Term
| Bacterial/Purulent Meningitis |
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Definition
| Epidemiology: -Community-acquired -18-50 yrs:Strep pneumonia, Neisseria meningitides ->50 yrs:Strep pneumonia, Neisseria meningitides, Listeria monocytogenes, gram negative bacilli Presentation:headache, fever, sensorial disturbances (ex: light/noise sensitivity), neck and back stiffness, positive Kernig & Brudzinski signs, and cerebrospinal fluid abnormalities, sometimes seizure. Diagnosis: blood count, blood culture, lumbar puncture for culture of CSF, chest film Treatment: - Begin antibiotics immediately (life threatening). - 90 min-2hr window after antibiotics for LP. - Supportive care (hydration, pain meds, anticonvulsants, antiemetics). |
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Term
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Definition
| Epidemiology - Herpes simplex virus, enterovirous group , Epstein Barr virus, Adenovirus. -Hand-to-mouth contact, coughing, fecal matter - Drug-induced aspetic meningitis has been reported with NSAIDs, sulfonamides Presentation: headache, fever, sensorial disturbances (ex: light/noise sensitivity), neck and back stiffness, positive Kernig & Brudzinski signs, and cerebrospinal fluid abnormalities, sometimes seizure. Diagnosis blood count, blood culture, lumbar puncture for culture of CSF, chest film Treatment -Symptom control (rest, nutrition, fluids, pain meds) |
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Term
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Definition
| Epidemiology: - Herpesviruses, arboviruses, rabies virus, flaviviruses, West nile -Respiratory, contaminated food/drink, insect bite, skin contact Presentation:headache, fever, sensorial disturbances (ex: light/noise sensitivity), neck and back stiffness, positive Kernig & Brudzinski signs, and cerebrospinal fluid abnormalities, sometimes seizure. - Often have altered mental status (ASM) Diagnosis: blood count, blood culture, lumbar puncture for culture of CSF, chest film -CSF may be entirely normal. Treatment: -Symptom control (rest, nutrition, fluids) |
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Term
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Definition
| Epidemiology: - Polymicrobial (S aureus, gram-negative bacilli, streptococci) and anaerobes. - Reach brain through blood -Most common source is lung infection less often, heart. -May enter body through injury (ex: gun shot, surgery) Presentation: -Presents as a space-occupying lesion. headache, fever, sensorial disturbances (ex: light/noise sensitivity), neck and back stiffness, positive Kernig & Brudzinski signs, and cerebrospinal fluid abnormalities, sometimes seizure. Diagnosis: CT Scan No LP b/c risk of brainstem herniation Treatment: -Broad spectrum antibiotics -Possibly surgery |
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Term
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Definition
| Epidemiology: -Neisseria Meningitidis -frequently lives in a person's UR tract without causing visible signs of illness. -Spread through respiratory droplets -Occurs more frequently in winter and early spring Presentation: headache, fever, sensorial disturbances (ex: light/noise sensitivity), neck and back stiffness, positive Kernig & Brudzinski signs, and cerebrospinal fluid abnormalities, sometimes seizure. -Petechial rash, hypotension, shock/sepsis Diagnosis: blood count, blood culture, lumbar puncture for culture of CSF, chest film Treatment: -Respiratory isolation for 24 hrs -IV Antibiotics & IV fluids -Breathing support -Clotting factors or platelet replacement -Medications for low BP -Wound care |
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Term
| Human Herpesvirus/ Herpes Simplex 1&2 |
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Definition
Epidemiology:
-Close personal contact via innoculatoin into susceptible mucosa (i.e., oropharynx, genitalia, cervix, conjunctiva/cornea, esophagus, rectum
Presentation:
-Dysuria, Pain, Itch, "rash" (multiple tender vesicles on erythematous base which ulcerate), Fever, HA, malaise, myalgias
-80% of infections are asymptomatic
Diagnosis:
-Viral culture or PCR assay to confirm
Treatment:
-Initial outbreak: Valcyclovir 1000mg bid x 7-10 days or Famiciclovir bid or Acyclovir tid-5x/day for 10 days (recurrences treated with smaller doses and fewer days) |
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Term
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Definition
Epidemiology:
-Recurrence of the varicella virus if the patient previously had chickenpox
Presentation:
-Painful, vesicular rash (grouped erythematous base) following dermatomes
-Can lead to postherpetic neuralgia
Diagnosis:
-No lab confirmation necessary.
