Term
Lyme disease
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-organism
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Definition
Spirochete B. burgdorferi transmitted by ixodid tick vector
Stage 1: erythema migrans(red macule with central clearing at site of tick bite, fever, headache, malaise
Stage 2: early disseminated Dz: cardiac block, multiple skin lesions, neuro lesions (CNS palsies, facial palsy)
Stage 3: late Dz-arthritis knee involvement
Treatment: Doxycycline (adults)
Amoxicillin (kids) |
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Term
Toxic shock syndrome
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Definition
Erythroderma: deep red, total body sunburn with palm/sole flaking in 1-2 weeks, fever, vomiting, myalgias, progress to hypotension, shock confusion
Organism: S aureus TSST toxin
Treatment: IV fluids |
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Term
Staph Scalded Skin (SSS)
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Definition
Description: Diffuse erythema with Nikolsky sign (gentle friction removes skin), fever, perioral erythema
Organism: S. aureus exfoliative toxins A and B
Treatment: IV fluids |
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Term
Rocky Mountain Spotted Fever -description
-organism -Treatment
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Definition
Description: Rash starts on palm/soles (wrists/ankles) and spreads towards trunk. Petechial rash. Start with fever, myalgias, headache and progress to meningismus, encephalopathy, pancytopenia and hyponatremia. Organism: R. rickettsia transmitted by tick vector Treatment: Doxycycline even for children
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Term
Kawasaki -description
-organism
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Definition
Description: Asian child (<8yo) usually male with blanching diffuse patchy measles-like rashmostly on trunk. - Phase 1: fever, rash, cervical lymphadenopathy wtih straberry tongue
- Phase 2: subacute, fingertip desquam
cardiac manifestations: CA vasculitis→aneurysms→MI
Organism: etiology unknown Treatment: IV immune globlin to prevent coronary aneurysms
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Term
Meningococcemia -description
-organism
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Definition
Description: non-blanching purpura/petechial rash with abrupt onset of fever, chills, malaise, rash which can progress to fulminant sustemic Dz w/MOF that can invade CNS. Waterhouse-Friderichsen Syndrome Organism: N. meningitidies (-) diplococcus Treatment:Ceftriaxone or penicillin and chemoprophylaxins of household contacts with Rifampin, Cipro, Ceftriaxone |
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Term
Parvovirus B19 -description
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Definition
Description: Facial rash-erythema infectiosum (slapped cheek). Lacy, symmetric, reticular macular rash on trunks and buttocks. Not contagious once rash develops. Transient aplastic crisis (sickle cell). Chronic erythroid hypoplasia Treatment: IV immune globulin for IC pts only |
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Term
Clinical Meningitis -description (with labs)
-organism
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Definition
Inflammation of membranes surrounding brain and spinal cord Description: Meningismus (stiff neck) as demonstrated by Brudzinski's sign (flexion of neck produces flexion of hips), Kernig sign (pain on knee extension when hip is flexed), opisthotonos (arched back)--> all stretch meninges. Also: fever, altered mental status, photophobia, vomiting due to increased ICP. Young and old likely to have atypical presentation. Host cytokines (TNFa and IL-1 exacerbate symptoms. Risk of death: 20%. Triad: fever, stiff neck, altered mental status Labs: -Bacterial: ↑WBC (PMNs), ↑ protein, ↓↓glucose -Viral: ↑WBC (lymphs), ↑protein, normal glucose -TB/Fungi: ↑WBC (lymphs), ↑protein, ↓glucose Organisms: Bacteria -S. pneumo, most common overall, high frequency in young and old -N. meningitidis: older children and young adults overwhelming sepsis -L. monocytogenes: Newborns, T-cell deficient, food borne, old people -GBS (Streptococcus agalactiae): common cause of neonatal meningitis 1st week of life, assoc w/infection from genital tract of mother -H Influenzae:formerly common in kids but eradicated w/Hib vaccine -S aureus: Neurosurgery or endocarditis GNB: rare except newborns or post neurosurg. salmonella bacterermia in newborns
Viral: Enterovirus, HSV-2, HIV, mumps Granulomatous: TB, Crypto, coccidiomycosis Syphilis, lyme Dz, noninfections: ibuprophen, casinomatous, vasculitis Treament: Ceftriaxone. Prophylaxis for N. meningitidis and H. influenzae for household contacts (Rifampin) |
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Term
| bacteria that cause meningitis |
