Infectious Disease 2 Flashcards
(16 cards)
Generally when you have catheter associated infection, you leave the catheter and start ABX therapy (and get blood culture), and exchange the catheter once patient is afebrile and clinically stable. What 5 situations do you remove the catheter asap?
1) Sepsis
2) HD instability
3) Infection metastasis (IE endocarditis, osteo)
4) Cont symptoms despite 72 hours of empiric ABX
5) Pus at catheter site
In suspected catheter associated infections, where there are no immediate indications to remove catheter, growth of what organisms in blood culture would require removal of catheter?
S. Aureus
Pseudomonas
Fungi
What is the single best test to dx osteomyelitis?
In what situation would you use a different test?
MRI
IF metal hardware and MRI C/I, then 3 phase bone scan or tagged WBC scan.
How is the urethral discharge and stain (of discharge) differ between Gonorrhea and Chlamydia?
Gonorrhea: Purulent, diplococci on stain
Chlamydiae: Watery, wbc with no organism on stain (aseptic stain).
How do you treat CONFIRMED Gonorrhea?
Ceftriaxone X1 and Azithromycin X1 (added to decrease dev of bacterial abx resistance).
How do you Treat CONFIRMED Chlamydia?
Azithromycin X1
What is the recommended SCREENING test for HIV?
p24 (HIV Ag)
+
HIV-1/HIV-2 Ab
When someone is newly dx with HIV, what other disease should you screen for that can help guide medication regimen?
HBV (some HIV meds also target HBV, so should be used preferentially)
How do you treat pregnant women with Lyme Disease? For how long?
AMOXACILLIN (14-21 days)
Avoid normal trx of Doxycycline because effect on fetal long bone and teeth discoloration
How does maternal Lyme disease effect fetus?
No associated congenital abnormalities when Maternal Lyme is adequately treated with 14-21 days of Amoxacillin.
What type of hospital infectious protocol is needed for HERPES ZOSTER?
Localized disease (1 dermatome +/- immediately adjacent areas only) –> Standard contact precautions + cover rash until completed crusted over.
Disseminated disease (much beyond 1 dermatome) –> Standard precaution + AIRBORN Precautions.
What is the next step in management when patient is positive RPR and neurologic symptoms?
Lumbar Puncture to rule out neurosyphilis.
IF positive, will see increased wbc and positive VDRL or FTA-Abs in CSF fluid
How do you treat Primary, Secondary and early tertiary (<1 year from infection) Syphilis?
Penicillin G(2.4 million units) IM X1
How do you treat late tertiary Syphilis (>12 months since infection)?
Penicillin G IM (2.4 million units) weekly for 3 weeks.
How do you treat Neurosyphilis?
IV Penicillin G (3-4 million units) Q4H for 10-14 days.
How do you treat Congenital Syphilis?
IV Penicillin G (50,000 units/kg/dose) Q8-12 hours, X 10 days.
