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69 Cards in this Set
- Front
- Back
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what is the Yellow Book |
CDC Health Information for International Travel |
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where is enterococcus usually found and what is its pathogenicity what is tx how is it spread |
-nl found in GI & female GU tract -pathogenic when translocates out of gut into blood or is contiguously spread to GU tract -tx with ampicillin, vance, daptomycin (in that order according to resistance) -spread person to person |
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what rash occurs in scarlet fever? |
diffuse erythematous papular rash with blanching "sandpaper" |
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Erysipelas bacteria? where on body? what rash? tx? |
-GAStrep -on face -macular erythematous lesion, flaccid bullae, superficial cellulitis -PCN, cephalosporin, Macrolide |
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Impetigo bacteria? what rash? tx? |
-strep pyogenes = MC, staph = bullous impetigo -thick crusty, honey yellow lesions -bactroban ointment or PO |
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Necrotizing Fasciitis bacteria? what sx? tx? |
-polymicrobial -fournier gangrene -pain out of proportion of PE, erythema, anxiety , sweating, crepitus, bull, discoloration, discharge, systemic toxicity -EMERGENT surgery |
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Toxic Shock Syndrome bacteria? what sx? tx? |
-strep and staph from vaginal foreign bodies -macular erythrodermic rash, fever, HOTN, GI renal hepatic stress, myopathy, TCP -abx/support |
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bad bugs, no drugs pneumonic |
NO ESKAPE
Enterococcus faecium Staphylococcus aureus Klebsiella pneumoiae Acinetobactor spp Pseudomonas aeruginosa Enterbacter spp
Clostridium difficile Enterbaterfacase?
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Botulism bacteria? spread? what sx? dx? tx? |
-Clostridium botulinum -honey to infants increases risk -visual changes, diplopia with loss of accommodation (36h), CN palsies, dysphonia, dry mouth, dysphagia, n/v, mental status changes, respiratory depression or failure -mouse antiserum -support for respiratory failure, alimentation support, anti-toxin thru CDC |
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Anthrax bacteria? spread? what sx? dx? tx? |
-Bacillus anthracis -inoculation or inhalation (terrorism and farm animals) -derm: painless vesicular lesion with central eschar pulmonary: cough, congestion, PNA,mediastinitis -fluoroquinolone |
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Cholera bacteria? spread? what sx? dx? tx? |
-Vibrio cholerae -contaminated food and water (areas of disaster, famine & poor hygiene) -profuse "rice water" diarrhea, no blood, dehydration, electrolyte abnl, HOTN -stool culture and assay -fluids, bactrim, quinolone, temporary vaccine booster q 6mo |
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Tetanus bacteria? what does it do? what sx? tx? |
-Clostridium Tetani (spores in soil) -neurotoxin = tetanospasm; inhibits transmission of inhibitry neurons causing uncontrolled UMN signs -pain at site of inoculation, spasticity, truisms, neck stiffness, hyperreflexia, opisthotonos (severe back hyperextension/spasticity), tonic convulsions, spasm of respiratory muscles, NO mental status changes -tetanus immunoglobulin IM; intubation, sedation, PCN
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Salmonellosis (3 subtypes) bacteria? spread? onset? what sx? dx? tx? complications? |
-Salmonella enterica
Enteric Fever (Typhoid) -ingestion of contained food/water (chlorination eradicated disease in USA) -5-14h -abd pain, pea soup diarrhea, no blood, fever, bradycar, splenomegaly, pink papular rash on trunk -blood cultures early -fluoroquinolone; immunize high risk pts -intestinal rupture, inflame of multiple organs
Gastroenterititis -undercooked chicken. contact with reptiles -8-48h -fever, vomiting, bloody diarrhea -stool culture -quinolone
Bactermia -prolonged fevers, seed other sites -IC -quinolone; look for source of ongoing infx
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Shigellosis bacteria? what sx? dx? tx? |
-S. sonnei, S. flexneri, S. dysenteriae -diarrhea, cramps, tenesmus, cramps, fever, dysentery, hematechezia -HLA-B27 (reactive arthritis), stool cultures, fecal leukocytes -fluids, electrolytes, bactrim, fluoroquinolones |
