Acutely Ill Infected Febrile Patient
What should you do in your workup BEFORE starting antibiotics?
Get blood cultures
What type of bugs most commonly cause aspiration pneumonia?
Anaerobes
What do you expect to see on imaging in someone with endocarditis?
vegetation
What is cellulitis?
is an acute inflammatory condition of the skin characterized by localized pain, erythema, swelling, and heat.
What is an abscess?
An infection in which viable infecting organisms, PMNs are contained in a fibrous capsule, is also a process by which the host confines microbes to a limited space to prevent further spread.
Mention 3 treatment options for uncomplicated cystitis
nitrofurantoin, TMP-SMX, Fosfomycin, Pivmecillinam, Fluoroquinolones, Beta-lactams
Which infectious disease predisposes individuals to infections and increased severity compared to general populations?
HIV
Which bug commonly complicates an influenza virus infection?
Staph aureus
What are the major criteria listed in Duke Criteria?
1. Positive blood culture
2. Evidence of endocardial involvement
Erysipelas affect what layer of the skin
epidermis
Mention 3 risk factors for perinephric abscess
Renal stones, DM, urologic abnormalities, trauma or surgery
Mention 3 possible side effects of fluoroquinolone
Petechial rashes are seen in which diseases?
Meningococcemia or Rocky Mountain spotted fever
What are the four classifications of pneumonia?
CAP - Community acquired pneumonia
HAP - Hospital acquired pneumonia
VAP - Ventilator associated pneumonia
HCAP - Health care associated pneumonia (ie MDR pathogens)
What is the most common bacterial species to cause endocarditis?
Staph aureus
Primary and alternative treatment for animal bite
Ampicillin-sulbactam - 1ary
clindamycin plus ciprofloxacin - alt
Antibiotic regimen for CAPD peritonitis
First generation cephalosporin and fluoroquinolone or third generation cephalosporin
Mention 2 of 3 antibiotics that minimally affect fecal flora
Nitrofurantoin, fosfomycin and pivmecillinam
How many sets of blood cultures should you obtain if you suspect endocarditis?
3
Why is an ET tube a risk factor for VAP?
Microaspirations are actually exacerbated by secretions pooling above the cough.
Which heart valve is most commonly affected in endocarditis in patients who use IV drugs?
Tricuspid
T/F
Cultures are positive in only 20% of cases of needle aspiration or punch biopsy of cellulitis tissue.
True
What is the difference of primary and secondary peritonitis?
Primary - without an apparent source of contamination, defect in filtration function. Single organism.
Secondary - bacteria contaminate the peritoneum as a result of spillage from intraabdominal viscus or chemical irritation. Mixed flora.
Who should be treated for asymptomatic bacteriuria?
Pregnant women and those undergoing urologic procedure
Which bugs most commonly cause sepsis in asplenic patients?
Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis
Fun fact: asplenic patients succumb to sepsis 58x more than the general population
How often are blood cultures positive in patients with HAP?
0-25%, 25-50%, 50-75%, or 75%+?
0-25% ---- <15%!
Which complication of endocarditis can cause heart block?
Aortic paravalvular infection
Mention 3 infectious agent for myositis and myonecrosis.
S. aureus, S. pyogenes, Clostridium spp. Mixed aerobic and anaerobic bacteria
What is the treatment for splenic abscess ?
Antibiotics and splenectomy
mention 3 antibiotics for UTI in pregnant women
Nitrofurantoin, ampicillin and cephalosporins