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Definition
S. pneumoniae: most common overall, high freq young and old N. meningitidis: older children and young adults, close living quarters-->overwhenlming sepsis L. monocytogenes: newborns, T-cell deficient, food borne H influenzae: formerly common in kids, eradicated by Hib vaccine Strep agalactiae (GBS): neonatal assoc w/maternal genital tract infection or old w/chronic Dz S. aureus: rare except post Nsurg or endocarditis GNB: rare except newborns or post Nsurg. Salmonella basteremia in newborns
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Term
| Other organisms that cause meningitis |
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Definition
viruses: enterovirus, HSV-2, HIV, mumps Granulomatous: TB, cryptococcus, coccidiomycosis Spirochetes: syphilis, lyme Dz noninfections: ibuprofen, carcinamatous, vasculitis, poliovirus
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Term
Encephalitis Description- Organisms- Treatment- |
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Definition
Description: cognitive disturbance (lethargy-->obtundation-->coma), necrosis and hemorrhage may occur. Can havemania, delirium, depression. Priority is to identify treatable Dz.
Organisms: Usually viral
HSV1>>HSV2 (except newborns, primary or secondary) - HSV1 encephalitis in adults is characteristically focal, most often temporal lobe, necrosis and hemorrhage
- HSV2 acquired from maternal genital tract during birth, disseminates hematogenously and results in diffuse encephalitis in newborn
Zoonotic (arboviruses: WNV, EEE, St Louis, LaCrosse) Rabies: bite-->retrograde travel up neuron-->CNS. Classic finding: hydrophobia (unable to swallow due to pharyngeal spasm), 1/3 present as flaccid paralysis JC virus-->PML, demyelination w/o inflammation Bacteria: mycoplasma pneumoniae, listeria monocytogenes
spirochetes: lyme, syphilis, rickettsiae
Also: prions
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Term
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Definition
| inflammation or abscess adjacent to or near the meninges |
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Term
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Definition
Enterovirus-most common, later summer/early fall HSV2-primary or recurrent HIV Mumps |
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Term
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Definition
subacute presentation Basilar meningitis-->CN palsies Organisms: TB (with or w/o) pulmonary Dz, cryptococcus, coccidiomycosis Spirochetal meningitis: syphilis, lyme Dz |
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Term
| noninfections causes of meningitis |
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Definition
Cacinomatous Drug-related: ibuprofen vasculitis |
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Term
Bacterial meningitis labs: WBC count WBC differential protein Glucose Other
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Definition
WBC count: Elevated (>1,000 mm3)
WBC differential: PMN
protein: Elevated
Glucose: depressed
Other: Gram stain (75%+), routine culture
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Term
Viral meningitis
WBC count WBC differential protein Glucose Other |
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Definition
WBC count: elevated
WBC differential: lymphs protein: elevated
Glucose: normal
Other: PCR, viral culture |
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Term
Granulomatous meningitis WBC count WBC differential protein Glucose Other |
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Definition
WBC count: elecated
WBC differential:lymphs protein: elevated
Glucose: depressed Other: AFB smear (low yeild), cryptococcal antigen, AFB and fungal cultures, weeks
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Term
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Definition
antimicrobial: ceftriaxone, vanco Corticosteroids: Tx of adults with abcterial meningitis w/dexamethasone 15-20 min before or with the first dose of of antibiotic and every 6 hr for 4 days improved outcomes esp with strep pneumo. Also good for TB NOT for Crypto.
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Term
Encephalitis Features: Organisms: Treatment: |
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Definition
Features: Organisms: Treatment: |
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Term
brain abcess Features: Organisms: Treatment: |
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Definition
Features: more often present with signs of intracranial mass the. Diagnosis with CT or MRI contrast which shows ring-enhancing lesion Spread from otitis media, sinusitis or hematogenous spread or direct (surgery) Organism: S. aureus, direct can be GNB Treatment: empiric, surgical drainage |
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