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Diptheria bacteria? spread? what sx? tx? complications? |
-Corynebacterium diphtheriae -respiratory droplets and release exotoxin -laryngeal infx -> airway obstx; pharyngeal infx MC (grey tenacious membrane covers tonsils and pharynx) -bactrim, erythromycin, antitoxin, immunization, pt is isolated til 3 -pharyngeal cultures -myocarditis, neuropathy |
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Neisseria gonorrhea bacteria? spread? onset? what sx? tx? |
-gram- intracellular diplococcus -sexual -2-8d -men: urethra discharge, pain, blood->prostatitis, epididymitis; women: purulent cervical discharge, dysuria, vaginitis->PID; bacteremia: septic arthritis, skin lesions, conjunctivitis -ceftriaxone +/ azithromycin |
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Neisseria meningitidis bacteria? spread? RF? what sx? dx? tx? |
-gram- intracellular diplocci -salivary and respiratory droplets - peds <5, teens, africans, college students living in dorms -meningitis, bacteremia, sepsis, DIC, waterhouse-friderichsen syndrome -direct isolation: CSF, blood; GS&culture, PCR -PCN G, ceftriaxone, chloramphenicol, adjuvant dexamethasone; Menactra vaccine; prophylaxis=rifampin or cipro |
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Ehrlichiosis bacteria? spread? what sx? dx? tx? |
-gram- obligate intracellular bacteria (anaplasma phagocytophilium, Ehrlichia chaffeensis) -lone star tick -flu like -. encephalitis, ARF -TCP, leukopenia, elevated LFTs, blood smear: morula (intracytoplasmia vacuoles containing organism) -doxycyclie or rifampin
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Chlamydial Infections bacteria? what sx? tx?
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-C. psittaci: psittacosis from birds/parrots, C pneumoniae: atypical pneumonia, C. trachomatis: trachoma, PNA, STD -Lymphogranuloma venereum: ulcer->inguinal buboes->breakdown with sinus tracts, proctitis with tenesmus, discharge, fistula Uretheritis/cervicitis: watery urethral discharge and pain in men, cervicitis, PID, infertility |
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Pasturella |
cat bites tx = augmentin |
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Eikinella |
human bites (HACEK IE) tx = augmentin |
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Bartonella henselae |
cat scratch disease in kids tx = macrolide |
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Bartonella quintana |
pediculosis, rare cause of IE bacillary angiomatosis in AIDS pts |
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Candidal Infections |
-C. albicans = MC -C. krusei - azole resistant -C. galbrata - azole resistant -C tropicalis - hgih MIC to micafungin -C. parpsolosis - azole senstivie, concerns with Micafungin -C. lusitaniae -C dubliniensis - azole resistance in AIDS pts
IC is main risk factor! |
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candidemia RF |
neutropenia burn pts NICU pts chemotherapy AIDS chronic corticosteroids IVDA broad spectrum abx |
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cutaneous disease of candidia |
diaper dermatitis/candidal dermatitis - dark moist areas: axillae, breasts, pannus -pink papules, vesicles with satellite lesions tx = topical antifungal (lotrimin, miconazole) |
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mucosal disease of candida |
thrush- white plaques easily scraped off with bleeding esophagitis- odynophagia in IC tx = PO flucoazole/nystatin |
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Histoplasmosis fungi? spread? what sx? dx? tx? |
-H. capsulatum -soil with bird dropping in mississippi and ohio -fever and prostration -anemia, elevated alk ph and LDH, pancyopenia, urine antigen +, compliment fixed titers, fungal blood cultures -amphotericin followed by Itraconazole x1yr, lifelong IC |
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Cryptococcus fungi? spread? what sx? dx? tx? |
-C. neoforms -soil with pigeon dung -pulmonary disease, cryptococcal meningits, disseminated disease (multiple organs and cutaneous lesions), cyptococcoma -CSF pleocytosis, culture, serum antigen testing (India Ink stain), elevated opening pressure on LP -amphotericin IV, APAP, benadryl, followed by fluconazole for life
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Pneumocystitis jiroveci fungi? spread? what sx? dx? tx? |
