
Chorioretinitis
Microcephaly
Periventricular calcifications
187
Leading cause of deadness in infants
CMV
188
Treatment for HSV 2 in infants
Acyclovir IV 60mg/kg/day every 8 hours
14 days for skin, mouth and eyes
21 days for CNS and disseminated
Acyclovir oral 300mg/m2/dose 3x a day for 6 months
189
most characteristic sign of German Measles/Rubella
Retroauricular, posterior cervical and postoccipital symmetrical LAD
190
Ulcers in uvulopalatal junction
Nagayama spots seen in Roseola
191
Type of polio also known as aseptic meningitis
Nonparalytic
192
Criteria for discharge in dengue
Afebrile for atleast 24-48 hours
Good well being
Stable hct without IVF and increasing platelet trend
Atleast 2-3 days from last episode of shock
193
Pathognomonic of rabies
Negri bodies
Rabies specific eosinophilic inclusions within the neuronal cytoplasm
194
Type of rabies with excessive restlessness, uncontrollable excitement, agitation, confusion, hallucination, hydrophobia,aerophobia, hypersalivation
Furious type (99%)
195
Type of rabies with ascending symmetric paralysis with flaccidity and decreased DTRs, respiratory paralysis, coma
Paralytic phase
196
HIV with flu like syndrome
Acute retroviral syndrome
197
HIV with declining CD4 counts
Latent infection
198
HIV with manifestations such as gen LAD, hepatosplenomegaly, FTT, oral thrush, recurrent bacterial infections
Symptomatic HIV
199
CD4 less than 200
| Patient succumbs to opportunistic infection within 2 years of developing aids
AIDS
200
most diagnostic of meningococcemia if isolated from
sterile body parts/fluids:
| CSF, blood, synovial fluid and scrapings from petechiae
201
most common cause of peritonitis in Nephrotic syndrome
Streptococcus pneumoniae
202
most prognosticating diagnostic in Kawasaki disease
2D echo
203
Clinical triad of Rocky Mountain Spotted Fever
Headache, Fever and Rash
204
Triad of congenital toxoplasmosis
Chorioretinitis
Hydrocephalus
Cerebral calcifications
205
Major reservoir and vehicle for transmission of Giardia is
Water contaminated by Giardia cysts
206
Almost always present in congenital syphilis
Hepatomegaly
207
Treatment of choice for Shigellosis?
Ciprofloxacin
208
Dengue classifications and symptoms
*** (Nelsons 21st Ch 295)
DHF- fever (2-7 days) , minor or major hemorrhagic manifestations positive tourniquet test, thrombocytopenia (≤100,000/μL), and objective
evidence of increased capillary permeability (hematocrit increased by ≥ 20%), pleural effusion or ascites (by CXR or UTZ), or hypoalbuminemia.
DSS- DHF criteria + hypotension, tachycardia, narrow pulse pressure (≤20 mm Hg), and signs of poor perfusion (cold extremities)
Dengue w/ warning signs- fever+ abd pain, persistent vomiting, mucosal bleeding, clinical signs of fluid accumulation, liver enlargement, low plt count, lethargy, inc in HCT
Compensated DSS- BP normal, other vs abnormal + clinical criteria from DSS
209
Vector for Japanese Encephalitis
Culex tritaeniorhynchus
Aedes aegypti- dengue fever and chikungunya
Anopheles- malaria
Ixodes-Lyme disease
210
Triad of pyogenic liver abscess
Fever
Abdominal pain (RUQ)
Hepatomegaly
211
Mainstay of treatment for pyogenic liver abscess
Antibiotic plus drainage
Piperacillin-Tazobactam
Ampicillin-Sulbactam
Metronidazole + 3rd gen cephalosporin + Vancomycin (MRSA)
Duration: 6 weeks
2-4 weeks IV
4-6 weeks oral with multiple abscess too small <2cm to be drained
212
Most common symptom of amebic liver abscess
RUQ pain
213
Coagulase positive staphylococci which produces a yellow or orange pigment and beta-hemolysis on blood agar
Staphylococcus aureus`
214
Coagulase positive staphylococci which produces a yellow or orange pigment and beta-hemolysis on blood agar
Staphylococcus aureus
215
Favorable prognosis in tetanus
long incubation period
absence of fever
localized disease
216
poor prognosis in tetanus
trismus < 7 days
spasms <3 days of trismus
very young and very old
217
in congenital syphilis, when is treatment indicated?
untreated or undocumented maternal tx
nonpenicillin drug
treatment
218
Jarisch-Herxheimer reaction
syphilis
219
cause of Roseola or exanthem subitum
HHV 6
