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Organism
Presentation
Prevention
Pharyngitis
Group A Strep
(streptococcus
pyogenes)
without
culture on single blood agar
treatment
plate (80-90% senstivie)
Rapid antigen test (<
Rheumatic Fever
sensitive)
may develop
Group A Strep
(streptococcus
pyogenes)
Scarlet Fever
Impetigo
Erysipelas
Arthritis
Necrotizing
Fasciitis
Streptococcal
Toxic Shock
Syndrome
Staphlycoccus
(temperate) or Group A
Streptococcus (tropical)
Gram +
Group A Strep
(streptococcus
pyogenes) or
Staphlycoccus
Group A Strep
(streptococcus
pyogenes)
Group A Strep
(streptococcus
pyogenes)
Pyogenic erythrotoxin
(Scarlet Fever) causes
massive release of
inflammatory cytokines
Diagnosis
presentation/culture
presentation/culture
presentation/culture
Pneumococcal
Pneumonia
Streptococcal
Pneumoniae
X-ray - lobar
consolidation/effusion,
Gram stain, Sputum
culture
Pneumococcal
Meningitis
Streptococcal
Pneumoniae
Disease
Organism
Staph Skin/Soft
Staphlycoccus Aureus
Tissue Infection
MRSA
Presentation
Prevention
Diagnosis
Culture
Culture
Culture
Blood cultures positive,
bone biopsy, bone scan,
plain films normal in early
course
Gas in tissue found on
palpation or radiograph,
anaerobic culture
confirms, may have other
bacteria present in wound
Disease
Organism
Listeriosis
Listeria
Diptheria
Corynebacteriym
diptheriae, spread by
respiratory secretions
Cutaneous
Anthrax
Bacillus anthracis
Spread by
contact with animal,
hide, or terrorist
Inhalation
Anthrax
GI Anthrax
Whooping
Cough
Bacillus anthracis
Bacillus anthracis
Presentation
Infection during 3rd trimester,
granulomatosis infantisepticum
(high mortality), bacteremia
neonates or
immunocompromised,
meningitis <2 months/elderly,
focal infections
Usually repiratory tract but can
involve mucous membranes,
tenacious gray pharynx, sore
throat, nasal discharge,
hoarsness, malaise, fever,
myocarditis, neuropathy
2 weeks post exposure : initial
erythematous papule that
ulcerates and necroses to
purple/black eschar (painless)
self limiting
2 stages: 10 days non-specific
viral symptoms, progresses
rapidly to fulminatnt stage,
overwhelming sepsis, death
Fever, diffuse abdominal pain
w/rebound, vomiting,
diarrhea/constipation,
ulcerative process- bloody
diarrhea
emesis
Catarrhaland
stage:
insidious
Prevention
Diagnosis
At risk : pregnant
women, infants,
immunoxomprom
ised, elderly
Disease
Organism
Presentation
Meningococcal
Meningitis
Neisseria meningitidis
foun in 40%
nasopharynx population
spread by droplet
Legionnaire's
Disease
Legionella pneumophillia
gram negative Fever, toxicity, pleuritic
spread by moisture from chest pain, grossly purulent
shower heads and a/c
sputum
heating
units
Salmonella typhi
Typhoid Fever
(Enteric Fever)
Salmonella
Gastroenteritis
Shigellosis
Gram negative,
short, aerobic, flagellated
bacillus
enteric fever can
be caused by any
Salmonella species,
transmitted in
contaminated
Most
commonfood/milk
form of
salmonellosis contracted
from contaminated
food/liquid, dairy
products and eggs
Invasive organism, selflimiting
Prevention
MPSV4 indicated
for ages 2-10 and
>55 MCV4
indicated for those
11 to 55 years,
recommended
upon entry to high
school and for
college freshmen,
military, asplenic,
and known
exposure
at risk:
immunocomprom
ised, smokers,
COPD
Diagnosis
Disease
Organism
E. Coli
Enterotoxigenic - travelers
diarrhea Enteroinvasive bloody diarrhea
Enterohemorrhagic
(O157:H7) - non-bloody
diarrhea, hemolytic uremic
syndrome and thrombotic
thrombocytopenic purpura,
transmitted via
undercooked hamburger
Cholera
Vibrio cholerae
Fecal-oral
transmission, releases
enterotoxin
Vibrio
Presentation
Prevention
Diagnosis
Brucellosis
Tularemia
(Rabbit Fever)
Disease
Organism
Presentation
Gonococcal
Infections
Local or disseminated
disease, sexually
transmitted
Chancroid
Haemophilus ducreyi
Painful ulcer
Mycobacterial
Infections
Tuberculosis
Prevention
