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Multisystems II > Microbiology-Bites > Flashcards

Flashcards in Microbiology-Bites Deck (27)
1

Most common cause of animal bites

Dogs

2

Animal bites with higher risk of infection than dog bites

Cats, deeper penetration w/deeper infection and osteomyelitis

3

Common microbial infections associated with cat and dog bites

Pasteurella, capnocytophagia, normal skin flora and anaerobes

4

What people are at higher risk for infection by capnocytophagia after a dog/cat bite? What symptoms are common? How do you treat?

Immunocompromised. Presents with fever, muscle aches and rare sepsis. Tx with augmentin, avoid bactrim and aminoglycosides.

5

Symptoms that commonly present with pasteurella infection after a cat/dog bite? How do you treat?

Fever, cellulitis, arthritis, pneumonia, endocarditis, meningitis 15 hours after bite. Tx with augmentin or azithromycin. Avoid erythromycin and clindamycin.

6

More common microbe involved in community acquired MRSA from animals

S. intermedius > S. aureus.

7

Indications for antibiotic prophylaxis after bits

Deep bites (cats), crush injuries, venous/lymphatic compromise, wounds close to bone, wounds that requires surgical care, immunocompromised. Drug of choice = augmentin. 

8

28 year old pregnant woman presents with a red and swollen cat bite. She has a penicillin allergy. What is appropriate empiric therapy?

Axithromycin

9

Cat-scratch disease

Bartonella henselae (mostly in fall/winter in outdoor cats and affects younger kids)

10

Cat scratch symptoms

Papule/pustule at site of infection, fever, enlarged lymph nodes 1-3 weeks after exposure.

11

Diagnosing and treating cat-scratch disease.

Dx clinically most of the time, can also use serology or PCR. Tx with azithromycin if symptoms do not resolve spontaneously (they usually do).

12

Common pathogens associated with human bites

Staph, strep, eikenella (facultative). Also worry about HSV, HIV, HepC and HepB.

13

A 52 year old man suffers a hand injury in a brawl from punching a guy in the face. He has bony fragments on x-ray. He was given cephalexin in the ER and sent home. 5 days later he returns tachycardic, hypotensive, feverish and confused. His hand is warm, edematous, painful to move and has decreased sensation. He was given Tdap shot, started on amp-sulbactam and has a fasciotomy for compartment syndrome. Gram stain shows an anaerobic gram negative bacilli. How do you treat him?

Eikenella corrodens is a common infection in human “bites”. It is resistant to cephalexin, clindamycin, erythromycin and metronidazole. Tx with augmentin, fluoroquinolones, TMP-SMX or doxycycline.

14

Common pathogens in pig bites? How do you treat them?

Strep, staph, pasteurella, actinobacillus, tx with augmentin + ciprofloxacin to cover actinobacillus.

15

Symptoms and pathogens associated with rat-bite fever?

Streptobacillus moniliformis (US, branching gram-negative bacillus shown below), spirillum minus (asia). Symptoms: fever, pustular rash (shown below), migratory polyarthritis and endocarditis. Tx with augmentin or doxycycline.

16

Pathogen associated with seal finger? Symptoms? Treatment?

Mycoplasma. Papular lesion with pain, swelling and joint involvement. Tx with tetracycline.

17

Pathogens associated with the candiru fish (cat fish in amazon river attracted to urea)?

They swim up your urethra and lodge there to get urea waste.

18

Bacterial infections associated with snake bites

Secondary flora wounds are rare because venom is sterile.

19

Things to not do when bit by a snake? What should you do?

Suck out the venom, apply a tourniquet, place ice packs. You should give anti-venom, first aid and ceftriaxone + clavulanate empirically.

20

Pathogens associated with monkey bites

Staph, strep, eikenella, Herpes B virus

21

Symptoms associated with herpes B virus after a monkey bite?

Reactivation, vesicular lesions, paresthesias, seizures, respiratory failure. (80% fatality rate)

22

Tx for person exposed to herpes B virus after a monkey bite

Prophylactic acyclovir if pregnant, valacyclovir for others (can be life-long). IV if CNS involved.

23

3 phases of rabies

1) Flu-like illness, prickling at bite site 2) Agitation, delirium 3) Coma death

24

Diagnosing rabies

1) Salive PCR 2) Neck biopsy (nerves) 3) Serum immunoassay 4) CSF immunoassay

25

Animal bites that merit immediate rabies prophylaxis

Skunks, raccoons, foxes and bats.  Give RIG if not previously vaccinated. Revaccinate if previously vaccinated, don’t give RIG if previously vaccinated.

26

Path of infection by clostridium tetani?

Spores enter wound, germinate and make toxin that causes muscular spasms and seizures.

27

Tx for tetanus

TIG, toxoid booster, antibiotics (penicillins or metronidazole). Give prophylaxis TIG and toxoid vaccine if immunization hx is unclear. Don’t give TIG if immunizations are clear and current.