-Dx by visual acknowledgment of unilateral, dermatomal rash becoming vesicular after 24-48 hrs.
Treatment:
-Oral antivirals (such as acyclovir, famiciclovir, or valacyclovir). Also, steroids and pain medication. |
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Term
| Infectious Mononucleosis (HHV-4) |
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Definition
Epidemiology:
-Oropharyngeal secretions (“kissing disease”)
Presentation:
-Fever, Pharyngitis, Lymphadenopathy (especially posterior cervical), Fatigue, Possible rash`
Diagnosis:
-Clinical or lab (CBC, Monospot, strep testing)
Treatment:
-Supportive (analgesic/antipyretic medications, steroids if significant tonsillar hypertrophy) |
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Term
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Definition
Epidemiology:
-Sexual contact, breastfeeding, blood products, transplanted organs, person-to-person, congenital
-60% of US population has been exposed
Presentation:
-asymptomatic, fever, sore throat, fatigue, lymphoadenopathy
Diagnosis:
-PCR or viral culture
Treatment:
-HAART (highly active antiretroviral treatment) or Ganciclovir |
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Term
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Definition
Epidemiology:
Respiratory
Presentation:
-Abrupt onset of fever, chills, dry cough, malaise/myalgias, coryza, fatigue
Diagnosis:
-Clinical during epidemic time
-Antigen detection of nasal secretions
Treatment:
-Antiretroviral meds (oseltamivir, zanamivir) or Vaccine |
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Term
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Definition
Epidemiology:
-Signs of an upper motor neuron lesion, CSF protein and opening pressure often increased, with lymphocytic pleocytosis
Presentation:
-Fever, malaise, sore throat, headache, gastrointestinal upset, lethargy
-Stupor progressing to coma.
Diagnosis:
-Testing of serum or CSF
Treatment:
-Reduction of intracranial pressure, monitoring of intraventricular pressure.
-Mostly supportive with maintenance of respiratory and circulatory support |
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Term
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Definition
Epidemiology:
-Rare in humans
-Cognitive decline, myoclonic fasciculations, ataxia, visual disturbances, pyramidal and extra pyramidal
Presentation:
-Usually present in the sixth or seventh decade of life
-Typical clinical picture is dementia that progresses over several months.
Diagnosis:
-Creutzfeldt-Jakob disease (“mad cow disease”): Rapidly progressive dementia, Ataxia
Treatment:
-Flupirtine may slow cognitive decline but does not affect survival.
-Non-treatable, and fatal in humans. |
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Term
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Definition
Epidemiology:
-Flavivirus from mosquito bite
Presentation:
-High fever, chills, “bone breaking” aching head, back and extremities. Pharyngitis, dehydration, malaise, rash
Diagnosis:
-Antibody titer for dengue virus types, CBC, PCR
Treatment:
-Symptom control.
-Fluids if dehydrated, Acetaminophen with high fever |
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Term
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Definition
Epidemiology:
-Rodent-borne; inhalation of urine and feces
Presentation:
-Similar to Dengue (chills, fever, myalgia, etc)
Diagnosis:
-CBC, CMP, CXR, Kidney/Liver function tests
Treatment:
-O2, breathing tube in severe cases |
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Term
| Rocky Mountain Spotted Fever |
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Definition
Epidemiology:
-Bite of infected tick
-Infects endothelial cells lining blood vessels & can be fatal within 1 week without treatment
Presentation:
-Fever, Rash (90% of cases), HA, N/V, ABD pain, myalgias, lack of appetite, conjunctival injection
Diagnosis:
-Early antibody testing negative (serial titers at 0 - 4 wks)
Treatment:
-High index of suspic --> treat presumptively (100mg Doxycycline BID x 2wks) |
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Term
Tick-Borne Illness
(-Many diff. types:
Anaplasmosis, Babesiosis, Ehrlichiosis, Lyme Disease, Rickettsia, RMSF, STARI, TBRF, Tularemia, 364D Rickettsiosis) |
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Definition
Epidemiology:
-Bite of various tick (depends on kind of illness…many different ones)
Presentation:
-Fever, chills, HA, fatigue, Myalgias, Joint pain (lymes), Rash (Lymes & STARI 70-80% erythema migrans)
Diagnosis:?
Treatment:
-Doxycycline 14 - 21 dys. Amoxicillin in children.
