N333 - Bacterial Pathogens and Infections

A ___ ___ infection has symptoms of skin abscesses, boils, cellulitis, fever, chills, fatigue with signs of redness, swelling, pus formation at infection site, tenderness, warmth over affected area

Staphylococcal Aureus

Staphylococcal Aureus Treatment

Drainage if abscess present, first-line = cephalexin and non-resistant strains and severe cases/MRSA = IV vancomycin

A ___ ___ infection which is gram + anaerobic, spore-forming rod has symptoms of watery diarrhea and abdominal pain with signs of leukocytosis emphasizing dehydration 

Clostridioides difficile (C. difficile)

Clostridioides difficile (C. difficile) Treatment

First-line = oral vancomycin and severe = vancomycin ± metronidazole 

A ____ infection is gram + and anaerobic rods with spore has symptoms of descending paralysis, difficulty swallowing, blurred vision + signs of drooping eyelids, dilated pupils, dry mouth

Clostridium botulinum: Botulism

Clostridium botulinum: Botulism Treatment

Botulism antitoxin from CDC or a wound botulism use Penicillin G or metronidazole

A ____ ____ infection is a contaminated traumatic wound with rapid tissue necrosis + gas has symptoms of severe pain, swelling, fever, shock and signs of tense swollen skin, discoloration, crepitus, foul-smelling discharge 

Clostridium perfringens: Gas Gangrene

Clostridium perfringens: Gas Gangrene Treatment

Penicillin G + clindamycin (± doxycycline) and URGENT surgical debridement also hyperbaric oxygen therapy (if available)

A ____ infection occurs with entry from a contaminated puncture wounds and has symptoms: of muscle rigidity, painful spasms and lockjaw (trismus) 

Clostridium tetani: Tetanus

Clostridium tetani: Tetanus Treatment

Tetanus immune globulin (TIG), penicillin G ± supportive care

A ____ infection occurs in the throat & mucous membranes and leads to gray tonsillar pseudomembrane from a possible airway obstruction with symptoms of sore throat, fever, cervical lymphadenopathy 

Corynebacterium diphtheriae: Diphtheria

Corynebacterium diphtheriae: Diphtheria Treatment

Diphtheria antitoxin, penicillin or erythromycin

A ___ infection is a gram negative anaerobic curved rod) with symptoms of watery diarrhea (rice-water stools), vomiting, dehydration and signs of sunken eyes, dry mouth, hypotension, tachycardia, oliguria

Vibrio cholerae - Cholera

Vibrio cholerae - Cholera Treatment

Doxycycline (for severe cases), fluid and electrolyte replacement 

A ____ or “ “ infection is spread via respiratory droplets has symptoms of severe coughing fits, whooping sound on inspiration and signs of cyanosis, excessive coughing spasms, inspiratory whooping sound

Bordetella pertussis – Pertussis “Whooping Cough” 

Bordetella pertussis – Pertussis “Whooping Cough” Treatment

Macrolides: azithromycin, clarithromycin, or erythromycin

A ___ ___ infection is a tick borne illness that can lead to neurological and cardiac complications with symptoms of erythema, migraines (bullseye rash), fever, fatigue, swollen lymph nodes

Borrelia burgdorferi infection - Lyme Disease 

Borrelia burgdorferi infection - Lyme Disease Treatment

Doxycycline (for adults) and amoxicillin (for children), Ceftriaxone for severe cases (like neurologic involvement) 

A ____ infection is transmitted via respiratory droplets with symptoms of severe headache, neck stiffness, nausea/vomiting and includes Kernigs and Brudzinki signs (Positive Kernig’s sign = meningeal irritation and Positive Brudzinski’s sign = neck flexion and hip/knee flexion)

Neisseria meningitidis - Meningitis

Neisseria meningitidis - Meningitis Treatment

Ceftriaxone or cefotaxime, vancomycin ± ampicillin (broader coverage) or corticosteroids to reduce inflammation

__ ___ is caused by streptococcus pyogenes with symptoms of a sore throat, pain w/ swallowing, fever and signs of tonsillar erythema ± white exudates, cervical lymphadenopathy

Strep Throat (Pharyngitis)

Strep Throat (Pharyngitis) Treatment

Penicillin or amoxicillin - cephalexin if penicillin allergy

___ ___ is caused by streptococcus pyogenes that often follows untreated strep throat with symptoms of fever, sore throat and signs of a diffuse red “sandpaper” rash, strawberry tongue, pastillas lines 

Scarlet Fever

Scarlet Fever Treatment

Penicillin or amoxicillin

___ is caused by streptococcus pyogenes or staphylococcus aureus, is highly contagious and common in children with symptoms of honey-colored crusted lesions usually around nose or mouth and signs of vesicles/bullae/pustules → rupture → ooze → crust

Impetigo 

Impetigo Treatment

Topical = mupirocin or oral antibiotics like cephalexin, or amoxicillin-clavulanate

___ is an infection caused by staphylococcus aureus or streptococcus pyogenes that is in the skin + underlying tissues (often lower legs) with symptoms of red, swollen, tender skin (pain/fever/chills) and signs or erythema, warmth, edema, possible abscess 

Cellulitis

Cellulitis Treatment

Antibiotics (cephalexin, clindamycin, dicloxacillin) 

