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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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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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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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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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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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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