-Duration of tx may depend on stage of dx for Lyme |
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Term
| Strep Pharyngitis (gram +/Cocci) |
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Definition
Epidemiology:
-Transmission occurs by droplets of infected secretions
-Increase spread in Winter (More time indoors)
-Family exposure: 40% risk of infection
-Toothbrushes, orthodontic appliances, and pets may carry/spread
Presentation:
-Fever, sore throat / dysphagia, tender cervical lymphadenopathy
-Stomach ache in children, nausea
-Red, edematous pharynx, tonsils, and soft palate
-Purulent exudate, tonsilar hypertrophy
-Petechiae on palate, strawberry tongue
Diagnosis:
-Throat culture (24-48 hour turn around; Gold standard; Sensitivity 90–95%; Sampling dependent)
-Rapid antigen tests
-Centor Criteria:Assign one point for each
•Hx of fever
•Tonsillar exudates
•Tender anterior cervical adenopathy
•Absence of cough
(The Modified Centor Criteria also adds patient's age )
Treatment:
-Most cases will resolve in 3-5 days w/o treatment
-Penicillin V, Amoxicillin, Penicillin G, Azithromycin, cefdinir, and cefpodoxime IgE |
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Term
| Enterococcal Infections +/Cocci |
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Definition
Epidemiology:
-Wound Infections
-Health-care associated infections
Presentation:
-UTI, Endocarditis
Diagnosis:
Labs
Treatment:
-High multi-drug resistance
-Often treated with Linezolid |
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Term
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Definition
Epidemiology:
-Most common bacterial cause of community-acquired penumonia
Presentation:
-Sinusitis, otitis media, meningitis, brain abscess, septic arthritis, fever/rigors
Diagnosis:
-CBC/differential Chemistry
-Blood & sputum cultures
-Chest X-ray (pleural effusion)
Treatment:
- Fluroquinolone, Levafloxacin, moxifloxacin
- Azithromycin + ceftriaxone, dependent on local resistance, etc.
-Antipyretics |
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Term
| Staphylococcus Infections +/Cocci |
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Definition
Epidemiology:
Skin-to-skin and skin-to-fomite contact
Presentation:
-Skin Infections
MSSA (methicillin-sensitive) and MRSA (methicillin-resistant) Staph aureus
-Folliculitis, Furuncles/boils, Impetigo (bullous)
Diagnosis:
-Endocarditis, osteomyelitis, pneumonia
-Food poisoning
-Urinary tract infection
Treatment:
-Incision and drainage depending on the MRSA (CA or HA)
-Outpatient and Inpatient antibiotics (Inpatient antibiotics if failed out-patient therapy) |
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Term
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Definition
Epidemiology:
-Serious infections
-Surgical wounds, catheters, IV lines, ventilators
Presentation:
-A red, swollen, painful area on the skin, abscess, boil, or pus-filled lesion
-May be accompanied by fever and warmth around the infected area.
-More serious infections: chest pain, chills, fatigue, headache, muscle aches, and rash.
Diagnosis:
-Blood culture, drainage from the infection, skin culture, sputum culture, or urine culture
Treatment:
-Multi-drug resistant, Vancomycin (is becoming resistant to)
- Linezolid, datomycin, tigecycline, some sort of antibiotic |
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Term
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Definition
Epidemiology:
-Mostly non-serious but recurrent.
-Skin-to-skin, wounds, contaminated surfaces, crowded conditions.
-Young healthy people.
- Skin and soft tissue infection, bone and joint infections.
Presentation:
-Pustules/ boils/ +/- cellulitis, may itch, red, swollen, painful, purulent/serpurulent drainage. (may be mistaken for spider bite) warm to touch, may contain pus
Diagnosis:
-Culture and test from drainage of the infection, perform D-test, skin culture, blood culture
Treatment:
-RESISTANT to PENICILLINS AND CEPHALSPORINS!!
-Treated with Vancomycin (IV), sulfamethoxazole, doxycycline, |
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Term
Clostridial Myonecrosis
+/Bacilli, anaerobic
(“Gas Gangrene”) |
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Definition
Epidemiology:
-Clostridium perfringens (80-90%), Cramosum, C bifermentans, Chistolyticum, C novyi.
-Common predisposing conditions: trauma and injection drug use.