-opportunistic fungal infx -MC infx or advanced HIV -fever, severe, dyspnea, nonproductive cough, low O2 -CXR: diffuse interstitial infiltrates or nl, spontaneous PTX, ABG: hypoxia, hypocapnia, reduces CO2 diffusion, elevated LDH, silver stain -bractrim IV x21d, dapsone- AE anemia |
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RF for oropharyngeal candidiasis
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IC dentures chemo previous abx |
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vulvovaginal candidiasis RF? sx? dx? tx? |
-extremes of age, prego, uncontrolled DM, steroids, HIV -pruritus, burning, dyspareunia, white cottage cheese discharge -KOH prep -diflucan (fluconazole), miconazole |
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Fungemia RF? sx? tx? complications? |
-IC, indwelling lines, FB material -RUQ pain, fever, nausea, elevated alk phos -tx: IV amphotericin + flucytosine -endocarditis, abscess, endopthalmitis, enchephalitis, hepatosplenic disease |
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Invasive Candidial Infections -spread? -where? -tx? |
-jt or bone infx -usually from hematogenous spread -peritonitis, PNA, empyema, mediastinitis, pericarditis, -Tx: amphotericin, micafungin |
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Aspergillus fungi? syndromes? tx? |
-Aspergillus niger (black mold) -Allergic Bronchompulmonary Disease, Aspergilloma (myetoma = fungus ball), Invasive (fever, hemoptysis) -Ampotericin aspergilloma tx = oral azole, surgical resections, intracavitary amphotericin |
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Blastomycosis what is it similar to? dx? |
similar syndrome to histoplasmosis dx: KOH prep |
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Sporothrix fungi? spread? sx? dx? tx? |
-Sporothrix schenckii -in soil; gardeners and Rose Handlers Disease -spreading papular and nodular lesions that ulcerate along lymphatic lines -staining, culture, and molecular methods -azoles for cutaneous disease |
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Atypical Mycobacterial Disease spread? sx? RF? dx? tx? |
-water, dust, soil -cough, dyspnea, malaise, fever, hemoptysis, wt loss, abd complaints -chronic lung disease, AIDS pts -CXR: nodules and bronchiectasis, AFB staining, biopsy -Clarithromycin + Ethambutol x12mo |
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NTM infx |
MC to pul disease = atypical mycobacterial disease M. kansasii: similar to TB M. marinum: skin infx form aquariums rapid growers: M. fortuitum, M. chelonae, M. abscessus |
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Leprosy fungi? spread? what sx? dx? tx? |
-Mycobacterium leprae -contact with armadillos, genetics, close contact, older age -chronic skin lesions, paresthesia, cutanseous lumps, nodules, claw fingers, foot drop, lack of eyebrows/lashes, lion facies -skin biopsy, PCR -dapsone x 2yrs |
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Malaria parasite? spread? what sx? dx? tx? |
-p. vivax, p malariae, p ovale, p falciparum -mosquito or vertical transmission -shaking chills, fever paroxysms (hot stage), jaundice, fatigue, GI distress, HA, myalgia, arthralgias, cough -elevated transaminases, TCP, anemia, elevated scr, leukocytosis or leukopenia, blood smears with Giemsa stain q8h x3d -chloroquine (1st line), IV quinine + doxycycline, mefloquine (rx and prophylaxis) |
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which malaria parasite is the worst |
P. falciparum- causes cerebral malaria |
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Amebiasis parasite? spread? what sx? dx? tx? |
-Entamoeba histolytica -human to human or fly dropping or contaminated soil and wate: poor sanitation, tropics, poor nutrition, creeks/streams -dysenteric colitis (bloody diarrhea), prostration, tenesmus, colic, vomiting, lots of complications -stool for O&P revel cysts or trophozoites, colonoscopy, CT/ultrasound, leukocytosis withOUT eosinophilia -supportive, flagyl + amebicide (dilozaninde), surgical drain + chloroquine |
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Hookworms (Ancylostomiasis) spread? what sx? dx? tx? |
-dogs, fecal, through skin, cough up and swallow -pruritic skin lesions (dermatitis), cough, wheeze, bloody sputum, low grade fever, anemia -eggs on stool culture, + stool occult blood, iron def anemia -mebendazole or albendazole x 3d, ferrous sulfate, supportive |
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Pinworms spread? what sx? dx? tx? |