Cervicitis: Purulent
cervical d/c, may
be asymptomatic,
salpigitis, proctitis,
vaginitis, becomes
symptomatic
during menses,
dysuria, frequency
and urgency,
chronic cervicitis,
can progress to
involve uterus and
tubes producing
sterility
Prophylaxis:
Clarithromycin or
Mycobacterium ayium
Azithromycin,
complex (MAC)
Rifabutin, Biaxin
persistent fever and weight
and Zithromax are
Disseminated dz seen in
loss
best tolerated. Can
HIV pt with CD4 cell
stop when CD4 cell
counts <50
count >100 x 3
months
TB skin test: does
not distinguish
between
active/latent
Primary (asymptomatic),
infection >5mm +
Latent (inactive dz,
malaise, anorexia, weight loss,
in HIV,
reactivation may occur if
fever, night sweats, chronic
immunocompromis
immune system is
cough which worsens and
ed, CXR suggestive
impaired), and Progressive develops purulent sputum,
of old dz
Primary (symptomatic,
malnourished and chronically
>10mm
atypical presentation in the ill, post tussive apical rales
+ IV drug, high
elderly)
risk, children <4
exposed
>15mm + no risk
Diagnosis
Blood culture
Definitive dx culture, 3
consecutive AM
specimens, bronchoscopy
with bronchial washings,
CXR shows small
homogenous infiltrates,
Hilar and peratrachial
lymph node enlargement,
pleural effusion
Treatment
Penicillin G injection
Penicillin VK PO QIDx10
Amoxicillin BID x 10
Macrolides (PCN allergy)
Penicillin G injection
Penicillin VK PO QIDx10
Amoxicillin BID x 10
Macrolides (PCN allergy)
Wash with soap and water and
use Topical agents: Mupriocin
(Bactroban) or Retapamulin
(Altabax)
or if systemic use
Cephalexin (Keflex) BID or
Doxycycline (Vibramycin) BID
Systemic/Face - Parenteral
Penicillin
if IV drug use/diabetes cover
strep as well
Parenteral Abx
Beta-lactams w/
surgical debridement
Beta-lactams
Treat Empirically:
Amoxicillin BID x 7-10
Penicillin allergic:
Azithromycin (Zithromax)
Clarithromycin (Biaxin)
Treat Empirically: IV
Ceftriaxone (Rocephin),
Vancomycin, and
Dexamethasone (antiinflammatory))
Treatment
I&D and penicillinaseresistant ABX like Keflex
or Diclox
Clindamycin, Doxycycline,
Trimethoprimsulfamethoxisole, NO
Macrolides
Nafcillin, Oxacillin,
Cefazolin (Ancef),
Vancomycin (if PCN
allergy), Linezolid (Zyvox)
Human tetanus
immune globulin (TIG)
within 24 hours of
presentation, sedation
and ventilation
Botulinus antitoxin,
ventilation, IV fluids,
notification of contacts
Treatment
IV Ampicillin divided
doses, Gentamycin
divided doses is
synergistic with ampicillin,
PCN allergic trimethoprim/sulfamethox
isole
Removal of membrane,
Antitoxin, PCN or
Erythromycin
Ciprofloxacin and
Doxycycline, second
line is Amoxicillin and
PCN G
Ciprofloxacin and
Doxycycline, second
line is Amoxicillin and
PCN G
Ciprofloxacin and
Doxycycline, second
line is Amoxicillin and
PCN G
Erythromycin or
Azithromycin may
shorten duration and
decrease severity
Treatment
Preventive by elimiation
of nasopharyngeal
carriage: Rifampin, PO
Cipro, Ceftriaxone
(Rocephin)
Treatment: Penicillin,
Ceftriaxone (Rocephin)
until afebrile x 5 days
Azithromycin (Zithromax),
Clairithromycin (Biaxin),
Levafloxacin (Levequin),
Duration 10-14 days or 21
for immunocompromised
pt
Ampicillin, Azythromycin,
Chloramphenacol,
Cephalosporins and
Bactrim all effective, treat
for 5-7 dayas if
uncomplicated, 10-14 if
complicated
severely ill, malnourished,
or sickle cell treat 3-5
days with Trimethoprimsulfamethoxazole,
Ampicillin, Ciprofloxacin
Rehydration and reversal
of HTN, Trimethoprinsulfamethsoxazole or a
Flouraquinolone, often
resistant to Ampicillin
Treatment
Fluid replacement, IV
Ringers Lactate, TCN,
Ampicillin,
Chloramphenicol, Bactrim,
and flouroquinolones will
shorten the course
Treatment
Ceftriaxone (Rocephin)
AND Doxycycline or
Azithromycin, Cefixime,
No Flouroquinolones
(especially for men),
treat spreading dz w/
PCN G IV, treat PID with
Cefoxitin IV
Unilateral adenitis treat
with Ceftriaxone or
Azithromycin