Presentation:
-Pain after trauma or post-op
-Sudden onset, tachycardia, hypotension, Gas in tissue on palpation, brown to blood-tinged watery exudate (with skin discoloration of surrounding area), slight fever
-can be fatal in 12 hrs
Diagnosis:
-1st: R/O bone infection
-2nd: rule out gas in the tissue with radiograph. -Radiograph is not specific so must do culture of smear of exudates to look for gram + rods.
Treatment:
-Surgical debridement
-Oxygen (Hyperbaric therapy)
-Empirical antibiotics
(Penicillin G, Clindamycin,
Chloramphenicol) |
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Term
Clostridium Difficile Colitis
+/Bacilli, anaerobic
(“C-diff”,
Pseudomembraneous colitis, or
Antibiotic-associated diarrhea / colitis) |
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Definition
Epidemiology:
-C difficile
-Common healthcare-associated infection usually occurs with use of antibiotics (wiping out normal flora in intestines)
Presentation:
-Presence of Pseudomembrane
(Adherent, yellowish plaques on intestinal mucosa)
-Mild-to-moderate diarrhea,
Cramping abdominal pain, Anorexia, Malaise,Fever
Diagnosis:
-Stool sample and culture
Treatment:
-Metronidazole (Growing resistance)
-Oral vancomycin (does not absorb, only local effects in the bowel) |
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Term
| Infective Endocarditis +/Cocci (Infection of the valvular or endocardial surface of the heart) |
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Definition
| Epidemiology: -Staph aureus -Rare: streptococcus,enterococcus, Fungal, gram negatives -Procedural causes of bacteremia: Endoscopy,Colonoscopy, Barium enema, Dental extractions, Transurethral resection of the prostate, Transesophageal echocardiography Presentation: -Fever and chills, Anorexia / weight loss, Chest pain, Shortness of breath, Malaise,Headache, Myalgias / arthralgias, Night sweats -Congestive heart failure (Due to valvular insufficiency), -Focal neurologic complaints(Embolic stroke -Back pain (Vertebral osteomyelitis) -peripheral lesions (petechiae and subungal –splinter hemorrages under fingernails. Diagnosis: -Blood cultures -Echocardiogram Treatment: -Pts should be prophylaxed b4 procedures -4-6 weeks IV antibiotics: Penicillin G, Ceftriaxone, Vancomycin -Others: Empiric initially, Adjusted for culture results |
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Term
| Haemophilus Influenza -/coccobacilli |
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Definition
Epidemiology:
-H.Influenzae
-Direct contact, Inhalation
Presentation:
•Sinusitis, otitis, bronchitis (COPD), epiglottitis, pneumonia, meningitis
Diagnosis:
•Many strains non-encapsulated / non-typeable
•Bacterial culture
Treatment:
•Amoxicillin first line non-serious infections
•Beta-lactamase producing strains
•Resistant to beta-lactam antibiotics
•Sensitive to Cephalosporins (later generation > 1st generation)
•Macrolides, Fluroquinolones |
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Term
Sepsis
(Systemic inflammatory response syndrome – SIRS) |
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Definition
Epidemiology:
- An illness in which the body has a severe response to bacteria or other germs.
-Germs do not cause symptoms; chemicals the body releases cause the response
-May begin anywhere but common places: bloodstream, bones, bowel, kidneys, brain, liver, gallbladder, lungs, skin
-IV lines, surgical drains, ulcers.
Presentation:
-Change in mental status and very fast breathing may be earliest signs
-Decreases BP resulting in shock
-Major organs and CNS stop working
-Chills, fever or hypotheramia, light-headedness, rapid HR, shaking, rash, warm skin, bruising.