-hands, formats,food, daycares -perianal pruritis, insomnia, enuresis, wt loss -scotch tape test -albendazole (albenza) and have to tx contacts
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Tapeworms spread? what sx? dx? tx? |
-beef, fish, pork all undercooked -asx, FTT, anemia, nausea, abd pain, passage of worm -eosinophilia, passage or obtainment of proglottids, c-scope -praziquantel
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Strongloiasis what paraiste? spread? what sx? dx? tx? |
-nematode/roundworm -similar to hookworms -asx, GI syndrome or cough and wheezing -eosinophilia, stool O&P -ivermectin x 2d |
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Ascariasis what parasite? spread? what sx? dx? tx? |
-round worm -contaminated soil by animals/human feces -anemia abd pain, FTT, SBO -albendazole, pyrantel pamoate in pregnancy |
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Cryptosporidiosis protozoa? spread? what sx? dx? tx? |
-Cyclosporsosis, Isosporosis protozoal species -swimming pools -water diarrhea, nausea, low grade fever, asx -modified AF stain of stool -restore CD4 counts (IC), nitazoxanide or paromomycin combo with azithromcin, HAART
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Giardiasis = MC in USA protozoa? spread? what sx? dx? tx? |
-Giardia lambia -person to person, sexual, contaminated fresh water, travel -abd cramping, flatulence, diarrhea, foul smelling greasy fatty stools -stool for O&P, no fecal WBCs or blood -flagyl, albendazole, water boiling, test contacts |
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Toxoplasmosis paraiste? transmission? who gets it? sx? dx? tx? |
-Toxoplasma gondi (obligate intracellular parasite) -in soil, consume undercooked meat, cat contamination, vertical, organ or bone marrow transplant -IC (and prego?) -encephalitis: multiple necrotic brain lesions, altered mentation, focal neurological deficits; pulmonary: cough, dyspnea; Chorioretinitis: ocular pain, visual changes; Myocarditis&pericarditis -serologic on body fluids, contrast enhanced CT or MRI (multiple ring enhancing lesions around corticomedullary junction and basal ganglia), brain biopsy -bactrim DS PO qd 4-6 wks with life long maintenance |
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Epstein-Barr Virus type? spread? what sx? dx? tx?
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-HHV-4 -salivary route -Mono: pharyngitis, malaise, palatal petechiae, lassitude, myalgias, nontender post. LAD, splenomegaly -leukocytosis, atypical lymphocytes, monospot -supportive, concurrent GABHS give macrolide, avoid contact sports, steroids for severe pharyngitis |
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Rabies type? spread? incubation? what sx? dx? tx? |
-retrovirus -saliva to open wound through bats, raccoons, skunks, foxes, and coyotes are MC -3-7wk -pian, paresthesia, sensitivity to bite site, restlessness, muscle spasms, bizarre behavior, seizure, thick tenacious saliva, paralysis (10d after sx), hydrophobia (severe spasms with drinking water) -test animal brain for viral abx, CSF RT PCR, MRI -supportive, rabies immuoglobulin, interferon alpha, ribavirin, keatmine |
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prevention of rabies |
-pet immunization, control bats -local wound care, no suturing of bites -post-exposure immunization: rabies immunoglobin the wound and vaccine -if possible bite give vaccine not immunoglobulin -give HDCV d 0, 3, 7, 14, 28
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Cytomegalovirus (CMV) type? spread? incubation? what sx? dx? tx? |
-HHV-5 -respiratory or bodily fluid exchange in HIV, neonates, transplant pts, oppotunistic infx -asx, preinatal CMV, acute CMV (flu-like), a TORCH infx, retinitis (blindness), neurologic, GI, pulmonary -lymphocytosis, serologies/PCR, tissue biopsy (owl eye) -leukocyte reduced/irradiated blood products, CMV IG & IV gancyclovir=1st line, valganciclovir (oral), cidofovir, foscarnet, HAART |
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Progressive Multifocal Leukoencephalopathy type? spread? what sx? dx? tx? |
-JC virus (John Cunningham) -childhood disease in IC -progressive ataxia, aphasia, hemipelegia, visual deficits, AMS,seizure, cranial nerve palsies, death -PCR, MRI -reduce IC, cidofovir, plasma exchange |
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BK Virus type? spread? what sx? dx? tx? |
-opportunist infx -transplant pts -hemorrhagic cystitis in BMT pts, graft failur in renal transplants -PCR of urine or blood -reduce IC, intravesicular or IV cidofovir |
