1. Abscess drainage 2. Induction phase: IV ceftazidime or meropenem 3. Maintenance: Bactrim or augmentin+doxycycline

Infectious Disease Flashcards by Ang Qing Kang Dominic

Septic workup components

Bloods
-BLOOD CULTURE
-FBC
-RP
-CRP/ESR

Procedures
-Lumbar puncture
-Catheterisation for Urine culture

Radio
-CXR+-

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CSF WBC to RBC ratio

1:500, in case of traumatic tap

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Organisms to consider with gram positive cocci in clusters

Staphylococci
-Coagulase positive
-Coagulase negative

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Organisms to consider in gram positive cocci in chains

Streptococci
Enterococci

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Main organisms that cause UTI

E Coli and Enterococcus

Staph if catheter associated infection

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Drugs that are high risk for causing C Diff associated Diarrhea

Clindamycin
Floroquinolones
Cephalosporins

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Drugs that are high risk for causing C Diff associated Diarrhea

Clindamycin
Floroquinolones
Cephalosporins

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Coverage of metronidazole

Anaerobes

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Treatment of MSSA

Cloxacillin or penicillin

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What to suspect in crytococcal meningitis

Immunocompromise/HIV

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Common pathogens causing liver abscess

Klebsiella pneumoniae
E Coli
Streptococci

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Indications for surgical drainage of liver abscess

1 Failure of percutaneous drainage
2. Good response to abx therapy
3. Large abscess >10cm
4.multiple/multifoculated abscesses

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What to consider to oralizing antibiotics

Sensitivity to the drug
Availability of oral formulation
Patient condition
Compliance

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Treatment of entamoeba histolytica liver abscess

Metronidazole or tinazole for abscess

Paromomycin for luminal eradication

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Microbes in cellitis

Staph and strep

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Antibiotics for cellulitis

Cloxacillin or cefazolin(superior)

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Mx of Nec fasc

Emergency surgical debridement

Blood cultures->triple therapy( ceftazidime, clindamycin and?)

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Causative agent of melioidosis

Burkholderia pseudomallei, a safety pin shaped gram negative rod

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Mx of Melioidosis

Abscess drainage
Induction phase: IV ceftazidime or meropenem
Maintenance: Bactrim or augmentin+doxycycline

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Risk factors for Listeria monocytogenes

Immunosuppressed host
Pregnancy
Alcoholics
Old
Young
Soft cheese in diet?

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Investigations to order for Lumbar puncture

Opening Pa
Cell count
CSF panel: protein, glucose paired with peripheral
MicroB; cultures and sensitivity +AFB
Cytology

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Suspicion from lymphocytic meningitis

TB vs Fungal vs Viral(glucose and protein not as deranged)

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Mx of HSV encephalitis

Acyclovir, reduces mortality rates

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Empirical Mx of CNS infection

IV ceftriaxone
IV Ampicillin
IV Acyclovir
Dexamethasone

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Cx of male UTI

Pyelonephritis Pyonephrosis Prostatitis AKI

Mx of Pyonephrosis

Percutaneous Nephrostomy+ Abx coverage

Most common sources of polymicrobial bacteremia

GI GU HBS

5 most common sites of nosocomial infection

1. SSTI 2. GU 3. Pneumonia 4. C diff Colitis 5. Line infection

What to rule out in Strep bovis bacteremia

GI malignancy

3 biochemical confirmations of HIV positive

1. CD4 counts low with normal TW 2. CD4:CD8 ratio increase 3. CD4 % low

Risk factor for toxoplasmosis

1. Cat LITTER 2. Handling contaminated meat 3. Vertical transmission

Test for Toxoplasma infection

Toxoplasma IgG

Medication for Toxoplasmosis and PCP prophylaxis

Bactrim

Dx of Toxoplasmosis

Positive serum IgG+MRI findings+ treatment trial Brain biopsy not usually done

Mx of CMV retinitis

Intra vitreal valgancyclovir

Indication for stool culture

Acute Colitis/GE looking for bacterial cause

Mx for esophageal candidiasis

Fluconazole

Mx of CMV colitis

IV gancyclovir

Pathogens that cause chronic lung infection

Tuberculosis Non Tuberculosis Mycobacteria Melioidosis Aspergillosis

Gold standard for Melioidosis diagnosis

Based on culture eg BAL

Mx of Melioidosis

1. 4 weeks IV Abx 2. Months of oral eradication therapy

Morphology on dengue rash

Diffuse petechial rash that is blanchable with islands of sparing

Number of dengue serotypes

Serious cx of dengue infection

Dengue hemorrhagic fever DHF Dengue shock syndrome DSS

7 warning signs of dengue

1. Abdo pain from gut ischemia 2.Persistent Emesis 3. Fluid accumulation 4. Mucosal bleeding 5. Lethargy and restlessness 6. Hepatomegaly >2cm 7. Haematocrit rise and rapid platelet drop