Diagnosis:
-Blood culture, blood gases, kidney function test, platelet count, WBC count
Treatment:
- IV antibiotics
-Oxygen and IV fluids
-Medications to increase BP
-Dialysis if kidney failure
-Mechanical ventilation if lung failure |
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Term
| Mycoplasma Pneumoniae -/Rod |
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Definition
Epidemiology:
Mycobacterium
Presentation:
-Myalgias, fever, cough, sore throat, headache, chills, nasal congestion, earache
Diagnosis:
-Chest X-ray
Often more severe than clinical condition
Diffuse or interstitial infiltrates
Unilateral or bilateral
Lobar consolidation unusual
Treatment:
-Macrolides, Tetracyclines
Fluroquinolones |
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Term
| Chlamydial Infections -/Rod |
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Definition
Epidemiology:
C trachomatis & Chlamydophila
Presentation:
- STD 5-21 days incubation
- Genital ulcers that disappears, infection can spread to lymph nodes and rectal area, Conjunctivitis (leading cause of blindness), urethritis and cervicitis in women
-75% of women asymptomatic
Diagnosis:
-Vaginal swab
Treatment:
-Cervicitis / urethritis:
Doxycycline
Azithromycin
Levofloxacin
-Treat for gonorrhea also
-HIV and syphilis testing recommended |
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Term
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Definition
Epidemiology:
- Escherichia Coli (Normal GI flora)
-Fecal-oral route, direct contact, inhalation
- Most common pathogen in urinary tract infections,
Traveler’s diarrhea, Some skin infections
- A few serotypes (O157:H7; 0104:H4) responsible for hemorrhagic colitis: from Undercooked ground beef, Swimming in / drinking contaminated water, Eating contaminated vegetables, contact with farm animals, house flies
Presentation:
-Bloody diarrhea,
Abdominal cramping,
+/- Fever
-Hemolytic-uremic syndrome (HUS) – 2-7%: Hallmark→ red blood cells in urine. can be serious. Seen more in Children and elderly, results in: Red blood cells destroyed(Check urine), Renal failure.
Diagnosis:
-Stool culture
Treatment:
-Supportive (e.coli will go away on its own)
-Antibiotics may make worse bc you’re killing bacteria and releasing toxins
-Antidiarrheal meds can also make it worse bc that’s how the body is ridding toxins |
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Term
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Definition
Epidemiology:
- A heterogeneous group of protozoan parasites belonging to the genus Leishmania.
- Spread by the bite of a female sandfly
- Cutaneous leishmaniasis (CL) reported in US military, primarily those stationed in Iraq & Afghanistan
Presentation:
-Most infections are asymptomatic.
-Cutaneous: Chronic, painless, moice, ulcers or dry nodules (looks like a pizza)
-Visceral: Irregular fever, progressive hepatosplenomegaly, pancytopenia, wasting
-Mucoutaneous: destructive nasopharyngeal lesions
Diagnosis:
-Cutaneous:Biopsy (find macrophages with amastigotes)
-Visceral:Fine-needle aspiration of spleen or bone marrow for culture
-Mucoutanous: Biopsy
Treatment:
-Anti-parasitics
(Sodium stibogluconate or Meglumine antimonite, Pentamidine or Paromomycin) |
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Term
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Definition
Epidemiology:
-Endemic throughout most of the tropics (South Amer., Asia, Africa, Central Amer.)
-Spread by the bite of a female Anopheles mosquito
Presentation:
-Asymptomatic for 12 to 35 days.
-Release of merozoites from infected RBC when they rupture
-Intermittent attacks of fever, chills, & sweating.
-Headache, myalgia, vomiting, splenomegaly, anemia, thrombocytopenia
Diagnosis:
-Biopsy patients that traveled to places that have malaria.
-Intraerythrocytic parasites identified in thick or thin blood smears.
Treatment:
-Anti-parasitics for specific type of Malaria (antimalarial)
(Chloroquine, Amodiaquine, piperaquine, Mefloquine, etc. p.1452)
-Control: vector control, treated mosquito nets, vaccine development |
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Term
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Definition
Epidemiology:
-Toxoplasma gondii (intracellular protozoan parasite)
-Ingestion of infectious oocysts (feline feces)
-Ingestion of tissue cysts in meat from an infected animal
-Vertical transmission from an infected mother to her fetus
-Blood transfusion or organ transplantation from an infected donor
Presentation:
-80-90% of acute T. gondii infections in immunocompetent hosts are asymptomatic
-Most common manifestation is bilateral, symmetrical, non-tender cervical adenopathy
-Fever, malaise, headache, sore throat
-Can cause retinochoroiditis when acquired congenitally (can cause blindness)
-HIV patients can develop an encephalitis with brain lesions, pneumonitis, myocartidis
Diagnosis:
-Biopsy.