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West Nile Virus type? spread? what sx? RF? dx? tx? |
-flavivirus, arbovirus -mosquitos -asx, flu-like, non-specific viral syndrome, meningitis, encephalitis -older, DM, EtOH abuse, IC,malignancy, renal disease -IgG & IgM antibodies, CSF PCR -supportive, ribavirin, interferon, immunoglobulin, corticosteroids
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Lyme Disease virus? transmission? endemic to? stages? dx? tx? |
-Borrelia Burgdoferi -deer tick: Ixodides scapularia -upper east coast -Early: erythema migrans (3-4wk) Early Disseminated: HA, malaise, jt issues, pericarditis, neurologic sequela (d-wk) Late Persistant: arthritis, encephalopathy with memory loss and mood changes, polyneuropathy (mo-yrs) -ELISA with western blot -doxycycline, amoxicillin for peds |
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Rocky Mountain Spotty Fever type? spread? what sx? dx? tx? |
-Spirochete: rickettsia, riskettsii -american dog tick in eastern and SE USA in late spring and summer -fever, rigors, HA, n/v, conjunctivitis, cough, faint MP rash on wrists/ankles then spreads proximal to palms/soles -serologies, skin lesion biopsy -doxycycline 5-7d |
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Fever of Unknown Origin (FUO) type? what sx? ddx? |
-infx (MC): syphilis, SBE (endocarditis), myocarditis -3wk of fever >38.3 and no one knows why -neoplasm, autoimmune, mediterranean fever, drug fever, transplant rejections, sarcoidosis, 15% go un-dx |
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Plague type? spread? what sx? dx? tx? |
-Yersinia pestis -bites of infected fleas, scratches of infected animals, inhalation of aerosols, contaminated food -bubonic: fever, focal LAD, meningitis; septic: no bubos, meningitis, tissue necrosis; pulmonary: sever dyspnea, cough, hemoptysis -specific strains, culture, serologies -streptomycin, gentamicin, chloramphenicol |
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Hantavirus type? spread? what sx? dx? tx? |
-RNA virus -rodent host -non-cardiogenic pulmonary edema, HOTN, ARF, MSOF, shock, acute dyspnea, shock -hematologic & electrolyte derangements, hepatits, lactic acidosis, elevated CK, +DIC panel, PCR for viral RNA -droplet isolation & lab protocols, cardiopulmonary disease needs MV, supportive, ribavrin |
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Ebola type? spread? what sx? dx? tx? |
-filovirus -body fluids, bats and monkeys -viral hemorrhagic fever,tissue necrosis, fever, pharyngitis, bilat conjunctivitis, petechial/purpuric rash, hematomas, lethargy, DIC, exsanguination, carditis, seizures, pulmonary edema, MSOF, shock & death -2 rapid ruien and serum assays, IgM & IgG serologies, RT-PCR, tissue culture, hematologic and metabolic derangements -supportive |
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Dengue type? spread? what sx? dx? tx? |
-RNA virus of Flavivirus -aedes aegypt (female mosquito) in caribbean, south america, south/east asia -myalgias, HA,malaise, arthralgia, "breakbone fever", petechiar, ecchymosis, hematemesis, hemorrhagic shock -leukopenia,TCP, elevated LFTs, elevated ESR, hyponatremia, RT-PCR, ELISA -supportive, fluids, APAP, ICU, avoid ASA and NSAIDS |
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Traveler's Diarrhea type? spread? tx? |
-nonhemorrhagic E. coli -poor sanitation and poor water -self-limiting, lomotil, chipper
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Tick-bourne Encephalitis virus? transmission? sx? dx? tx? |
-RNA virus -Ixodes ticks and mouse reservoir -acute febrile illness with CNS findings (aseptic meningitis, encephalitis, or myelitis) -history to travel, CNS signs within 4wk, ELISA- serum IgG -supportive |
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Trypanosomiasis parasite? sx? dx? tx? |
African Sleeping Sickness -Trypanosoma brucei, tsetse fly -high fever, chancre, rash, TCP, CNS changes, renal failure, CHF. disrupted sleep pattern (1-3wk) -blood smear, lymph tissue (see parasites), CSF eval -anti-trypanosomal therapy depending on stage (suramin, melarsoprol, eflornithine) |
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Schistosomiasis parasites? transmission? sx? dx? tx? |
-S. mansoni, S. japonicum, S. haematobium -larvae from fresh water: penetrates skin and seeds bladder -febrile illness, diarrhea, rash, bladder calcifications, MC bladder CA worldwide -eosinophilia, see eggs in stool or urine -Praziquantel |
