Introduction to infectious diseases

Question 1

How do you treat pasteurella?

Answer 1

Augmentin

Question 2

How do you diagnose necrotizing fasciitis?

Answer 2

MRI

Question 3

describe the how you would call infections of the:

1. epidermis
2. dermis
3. subcutaneous

Answer 3

epidermis=impetigo
dermis=erysipelas
subq=cellulitis

Question 4

What are the most common causes of impetigo?

Answer 4

1. S pyogenes

2. S. aureus

Question 5

How would you treat impetigo?

Answer 5

dicloxacillin or cephalex. You’re worried about post-infectious glomerulonephritis.

• -Dicloxacillin for staph
• -Cephalex for strep

Question 6

Treat erysipelas with

Answer 6

penicillin. It’s caused by group A strep

Question 7

Cellulitis from fresh water

Answer 7

Aeromonas hydrophilia

Question 8

Cellulitis from salt water

Answer 8

V vulnificus

Question 9

Predisposing factors for cellulitis (5)

Answer 9

1. trauma
2. obesity
3. edema (gravity dependent)
4. impaired lymphatic drainage
5. tinea pedis

Question 10

How do you diagnose cellulitis?

Answer 10

Usually clinical

• -blood cultures rarely positive
• -aspiration has lots of false positives
• -punch biopsy usually not positive

Question 11

What causes recurrent cellulitis?

Answer 11

Venous obstruction or lymphatic blockage

–Tx: oral penicillin

Question 12

How do you treat folliculitis?

Answer 12

Usually S. aureus.

• -Treat with polymyxin B/neomycin/bacitracin
• -also mupirocin ointment

Question 13

Describe three bugs that can cause ulcers

Answer 13

1. sporotrichosis
2. myobacterium marinum
3. anthrax

Question 14

Describe the typical pt with sporotrichosis

Answer 14

Gardeners/farmers present with a painless pustule/nodule.

Question 15

What type of organism is sporotrichosis?

Answer 15

It’s a fungus.

Question 16

Describe the typical pt with mycobacterium marinum

Answer 16

A person who works with aquarium or other fresh water areas. Will present with an ulcerating papule

Question 17

Describe the typical patient with anthrax

Answer 17

A wool hide tanner comes in with a painless papule and also an ESCHAR (local black, necrotic lesion)

Question 18

What does anthrax look like on gram stain?

Answer 18

Gram positive, large, rod

Question 19

“puncture wound through sneaker” makes you think of what bug?

Answer 19

pseudomonas

Question 20

What bugs come up in infected human bites?

Answer 20

1. staph/strep
2. eikenella corrodens
3. fusobacteria
4. prevotella

Question 21

What do you use to treat infected human bites?

Answer 21

IV ampicillin and sulbactam (unasyn)

Question 22

How do you decide what dose is high enough?

Answer 22

Give 4 x MIC

Question 23

When would it be ok or not ok to prescribe someone with a penicillin allergy a cephalosporin?

Answer 23

If anaphylaxis with penicillin, then do NOT use a cephalosporin

Question 24

What does clindamycin cover?

Answer 24

Gram positives and anaerobes

Question 25

What kind of coverage do aminoglycosides provide?

Answer 25

Gram -

Question 26

which drugs cover anaerobes?

Answer 26

metronidazole, clindamycin, and Beta-lactams with beta-lactamase inhibitors