-Primary infection: Postive IgG & IgM serologic tests
-In immunocompromised: (+) IgG but (-) IgM serologic tests
Treatment:
-Anti-parasitics
(Sulfadiazine and pyrimethamine) |
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Term
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Definition
Epidemiology:
-Entamoeba histolytica (intestinal protozoan)
Presentation:
-Most are asymptomatic
-Can get amoebic dysentery, amoebic liver abscesses
-Rare: pulmonary, cardiac
Diagnosis:
-Stool antigen, stool exam
-Serum antibody
-Liver lesion
Treatment:
-Metronidazole |
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Term
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Definition
Epidemiology:
-Giardia lamblia (protozoan)
Presentation:
-Diarrhea (sudden onset), malaise, foul smelling and fatty stool, abd cramps, flatulence, N/V, weight loss
Diagnosis:
-Stool exam (3 different exams is 80-90% definitive
Treatment:
-Nitroimidazoles (Mainly Metronidazole) |
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Term
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Definition
Epidemiology:
-Trichomonoas vaginalis
Presentation:
-Symptoms range from asymptomatic carrier to severe, acute, inflam. Dz
-Pregnant women: can cause PROM
Diagnosis:
-Urine test or vaginal swab
Treatment:
-Metronidazole or tinidazole (avoid in 1st trimester) |
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Term
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Definition
Epidemiology:
-S. mansoni, S. japonicum, S. maemotobium (parasitic blood flukes - schistosomes)
-Snails intermediate hosts
Presentation:
-Anemia, chronic pain, swimmer's itch, Katayama fever (eosinophilia), diarrhea, malnutrition, bladder cancer
Diagnosis:
-Recognized by stool or urine exam
-Rare cases can be ID via antibody test
Treatment:
-Praziquantel |
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Term
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Definition
Epidemiology:
-Ascaris lumbricoides (intestinal nematode)
Presentation:
-Intestinal symptoms, bad=intestinal obstruction, rare=hypersensitivity from lung infestation
Diagnosis:
-Stool exam
-Microscopic prep
-CBC for eosinophilia
Treatment:
-Albendazole or Mebendazole |
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Term
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Definition
Epidemiology:
-Ancylostoma duodenale in Mediterranean countries
-Necator Americanus in North and South America
-Eggs are deposited on warm moist soil-Larvae penetrate skin & find their way to the small intestine where they mature, attach to the intestinal mucosa, and suck blood
Presentation:
-Most infxns asymptomatic
-Transient pruritic maculopapular skin rash may occur at site of larval penetration
-~1 month after infection - GI symptoms may develop (abdominal pain, anorexia, and diarrhea)
-Chronic infxns can cause anemia & nutritional deficiencies
Diagnosis:
- Based on the demonstration of characteristic eggs in feces
-Microcytic anemia, occult blood in the stool, hypoalbuminemia are common.
Treatment:
-albendazole or mebendazole
-Pyrantel pamoate & levamisole are also effective. |
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Term
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Definition
Epidemiology:
-Strongyloides stercoralis
-Severe infections in the immunocompromised
-Tropical & subtropical regions. Also in temperate regions of North America, Europe, Japan, and Australia
Presentation:
-Most infxns asymptomatic
-Pruritic, erythematous, maculopapular skin rash - usually at the feet
-Pulmonary symptoms (dry cough, wheezing, dyspnea)
-GI symptoms after some weeks (epigastric pain, nausea, diarrhea)
-Chronic infxns: anemia
-Hyperinfection: large #’s of larvae can migrate to many tissues (lungs, CNS, kidneys,liver) --> bacterial sepsis is common
Diagnosis:
-Rhabditiform larvae in the stool or duodenal contents
-Larvae need to be distinguished from hookworm larvae -- so repeated examinations of stool or of duodenal fluid
-Eosinophilia common but may fluctuate
Treatment:
-Ivermectin or Albendazole. |
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Term
| Trichinellosis (or Trichinosis) |
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Definition
Epidemiology:
-Nematode parasite Trichinella spiralis
-Spread by ingestion of undercooked meat containing Trichinella cysts
-Most common in China, Thailand, Mexico, Argentina, Bolivia & former Soviet Union
Presentation:
-Most infxns asymptomatic
-Parasites invade muscle cells, enlarge, and form cysts
-Transient intestinal symptoms followed by fever, myalgias, and periorbital edema
Diagnosis:
-Lab findings - eosinophilia & elevated serum muscle enzymes
-Muscle biopsy may identify Trichinella larvae
Treatment:
-No effective specific therapy for full-blown trichinosis
-If suspected early: Mebendazole or Albendazole
-Supportive therapy (analgesics, antipyretics, bed rest, corticosteroids) |
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Term
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Definition
Epidemiology:
-Infection with the dog roundworm, Toxocara canis, or less commonly the cat roundworm, Toxocara cati, produces this syndrome in humans
Presentation:
-VLM seen principally in children, but most inxns asymptomatic.