___ inhibits bacterial protein synthesis and is used for treatment of skin infections (impetigo, folliculitis) and infected wounds (including MRSA) but should be avoided on large open wounds or broken skin

Mupirocin (Topical Antibiotic)

___ ___ ___ occurs with exotoxin superantigens that lead to massive immune activation with symptoms of high fever, diffuse sunburn-like rash, vomiting, diarrhea and signs of hypotension, shock, desquamation (peeling skin, palms/soles) and multi-organ involvement 

Toxic Shock Syndrome (TSS)

Toxic Shock Syndrome (TSS) Treatment

IV antibiotics (clindamycin + vancomycin)

___ ____ is an infection with symptoms of severe pain, swelling, fever, shock and signs of rapid tissue necrosis, severe erythema, crepitus (gas in tissue)

Necrotizing Fasciitis

Necrotizing Fasciitis Treatment

Urgent surgical debridement and IV antibiotics (penicillin + clindamycin) and supportive care → IV fluids ± vasopressors

___ ___ ___ is an infection caused by inflammation and impaired kidney function with symptoms of hematuria, edema, hypertension, oliguria and signs of facial and peripheral edema, elevated blood pressure 

Post Streptococcal Glomerulonephritis

Post Streptococcal Glomerulonephritis

Supportive care, antihypertensives, diuretics

___ ___ ___ symptoms include fever, joint pain, fatigue, shortness of breath, chest pain with signs of erythema marginatum rash, migratory arthritis, heart murmur → sydenham chorea (facial tics)

Rheumatic Heart Disease (RHD)

Rheumatic Heart Disease (RHD) Treatment

Penicillin (± long-term prophylaxis), anti-inflammatories → aspirin or corticosteroids or valve repair/replacement for severe disease

___ ___ occurs in healthy, non-pregnant women with no structural or urinary tract abnormalities, has symptoms of mild dysuria, urinary frequency, urgency, signs of pyuria, bacteriuria, hematuria 

Uncomplicated UTIs

Uncomplicated UTIs Treatment

Phenazopyridine for dysuria (urine turns red/orange) and follow-up (re-evaluate if symptoms persist for more than 3 days after treatment)

___ ____ occurs in pts w/ risk factors → male sex, urinary tract abnormalities, diabetes, immunocompromise, indwelling catheter and has symptoms similar to uncomplicated UTI but more severe - sepsis (severe cases) 

Complicated UTIs

Complicated UTIs Treatment

First-line antibiotics like ciprofloxacin, levofloxacin, or ceftriaxone, CAUTI → remove or replace catheter

___ ____ is a gram (+) diplococci → pairs / short chains that colonizes the nasopharynx (common in children) contains different resistant strains and is the leading cause of community-acquired pneumonia (CAP), otitis media, meningitis and severe cases = sepsis (↑ risk in immunocompromised)

Streptococcus pneumoniae (S. pneumo)

____ (CAP) is cuased by streptococcus pneumoniae, haemophilus influenzae with signs of high fever, tachypnea, productive cough, dullness to percussion (consolidation), localized crackles/rales, egophony and a CXR shows lobar consolidation

Typical Community Aquired Pneumonia

Typical Community Aquired Pneumonia Treatment

First-line = high-dose amoxicillin ± doxycycline and Severe CAP = ceftriaxone + azithromycin or doxycyclin

___ (CAP) is caused by mycoplasma pneumoniae, chlamydia pneumoniae, legionella pneumophila and is also known as interstitial / “walking” pneumonia) with signs of a low-grade fever, dry, nonproductive cough where a CXR shows patchy/interstitial infiltrates

Atypical Community Aquired Pneumonia

Atypical Community Aquired Pneumonia Treatment

Doxycycline for mycoplasma and chalmydia and levofloxacin for legionella  

HAP/VAP (pseudomonas aeruginosa, klebsiella pneumoniae, staph aureus) Treatment

First-line → piperacillin-tazobactam, meropenem, cefepime (4th gen)

Drug-Resistant S. pneumoniae (DRSP) Treatment

High-dose amoxicillin, ceftriaxone, levofloxacin, vancomycin, linezolid

___ ___ infections are a gram-negative aerobic rod; major cause of hospital-acquired infections, especially in immunocompromised patients usually caused by ventilator-associated pneumonia (VAP) and catheter-associated infections (CAUTI), wounds and burns with signs of fever, chills, local infection signs → redness, warmth, swelling, pus and fruity “grape-like” odor

Pseudomonas aeruginosa Infections

Pseudomonas Aeruginosa Infections Treatment

Non-resistant: piperacillintazobactam, cefepime, meropenem 

MDR strains: Ceftazidimeavibactam, meropenemvaborbactam 

Severe infections: Combination therapy often required

What drugs should u administer on an empty stomach (1 hour before or 2 hours after)

Ampicillin (Aminopenicillins), Fosfomycin, Tetraycyclines/Doxyclines

What drugs should you monitor peak and trough levels to ensure therapeutic dosing

Vacomycin and Gentamicin

Which drugs are associated with QT prolongation (torsades de pointes)

Macrolides (erythromycin/azithromycin), florquinoloes (ciprofloxacin and levoflixacin)