Infectious Disease

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Missed Concepts

  • Catscratch disease is the most common cause of chronic unilateral cervical adenitis in children. Complications include lymph node suppuration.
  • Acute LE or facial rash that is elevated, edematous, sharply demarcated, red, painful, and associated with fever/chills/malaise: erysipelas caused by GAS.
  • Varicella vaccine can still be administered to close contacts of immunocompromised people, but they should be monitored for a rash.
  • 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.
  • 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).
  • A resident who intubates someone with N. meningitidis needs prophylactic treatment.
  • Meningitis that is slower onset and less severe may be early neurosyphilis.
  • Lyme does not grow on standard cultures, get an ELISA instead.
  • 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.