- Mild inxn may be asymptomatic
-Heavy infection may result in fever, anorexia, malaise, irritability, hepatomegaly, and pruritic urticaria-like cutaneous lesions.
Diagnosis:
-Mild inxn: only suspected by elevated blood eosinophilia
-Finding of eosinophilia; confirmed by the identification of larvae in a biopsy of infected tissue
Treatment:
-No drugs have been proven effective, but albendazole has been used & recommended |
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Term
Cutaneous Larvae Migrains
(CLM) |
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Definition
Epidemiology:
-Typically caused by the infective stage larvae of the dog or cat hookworm Ancylostoma braziliense & A. caninum
-Most common in children
Presentation:
-Pruritic erythematous papule develops initially at the site of each larval entry
-Larvae migrate under the skin causing linear skin lesions
Diagnosis:
-Based on the characteristic appearance of the lesions
Treatment:
-Mild cases do not require treatment -- Larvae die and absorbed without treatment
-Topical treatment for skin lesions – thiabendazole
-Systemic therapy - albendazole or ivermectin |
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Term
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Definition
Epidemiology:
- one of 3 nematodes;
Wuchereria bancrofti,
Brugia malayi, Brugia timori,
-Acquired by a mosquito bite.
-Migrate in the skin to the lymphatics and cause blockages.
Presentation:
-Elephantiasis (edema with thickening of the skin and underlying tissue)
-Usually seen in lower extremities
Diagnosis:
- Giemsa stain
- Finger prick test for blood smear
Treatment:
-in U.S.:albendazole combined with ivermectin.
A combination of diethylcarbamazine (DEC) and albendazole is also effective.
-The treatments do not have any effect on adult worms. |
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Term
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Definition
Epidemiology:
-C. albican in most cases.
-Opportunistic pathogen.
-Infects mucous membranes (oropharyngeal/vulvovaginal) or can disseminate.
-Risk factors: pregnancy, uncontrolled diabetes mellitus, intravascular catheters, advanced chronic kidney disease, broad-spectrum abx, corticosteroid use, injection drug use, HIV
Presenation:
-Esophagitis is most common and can be associated with oral candidiasis.
-Odynophagia, gastroesophageal reflux.
-Vulvovaginal : pruritis, buring, dyspareunia.
-Disseminated candidiasis (both sputum and urine are positive).
-Endocarditis is rare (prosthetic valves, transplant surgery).
Diagnosis:
-Culture.
Treatment:
-Antifungal (fluconazole) |
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Term
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Definition
Epidemiology:
-Bird droppings and bat exposure(inhalation of conidia).
Presentation:
- Most pts asymptomatic.
-Some develop mild influenza-like illness (1-4 days)
-Some experience pneumonia with mediastinal or hilar lymphadenopathy and/or masses, pulmonary nodule, cavitary lung disease, pericarditis, arthritis or arthralgia plus erythema nodosum (5-15 days).
Diagnosis:
- Biopsy, culture, antigen in urine/serum
Treatment:
Antifungal |
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Term
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Definition
Epidemiology:
-Inhalation of arthroconidia ofmold C. immitis and C. posadasii
- Exposure to endemic area (SW USA, Mexico, Central and S. America).
Presentation:
- Symptoms in 40% of infxns.
- Influenza-like with malaise, fever, backache, headache, cough.
-Erythema nodosum w/acute infection.
- Pneumonia, arthralgia.
-Symptoms may last weeks to months.
Diagnosis:
- Biopsy, culture, serologic test of sputum or tissues, chest x-ray.
Treatment:
- Antifungal therapy
-Antibiotics for pulmonary |
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Term
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Definition
Epidemiology:
-Common in immunocompromised with cancer, severe malnutrition, debility, immunosuppressive or cytotoxic drugs
-Occurs in 80% of AIDS patients not receiving prophylaxis. Incidence increases as CD4 levels fall
Presentation:
-Fever, Dyspnea, nonproductive cough
-Can have bibasilar crackles in lungs
-Hypoxia
-Pneumonia in AIDS patients
Diagnosis:
-X-ray shows cotton wool exudates
-In Pneumonia that does not go away with typical treatment consider pneumocystis
Treatment:
-High doses of bactrim and steroids
-Prophylaxis important for HIV pts, especially with low CD4 |
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Term
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Definition
Epidemiology:
-Inhalation of budding yeast in soil and dried pigeon dung
-Common in immunocompormised patients (Hodgkin disease, long term corticosteroid therapy, solid organ transplant, HIV)
-Most common cause of fungal meningitis
Presentation:
-Headache, abnormal mental status
-Meningismus seen occasionally
-Nuchal rigidity and other meningeal signs occur 50% of time and often not in HIV pts.
