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DNA Viruses
Infectious Diseases
Tick-Borne Infections
Lyme Disease Etiology Borrelia burgdoferi → Ixodes scapularis tick Northeast camping/hiking Presentation Fever Rash 5-14d after Erythema migrans → Target lesion Joint pain → Knee most common Neurologic Bells palsy → Most common Meningitis/Encephalitis CN palsy Cardiac Myocarditis Transient AV block → Most common Diagnosis Typical lesion does NOT need confirmatory test Serology → IgM,...
Read moreEndocarditis
Etiology Acute S. aureus → Most common Normal valve IVDU → Tricuspid > Mitral > Aortic Pacemaker Strep pneumo Neisseria gonorrhoeae Subacute S. epidermis → Subacute in prosthetic valves, Pacemaker Viridans strep → Dental things, Respiratory biopsy Colonic pathology → if grows on culture → Perform Colonoscopy Strep bovis Clostridium septicum Eikenella...
Read moreUrinary Tract Infection (UTI)
Etiology Organisms → SEEKS PP Serratia E coli → Most common Enterobacter Klebsiella S. saprophyticus Pseudomonas Proteus Defects Stone Stricture Tumor BPH Diabetes Foley Neurogenic bladder General Treatment Guidelines Pregnant (Asymptomatic bacteriuria or Symptomatic UTI) Amoxicillin → 3-7d Penicillin allergy → Nitrofurantoin Uncomplicated UTI TMP/SMX (if no CKD) Nitrofurantoin Fosfomycin Complicated...
Read moreSTDs
Urethritis Etiology Neisseria gonorrhea Chlamydia Mycoplasma genitalum Ureaplasma Presentation Dysurea Urethral discharge → Differentiate from cystitis Diagnosis Best initial → Urethral swab gram stain Intracellular diplococci → Gonorrhea NAAT → Nucleic acid amplification test ↑WBC Most accurate → Urethral culture Treatment Ceftriaxon (x1 IM) + Doxycycline (7d) Ceftriaxon (x1 IM) + Azithromycin (x1 PO)...
Read moreHepatitis
Acute Hepatitis Etiology Viral Hep B Hep C Hep D → Over Hep B Hep A → Food born Hep E → Food born, Pregnancy, Asians Drugs Alcohol Acetaminophen INH Methyldopa Presentation Jaudice Fever Weight loss Fatigue Dark urine Hepatosplenomegaly N/V Abdominal pain Diagnosis ↑ Direct bilirubin ↑ ALT > AST ↑...
Read moreInfectious Diarrhea
Scombroid Fish poisoning Most rapid onset Wheezing, Flushing, Rash Treatment → Anihistamines Infectious Diarrhea Blood/WBC ⨁ Campylobacter Etiology Most common Food/Water Presentation Children/Young adults 7-10d Complication → Guillain-Barre Treatment → Ciprofloxacin, Azithromycin Salmonella Etiology Chicken, Egg Presentation Children/Elderly 2-5d Prodromal → Headache, Fever, Myalgia, Abdominal pain Complication Sepsis Sickle cell...
Read moreHead/Neck Infections
Otitis Media Presentation Tympanic Redness Immobility → Most sensitive Bulging ↓ Light reflex Pain ↓Hearing Fever Diagnosis Most accurate → Tempanocentesis → Sample Recurrence No response to treatment Radiology is WRONG Treatment Best initial → Amoxicillin If no response Amoxicillin/clavulanate Azithromycin, Clarithromycin Cefuroxime Loracarbef Levofloxacin. Gemifloxacin, Moxifloxacin Sinusitis Etiology Acute (<1m) Viral S. pneumo...
Read moreCNS Infections
Meningitis Etiology Viral Strep Pneumonia Group B H. Influenza Neisseria → Adolescent, Petechial rash Listeria → Immunocompromised Staph → After neurosurgery Cryptococcus → AIDS, High opening pressure Lyme → Camper, Tick, Target rash, Joint pain, Facial palsy Rickettsia → Camper, Tick, Rash from limbs to trunk TB → Pulmonary TB 0-6m 6m-6y 6-60y >60y GBS...
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