Difference between revisions of "Infectious Disease"
Jump to navigation
Jump to search
| (7 intermediate revisions by the same user not shown) | |||
| Line 1: | Line 1: | ||
| − | = | + | =Bacteria= |
| + | *TST and interferon gamma don't differentiate between active and latent TB, sputum culture does. | ||
| + | *Tetanus IG is only indicated in severe/dirty wounds and in patients who are not fully immunized. | ||
| + | *Lyme does not grow on standard cultures, get an ELISA instead. | ||
| + | *Bacterial conjunctivitis has thick, unilateral discharge that crusts over. Viral and allergic are more watery and more likely to be bilateral. Allergic is itchy. Certain patients with bacterial conjunctivitis ('''e.g. contact lens wearers''') should be treated with fluoroquinolone for Pseudomonas coverage. These patients also have an increased risk of '''bacterial keratitis''' | ||
| + | *A resident who intubates someone with N. meningitidis needs prophylactic treatment. | ||
| + | *Acute LE or facial rash that is elevated, edematous, sharply demarcated, red, painful, and associated with fever/chills/malaise: '''erysipelas caused by GAS'''. | ||
*'''Catscratch disease''' is the most common cause of chronic unilateral cervical adenitis in children. Complications include lymph node suppuration. | *'''Catscratch disease''' is the most common cause of chronic unilateral cervical adenitis in children. Complications include lymph node suppuration. | ||
| − | * | + | *Meningitis that is slower onset and less severe may be '''early neurosyphilis'''. |
| + | *No need for urine culture in non-pregnant women with UTI symptoms. Treat empirically. | ||
| + | *Empiric coverage for septic arthritis in a child is '''vancomycin''' | ||
| + | |||
| + | =Viruses= | ||
| + | *Measles complications can be minimized in children by giving '''vitamin A''' | ||
| + | *For prevention of vertical transmission of HepB, '''give IVIG and vaccine within 12 hrs of birth''' then follow the routine vaccination schedule of '''0, 2, 6 months.''' | ||
*Varicella vaccine can still be administered to close contacts of immunocompromised people, but they should be monitored for a rash. | *Varicella vaccine can still be administered to close contacts of immunocompromised people, but they should be monitored for a rash. | ||
| + | *Management of a needlestick that is high-risk for HIV includes '''PEP for 4 weeks; HIV testing immediately, at 4 weeks, and 6 months; testing of the source patient (often legally mandatory).''' | ||
*Acute HIV infection has fever, fatigue, weight loss, lymphadenopathy, abdominal pain, diarrhea, and rash. '''Exudative pharyngitis and hepatosplenomegaly are not a common features'''. | *Acute HIV infection has fever, fatigue, weight loss, lymphadenopathy, abdominal pain, diarrhea, and rash. '''Exudative pharyngitis and hepatosplenomegaly are not a common features'''. | ||
*EBV infectious mononucleosis (IM) is diagnosed with the '''monospot (heterophiles antibody)''' test. Treatment is '''supportive, and avoid contact sports for 4-6 weeks'''. | *EBV infectious mononucleosis (IM) is diagnosed with the '''monospot (heterophiles antibody)''' test. Treatment is '''supportive, and avoid contact sports for 4-6 weeks'''. | ||
| − | + | ||
| − | + | =Fungi= | |
| − | |||
| − | |||
| − | |||
*Oral pharyngeal thrush is an AIDS defining illness in the absence of inhaled steroids or chemo. | *Oral pharyngeal thrush is an AIDS defining illness in the absence of inhaled steroids or chemo. | ||
| + | |||
| + | =Parasites= | ||
| + | *Giardia transmission prevention: symptomatic shedders shouldn't swim. | ||
Latest revision as of 16:23, 15 January 2023
Bacteria
- TST and interferon gamma don't differentiate between active and latent TB, sputum culture does.
- Tetanus IG is only indicated in severe/dirty wounds and in patients who are not fully immunized.
- Lyme does not grow on standard cultures, get an ELISA instead.
- Bacterial conjunctivitis has thick, unilateral discharge that crusts over. Viral and allergic are more watery and more likely to be bilateral. Allergic is itchy. Certain patients with bacterial conjunctivitis (e.g. contact lens wearers) should be treated with fluoroquinolone for Pseudomonas coverage. These patients also have an increased risk of bacterial keratitis
- A resident who intubates someone with N. meningitidis needs prophylactic treatment.
- Acute LE or facial rash that is elevated, edematous, sharply demarcated, red, painful, and associated with fever/chills/malaise: erysipelas caused by GAS.
- Catscratch disease is the most common cause of chronic unilateral cervical adenitis in children. Complications include lymph node suppuration.
- Meningitis that is slower onset and less severe may be early neurosyphilis.
- No need for urine culture in non-pregnant women with UTI symptoms. Treat empirically.
- Empiric coverage for septic arthritis in a child is vancomycin
Viruses
- Measles complications can be minimized in children by giving vitamin A
- For prevention of vertical transmission of HepB, give IVIG and vaccine within 12 hrs of birth then follow the routine vaccination schedule of 0, 2, 6 months.
- Varicella vaccine can still be administered to close contacts of immunocompromised people, but they should be monitored for a rash.
- Management of a needlestick that is high-risk for HIV includes PEP for 4 weeks; HIV testing immediately, at 4 weeks, and 6 months; testing of the source patient (often legally mandatory).
- Acute HIV infection has fever, fatigue, weight loss, lymphadenopathy, abdominal pain, diarrhea, and rash. Exudative pharyngitis and hepatosplenomegaly are not a common features.
- EBV infectious mononucleosis (IM) is diagnosed with the monospot (heterophiles antibody) test. Treatment is supportive, and avoid contact sports for 4-6 weeks.
Fungi
- Oral pharyngeal thrush is an AIDS defining illness in the absence of inhaled steroids or chemo.
Parasites
- Giardia transmission prevention: symptomatic shedders shouldn't swim.