Diagnosis:
-Culture respiratory secretions, pleural fluid, and/or spinal fluid
Treatment:
-Amphotericin B and 5 FC
-Maintained on Fluconazole until immune reconstruction |
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Term
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Definition
Epidemiology:
- Inhalation of Aspergillus fungus
- Found growing on dead leaves, stored grain, compost piles, or in other decaying vegetation
- Marijuana plants
-Predisposing factors: neutropenic pts. leukemia, bone marrow/organ transplant, late HIV infection
Presentation:
-Infxn rarely occurs in immunocompetent
-Lungs, sinuses, and brain most often involved
-Lung or extra pulmonary infection
Diagnosis:
-Sinusitis, aspergillomas (“fungus ball”) in immunocompromised
Treatment:
-Voriconazole
-Surgical excision is treatment of choice |
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Term
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Definition
Epidemiology:
-Inhalation of conidia
-Dimorphic fungus
-Most often in men during occupational/recreational outdoors activities in South central and midwestern US and Canada.
-Often in immunocompetent individuals
Presentation:
-May be asymptomatic.
-Cough, moderate fever, dyspnea, chest pain
-Progress to sputum production, pleurisy, fever, chills, weight loss, prostration.
-If dissemination: lesions often found on skin bones, and urogenital system.
Diagnosis:
-Chronic pulmonary infection
(pneumonia is most common, extrapulmonary infection can also occur)
Treatment:
-Itraconazole
-Amphotericin B for more severe case |
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Term
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Definition
Epidemiology:
-Saliva and open wound
Presentation:
-Early: fever, HA, general weakness, malaise
-Later: insomnia, anxiety, confusion, partial paralysis, excitation, hallucinations, agitation, hypersalivation, difficult swallowing, and hydrophobia
-Almost universally fatal
Diagnosis:
-Find animal and test; bodily fluid tests, skin biopsies, PCR, rabies antibodies
Treatment:
-Vaccine: Human Rabites Immunoglobulin (HRIG) |
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Term
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Definition
Epidemiology:
-Transmitted among rodents and to humans by bites of fleas
-Endemic to CA, AZ,NV and NM (US STATES)
Presentation:
-Sudden onset of high fever, malaise, muscular pains, tachycardia, Headache, Delirium
-Bacteremia, Pneumonitis and meningitis may occur
Diagnosis:
-Previous Sx’s
-Positive smear and culture from bubo(aspirate or pus) and positive blood culture
Treatment:
- IV Streptomycin or Gentamicin
-IV or oral Doxycycline |
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Term
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Definition
Epidemiology:
- Salmonella species
-Transmitted by consumption of feces-contaminated food or drink
Presentation:
-Gradual onset of malaise, headache, nausea, vomiting and abdominal pain
-Rose spots (2nd week of disease, pink papule on trunk, fades on pressure) relative bradycardia, splenomegaly, and abdominal distention and tenderness
Diagnosis:
-Previous Sx’s
-Leukopenia;
-Cultures: blood (best Dx)
- Urine and stool positive for salmonella, not always reliable for certain cases
Treatment:
- Ampicillin, Azithromycin,3rd gen. cephalosporin
-Beware of resistant strains and prescribe accordingly
-Treatment of Carriers also antibiotics. |
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Term
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Definition
Epidemiology:
-Occurs under conditions of crowding, war and famine and areas with poor sanitations
-Post disaster in Haiti
-Results from ingestion of contaminated food or water
Presentation:
-Sudden onset of severe, frequent watery diarrhea.
-Gray; turbid and w/o fecal odor, blood or pus “rice water stool”
-Dehydration
-Hypotension
Diagnosis:
-Previous Sx’s
-Positive stool cultures
Treatment:
-Fluid replacement
(Oral or IV depending on severity)
-Antimicrobials to shorten course illness.
-Tetracycline,ampicillin, fluoroquinolones, azithromycin |
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