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Infectious Diseases
COVID-19
Global pandemic 2020-2021 Etiology SARS-CoV-2 virus Presentation Fever Maiais Flu like symptoms SOB Diagnosis test Best initial → test Subtitle 2 Subtitle 3 Most accurate → test Subtitle 2 Subtitle 3 Complications Thrombosis Myocarditis Treatment test Best initial → test drug Subtitle 2 Subtitle 3 Most accurate → test drug Subtitle 2...
Read moreAntibiotic treatment
Empiric Ob/Gyn GBS prophylaxis → Ampicillin Allergic → Erythromycin Postpartum endometritis → Clinda + Genta Mastatis → Oxacillin or cephalexin → Continue feeding PID Inpatient → Cefoxitin/Cefotetan + Doxy Outpatient → Ceftria + Doxy + Metro Tampon TSS → Clinda + Vanco Vaginitis Candida -> Miconazol Bacterial vaginosis → Metro/Clinda...
Read moreOther Infections
Cysticercosis Farmer Uncooked pork meat Tinea solium Neurocysticercosis Don’t confuse with: Cryptococcus → HIV Meningitis Cryptosporidium → HIV Diarrhea, Watery diarrhea Coccidioidomycosis → Pneumonia Cutaneous Larva Migrans Walking barefoot in beach Hookworm Pruritic red tracks on foot Ivermectin Sporotricosis Decaying vegetation → Fungus Pustules → Nonpurulent discharge Follow lymphatics...
Read moreInfectious Mononucleosis
Etiology EBV Young adults Saliva exchange Presentation Fever Pharyngitis Fatigue → Persists 3-6 months LAP Posterior cervical Generalized Tonsillar exudate Palatal petechia Generalized maculopapular rash Splenomegaly Bilateral upper eyelid edema 2-5w after infection Diagnosis Best initial → Heterophil Ab (Monospot) Negative FIRST week If ⊖ → EBV-specific Ab If...
Read moreMalaria
Etiology Tropical areas → Female Anopheles Plasmodium Falciparum → Most dangerous Vivax Ovale Malariae Presentation Fever Periodic attacks → Every 2-3 days >41 ℃ Lasts 4-6h Chills Diaphoresis Splenomegaly → 4d later NO rash/ulcer/LAP Diagnosis Best initial → Tick and Thin blood films → Giamsa and Wright stain Most...
Read moreChikungunya Fever
Severe polyarthralgia and swelling + fever after trop to Caribbeans 7-10 days Management is supportive Complication -> Chronic arthritis
Read moreC infections
Cysticercosis → Farmer -> Pork meat -> Tinea solium Cryptococcus → HIV Meningitis Cryptosporidium → HIV Diarrhea Coccidioidomycosis → Pneumonia
Read moreOpportunistic Infections
Thrush (Oropharyngeal Candidiasis) Etiology Xerostomia → Dry mouth Antibiotic use Denture ↓Immune Presentation Soft white plaque CAN be rubbed off Erythematous base Mucosal burning Candidial Esophagitis → Odynophagia Oral Hairy Leukoplakia EBV Lateral border of tongue Can NOT be rubbed off Diagnosis Clinical KOH/Gram stain → Budding yeast or...
Read moreSystemic Fungal Infections
Coccidioidomycosis Etiology Coccidioides imitis Southwest US Presentation Pneumonia Fever Anorexia Headache Chest pain Cough Dyspnea Arthralgia Night sweats Flulike illness Extrapulmonary CNS → Meningitis Bone → Osteomyelitis Skin Erythema nodosum Erythema multiform Diagnosis Best initial → Serology → If negative repeat testing Most accurate → PCR Bronchoalveolar lavage Culture...
Read moreHIV
Transmission Blood Sexual Vertical Presentation Acute Retroviral Syndrome Mono-like → days to weeks post exposure Fever LAD Rash → Maculopapular Pharyngitis Diarrhea N/V ↓Weight Headache Latent Phase Asymptomatic AIDS Night sweats ↓Weight Thrush Recurrent infections Opportunistic infections CD4 <500 Bacterial infection Tuberculosis HSV VZV Vaginal candidiasis Hairy leukoplakia (EBV)...
Read moreOrganisms and their treatments
Gram ⨁ Cocci Penicillins Oxacillin Cloxacillin Dicloxacillin Nafcillin 1st Gen cephalosporins Cefazolin Cephalexin Fluoroquinolones Macrolides → Less efficacy Azithromycin Clarithromycin Erythromycin → More toxic → N/V, Diarrhea MRSA Best choice Vancomycin Linezolid → Reversible BM suppression Daptomycin → ↑CPK Tigecycline Ceftaroline Telavancin Minor skin infections TMP/SMX Clindamycin Doxycycline Linezolid Anaerobes Above diaphragm Penicillin...
Read moreHIV Drugs
NRTI → BM suppression, Neuropathy Zidovudine (AZT) → Thrombocytopenia, Megaloblastic anemia Didanosine → Peripheral neuropathy, Pancreatitis Abacavir → HLA B5701 → Hypersensitivity/Stevens-Johnson Stavudine → Peripheral neuropathy, Pancreatitis Tenofovir → Renal failure Lamivudine Emtricitabine NNRTI Efavirenz → Vivid dreams, hallucination Teratogenic → Avoid in pregnancy Nevirapine → Hepatic failure Etravirine Rilpivirine PI → Hyperlipidemia, Hyperglycemia, lipodystrophy Indinavir → Crystal nephropathy,...
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