Otitis Media

Rhinitis

Sinusitis

Pharyngitis

Bronchitis

Usually caused by viruses

Presentation: Presents with a runny nose, a cardinal symptom of the common cold. Inflammation of nasal mucosa, may be accompanied by sinusitis, pharyngitis, headache and constitutional symptoms.

Etiologies: almost always due to a virus (Rhinovirus or Coronavirus) or to non-infectious causes (such as allergies).

Treatment: Symptomatic only. Generally antibiotics can be withheld.

Presentation: Patients with a cold usually have some degree of sinusitis, inflammation of the sinuses, may have yellow or green nasal discharge but this does NOT distinguish viral from bacterial etiologies.

Bacterial etiologies may have facial pain/tenderness and high fever.

Etiologies: usually viral (Rhinovirus), some bacterial infections (most commonly Strep pneumoniae but also Haemophilus influenzae).

Presentation: middle ear infection, very common in kids. May accompany the common cold.

Etiologies: Usually viral but bacterial infections (Strep pneumoniae or Haemophilus influenzae) may occur

Presentation: inflammation of the pharynx/tonsils. Sore throat.

Etiologies: usually due to viruses (Rhinovirus, Coronavirus), but Group A Streptococcus (a.k.a. Streptococcus pyogenes) is most common bacterial cause and needs to be excluded in isolated pharyngitis. Important to note that 1/3 people are colonized by Group A strep without symptoms, so if you find Group A strep it's not necessarily the cause of the sore throat.

Presentation: cough, typically productive of sputum. May sometimes be associated with wheeze (bronchospasm).

Etiologies: in healthy people usually viral--rhinovirus, adenovirus, influenzavirus. When due to bacteria, Strep pneumonia or Haemophilus influenzae are most common.

Presentation: patients with heavy smoking histories may develop chronic bronchitis. Productive cough year round.

Etiologies: Viral or bacterial infections may cause exacerbations (acute on chronic). Bacterial etiologies are usually Strep pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.

At risk: debilitated, neurologically impaired patients may develop aspiration pneumonia (drunks, etc).

Patients in ICU who are mechanically ventilated.

Etiologies: MRSA and extended spectrum beta-lactamases producing Gram -ve rods for VAP (didn't say about the debilitated ppl)

Gram -ve rods: Pseudomonas aeruginosa, Acinetobacter spp., Enterobacter cloacae, Klebsiella pneumoniae.

Staphylococcus aureus (Gram +ve cocci)

Presentation: sudden onset of chills, accompanied by severe muscle aches (like you got hit by a train), fever, and cough. Can isolate influenza virus from nose or pharynx.

Etiologies: influenza virus (A or B)

Treatment: specific anti-influenza drugs available, but only effective if given in the first 36-48 hours are first onset of symptoms.

Infection of the lower airways/alveoli (as opposed to an upper respiratory infection).

Visible as an "inflitrate" or "consolidation" of the lung on CXR.

Presentation: cardinal symptoms: productive cough, pleuritic chest pain, shortness of breath, fever.

Etiologies: Streptococcus pneumonia (MOST COMMON BY FAR)

Haemophilus influenzae, Moraxella catarrhalis (COMMON)

Chlamydophila pneumoniae, Legionella pneumophila, Mycoplasma pneumonia (ATYPICAL).

It's inflammation of the kidney (the upper urinary tract). May result from inadequately treated cystitis (inflammation of the bladder). Called a complicated UTI.

Presentation: fever, flank pain, in addition to urinary tract symptoms.

Etiologies: CA pyelonephritis most often caused by E. coli

Catheterization can also cause, because it provides a hospitable habitat for:

E. coli, Enterococcus faecalis, Proteus mirabilis, Candida albicans.

Treatment: remove catheter is usually all that's needed.

Cystitis is a type of UTI (lower tract, inflammation of the bladder).

Presentation: very common in women, dysuria, urinary frequency.

Etiologies: In young women, Escherichia coli (GNR) is by far most common. Also get Staph saprophyticus (GPC).

Bacteria: Salmonella spp, Campylobacter spp., Shigella spp., and E. coli (all GNR)

Protozoa: Giardia lamblia, Cryptosporidium

Viruses: Rotavirus, Norovirus

1. a pneumonia or kidney infection moves into blood.

2. vascular lines provide ready access for skin organisms to get into the blood. Usu. Staph aureus or coagulase negative staphylococci. For femoral lines watch out for Gram -ves.

3. Prolonged bacteremia is probably from an endovascular source--bacteria attach to intravascular device (catheter, pacemaker,heart valve). Staph aureus and Streptococci are most likely pathogens in this case.

Usually viral:

Herpes simplex virus

Vector borne infections (e.g. West Nile virus)

Presentation: severe headache and neck stiffness.

Etiologies: Neisseria meningitidis, Streptococcus pneumonia, Listeria monocytogenes, and enteroviruses.

Treatment: Make sure you cover N. meningitidis, S. pneumonia, and L. monocytogenes when you treat empirically.

*Note: do a spinal tap. if it's cloudy w/ neutrophils, think N. meningitidis and S. pneumonia. If it's clear w/ lymphocytes, think and enterovirus.

Those that cause:

1. urethritis (Chlamydia trachomatis and Neisseria gonorrhoeae)

2. genital ulcers (herpes simplex virus and syphilis (Treponema pallidum)

3. genital warts (human papillomavirus).

4. Systemic viral infections (HIV, Hep B, Hep C)

It's a urethritis.

Presentation: Men: penile discharge, dysuria.

Women: vaginal discharge, dysuria, abdominal pain. Most often asymptomatic.

Etiologies: Neisseria gonorrhoeae (GN), Chlamydia trachomatis.

Fungi and yeasts: Pneumocystis jarovecii, Candida, Cryptococcus.

Bacteria: Mycobacteria

Viruses: CMV

Parasites: Toxoplasmosa

Remember this is very superficial inflammation of the skin.

Etiologies: non-infectious (allergic rxns, excema)

infectious: dermatophytes (Tinea spp) and Candida spp.

Superficial cellulitis: Streptococcus pyogenes (Group A Strep, GPC), Staphylococcus aureus (GPC) NOT Staph epidermidis.

Skin abscess: Staph aureus (NOT S. epidermidis)

Systemic Infections: have manifestations in skin sometimes. E.g. infective endocarditis, Pseudomonas aeruginosa bacteremia, and disseminated fungal infections)

1st: GPCs (Staph/Strep)

2nd: GNs (E. coli) and Enterococcus (CPC)

3rd: resistant GNs (Pseudomonas).

Strep. pneumo (GPC), Haemophilus influenzae (GN), Neisseria meningitidis (GN).

For an IgA deficiency Giardia.