Biochemical sequence in primary dengue

NS1 positive D1-5 IgM D5 IgG D10

Purpose of trending platelets in dengue

Not for recovery but to help cfm the dx of dengue

3 rules in dengue

1. Fever in dengue is 7> day 2. Platelets will fall during febrile phase, and a big fall in critical phase(day fever settles) 3. Platelets will only recover/rise 1-2 days after fever settles

Causes of death in Severe dengue

1. Multi organ failure(Liver, myocardium, 2. Third spacing and shock 3. DIVC?

Vancomycin vs cloxacillin for MSSA bacteremia

Cloxacillin lower mortality outcomes

Criteria for IE

Duke criteria

Virus that causes oral hairy leukoplakia

EBV

Common causative agent of viral meningitis

HSV 1 and 2

Test for Gonorrhea and chlamydia

GC swab of relevant anatomical areas

Test for Gonorrhea and chlamydia

GC swab of relevant anatomical areas

Differential diagnosis for hands on hands and feet

1. HFMD: RVEV and coxsackie 2. Secondary syphilis 3. Rocky Mountain spotted fever

Window for HIV testing

4-6/52 and 3/12 from exposure

How Chlamydia is screened

First pass urine NOT mid stream Swab if visible lesions/discharge

Regimen for daily prep

Take 1/52 before, stop 1/52 to 1/12 after sexual act - good for CSWs

Cx of VZV

1. Secondary bacterial skin infection 2. VZV pneumonitis 3. Transaminitis 4. Bleeding diathesis 5. Guillian barre

Mx of VZV

1. Symptomatic Mx 2. Mx lesions 3. Acyclovir/Valacyclovir(renal adj.) 4. Contact tracing 5. Vaccination

Virus most likely to cause arthralgia

Chikugunya

Triad of flu like symptoms

Fever Sore throat Cough

Triad of Infectious Mononucleosis Syndrome

Fever Sore throat Lymphadenopathy

What is Dengue duo

PCR and Ab

Cutoff for high grade fever

38.5

Most common areas enterococci can be found without being virulent

Skin, gut and biliary tree

Mx of fibroepithelial polyps(skin tags)

1. Snip excision 2. Electrocautery 3. Liquid nitrogen

Causative agents of viral related cancers

HHV8: Kaposi Sarcoma EBV: Primary CNS Lymphoma, NPC HPV: Cervical Ca

Linezolid coverage

Drug resistant gram positives eg VRE MRSA

Antibiotic choices for CAP

Septic Shock: Augmentin + Ceftazidime + Azithromycin Stable: Augmentin/Ceftriaxone + Azithromycin

Antibiotic choice for HAP

Pip Tazo

Mx of Cellulitis

Cefazolin or cloxacillin Add ciprofloxacin if marine/freshwater exposure

Mx of osteomyelitis

IV cefazolin/ cloxacillin add Pip Tazo if immunocompromise Vancomycin if prosthetic joint

Contraindications in neutropenic sepsis

DRE and Per Vaginal examinations: May cause bacterial translocation

Why pyridoxine is given with isoniazid

To reduce risk of isoniazid induced neuropathy

Indication for IV dexamethasone for COVID patients

2-4l of O2 supplementation required

Ring enhancing lesions on CT brain suggest

CNS toxoplasmosis Ddx: CNS lymphoma

Duration of treatment for MSSA/MRSA bacteremia

4-6 weeks Abx

New name for red man syndrome

Vancomycin flushing syndrome

First line abx for febrile neutropenia

Pip tazo or cefepime Mero IF neutropenic sepsis

Treatment for candida fungemia

Fungins eg micafungin, fluconazole not 1st line

Infectious Disease Flashcards

(83 cards)