Infectious Disease Flashcards
(34 cards)
Antibiotic choices for pneumonia
Azithro if atypical
Amox = outpatients
Amp = inpatients
CTX = resp failure, septic shock
Add vanco if decompensating
Pneumonia treatment duration
Mild = 5 days
Most patients = 7-10 days
Complicated = 2-4 weeks
Parinaud oculoglandular syndrome
Unilateral conjunctivitis and preauricular lymphadenopathy
From direct eye inoculation with Bartonella
Cat scratch disease
Most common cause of chronic regional lymphadenitis
Usually axillary or cervical
Primary skin lesion precedes lymphadenopathy
Can also get non specific and systemic symptoms
Dx with serology or PCR
Usually self resolves in 2-4 months, but 5 days of azithro can speed recovery
Do NOT I+D, can cause sinus tract
Mycobacterium avium lymphadenitis
Subacute, painless, rubbery-firm, blueish tinged
Cervicofacial nodes
Can become suppurative
Excision is diagnostic and therapeutic
Flu vaccine recommendations
6+ months, annually
First year and < 9 years: 2 doses, 4 weeks apart
IN can only be used for 2-17 year olds
Contraindications: GBS, NOT egg allergy
IN cannot be used < 2 years, immunocompromised, severe asthma, receiving ASA, pregnant
Measles infectious period
3 days before to 4-6 days after RASH onset
Infection risk with powdered formula
Enterobacter sakazakii
How long to wait post IVIG to give
1. Live
2. Inactivated
vaccines
- 11 months
- No need to wait
PANDAS
Pediatric autoimmune neuropsychiatric disorders associated with S pyogenes
Hypothesized relationship, thought to be from cross reactivity of autoimmune antibodies
IVIG is proposed management
What abx to use for GBS + moms if they are allergic to penicillin
Cefazolin if low risk for anaphylaxis
Clinda if sensitive to clinda and erythro
Vanco if unknown susceptibilities or resistant to clinda
Clinda and vanco should be treated as inadequate prophylaxis
Abx choice for empiric abx in
1. 0-7 days
2. 8-28 days
3. 29-60 days
4. 61-90 days
- amp and gent/tobra, can use cefotax if concerns for meningitis
- same as above
- ceftriaxone + vanco if concerns for meningitis
- same as above
UTI in infants 1-3 mo
If low risk, can treat with PO cefixime
Gianotti-Crosti syndrome
Papular acrodermatitis of childhood
Due to EBV
Mildly itchy, papular, symmetric on face, buttocks, extensor surfaces
How long to avoid sports with EBV
21 days
Simple abscess management
1. < 1 mo
2. 1-3 mo
3. > 3 mo and well
4. > 3 mo with fever/cellulitis
5. All other scenarios
<1 mos = IV Abx
1 to 3 mos = PO Septra
>3 mos and well = I&D alone
>3 mos with fever/cellulitis = PO Septra + Keflex
Other scenarios usually need IV abx
Ramsay-Hunt syndrome
Shingles (VZV) involving portion of facial nerve near the ear
Vesicular rash on ear and facial weakness/paralysis
Triad: unilateral facial palsy, otalgia, vesicles in ear
Treat with antivirals and high dose steroids
Failed AOM with amox, next line treatment
Amox clav
Could be due to H flu or Moraxella
Limits to when vaccines can be given pre biologics
4 weeks before for live vaccines
2 weeks before for inactivated
Definition of C diff infections
1. Mild
2. Moderate
3. Severe
4. Severe, complicated
- < 4 stools per day
- 4 + stools a day
- Systemic toxicity
- Systemic toxicity and severe colitis (shock, peritonitis, ileus, megacolon)
Management of C diff infections
1. Mild
2. Moderate
3. Severe
4. Severe, complicated
5. First recurrence
6. Second recurrence
Discontinue antibiotics for all
1. Follow and reassess
2. Flagyl 10-14 d
3. Vanco 10-14 d
4. Vanco and Flagyl 10-14 d
5. Repeat regimen that worked > vanco x 10 d
6. Vanco tapered or pulsed
How to diagnose
1. Early
2. Late
Lyme disease
- Clinical (serology not helpful in first 4 weeks)
- ELISA then Western Blot
Management of
1. Early cutaneous
2. Late extracutaneous
Lyme disease
- Doxycycline x 10 days (or amox, cefuroxime, azithro)
- Doxycycline (CTX if persistent arthritis, meningitis, heart block)
Jarisch-Herxheimer reaction
Fever, headache, myalgia with initiation of antibiotics
Keep treating, NSAIDs for comfort
