Exam 1 Diseases Micro

Viral Conjunctivitis Symptoms

Watery/thin discharge, crusting, history of conjunctivitis (often bilateral), hyperemia/scleral injection, pruritus, lid swelling, photophobia

Viral Conjunctivitis Diagnosis

Clinical presentation

Viral Conjunctivitis Cause

Adenovirus

Viral Conjunctivitis Treatment

Education/hand hygiene, supportive care, cool compresses, baby shampoo for crusting

Bacterial Conjunctivitis Symptoms

Thick, copious, purulent discharge, hyperemia, scleral injection, pruritus

Bacterial Conjunctivitis Diagnosis

Clinical presentation

Bacterial Conjunctivitis Cause

S. aureus, S. pneumoniae, H. influenzae

Bacterial Conjunctivitis Treatment

Topical ophthalmic antibiotic ointment or solution

Allergic Conjunctivitis Symptoms

Thin, stringy discharge, cobblestoning, tearing, redness, itching

Allergic Conjunctivitis Diagnosis

Clinical presentation; cobblestoning helps differentiate it from viral conjunctivitis

Allergic Conjunctivitis Cause

Seasonal allergies

Allergic Conjunctivitis Treatment

Cool compresses, baby shampoo, allergy medications

Neonatal Conjunctivitis Symptoms

Watery discharge, crusting, lid swelling

Neonatal Conjunctivitis Diagnosis

Clinical presentation

Neonatal Conjunctivitis Cause

N. gonorrhoeae, Chlamydia trachomatis, HSV-2

Neonatal Conjunctivitis Treatment

Erythromycin ointment

Trachoma Symptoms

Chronic follicular conjunctiva, trichiasis (inward turning of eyelashes), repeated infection, hyperemia, tearing, discharge

Trachoma Diagnosis

Clinical presentation

Trachoma Cause

C. trachomatis

Trachoma Treatment

Oral/topical antibiotics; sometimes surgical correction of trichiasis

Keratitis Symptoms

Hypopyon, corneal ulcers, eye pain, photophobia, hyperemia, discharge

Keratitis Diagnosis

Slit-lamp binocular scope with fluorescent/stain light to examine corneal ulceration

Keratitis Cause

Bacterial—Pseudomonas aeruginosa; Viral—adenovirus, HSV-1, VZV

Keratitis Treatment

Empirical antibiotics and topical steroids

Stye/Hordeolum Symptoms

Focal pain, swelling, erythema of eyelid

Stye/Hordeolum Diagnosis

Clinical presentation

Stye/Hordeolum Cause

S. aureus

Stye/Hordeolum Treatment

Warm compresses; topical antibiotics such as bacitracin or erythromycin

Chalazion Symptoms

Swelling of the meibomian gland; no pain

Chalazion Diagnosis

Clinical presentation

Chalazion Cause

Swelling of the meibomian gland

Blepharitis Symptoms

Inflammation of eyelid margin, plugging of meibomian glands, crusting

Blepharitis Diagnosis

Clinical presentation

Blepharitis Cause

S. aureus

Blepharitis Treatment

Baby shampoo, cool compresses, topical antibiotics

Dacryocystitis Symptoms

Increased tearing, pain, swelling, erythema at nasal corner of eye

Dacryocystitis Diagnosis

Clinical presentation

Dacryocystitis Cause

S. aureus, Streptococcal species, E. coli

Dacryocystitis Treatment

Oral antibiotics; possible incision and drainage

Preseptal/Periorbital Cellulitis Symptoms

Edema/erythema of periorbital skin, no visual disturbances, excessive tearing, fever, preceding URI symptoms

Preseptal/Periorbital Cellulitis Diagnosis

PERRLA and EOMI

Preseptal/Periorbital Cellulitis Cause

S. aureus, Group A Streptococcus species

Preseptal/Periorbital Cellulitis Treatment

Antibiotics

Postseptal/Orbital Cellulitis Symptoms

Facial pressure and pain, pain/limitation with eye movement, chemosis, proptosis, abnormal pupillary response, decreased visual acuity, excessive tearing, fever, preceding URI symptoms

Postseptal/Orbital Cellulitis Diagnosis

Abnormal pupillary response, decreased visual acuity, pain/limitation with eye movement

Postseptal/Orbital Cellulitis Cause

Polymicrobial; S. aureus including MRSA; Group A Streptococcus species

Postseptal/Orbital Cellulitis Treatment

Broad-spectrum antibiotics, most likely IV

Otitis Externa Symptoms

Pruritus, possible hearing loss, otalgia, otorrhea, edema of auditory canal; TM may be difficult to visualize

Otitis Externa Diagnosis

Clinical presentation; TM may not be visible due to inflammation

Otitis Externa Cause

Gram-negative species, Pseudomonas aeruginosa

Otitis Externa Treatment

Otic antibiotic solution, steroids, IV/PO antipseudomonal therapy

Acute Otitis Media Symptoms

Fussiness/irritability/ear pulling in infants, loss of light reflex, erythema of TM, otalgia, URI symptoms, fever, hearing loss, otorrhea

Acute Otitis Media Diagnosis

Otoscopic findings including loss of light reflex and erythematous TM

Acute Otitis Media Cause

S. pneumoniae (most common), H. influenzae, Moraxella catarrhalis; RSV and rhinovirus

Acute Otitis Media Treatment

PO antibiotics, nasal decongestants, pain control; mastoiditis requires drainage and IV antibiotics

Common Cold Symptoms

Nasal congestion, rhinorrhea, sneezing, cough, malaise, pharyngitis, anosmia

Common Cold Diagnosis

Clinical presentation

Common Cold Cause

Rhinoviruses, adenoviruses, coronaviruses, enteroviruses

Common Cold Treatment

Liquids, rest, cold medicine

Sinusitis Symptoms

Facial pain over frontal/maxillary sinuses, sinus headache, nasal congestion, purulent nasal discharge, anosmia

Sinusitis Diagnosis

Clinical presentation

Sinusitis Cause

Usually viral; bacterial superinfection can involve S. pneumoniae, H. influenzae, M. catarrhalis

Sinusitis Treatment

Intranasal steroids, decongestants; PO antibiotics if severe/persistent

GABHS Pharyngitis Symptoms

Fever, tender anterior cervical lymphadenopathy, lack of cough, pharyngotonsillitis exudate

GABHS Pharyngitis Diagnosis

Centor Criteria—cervical lymphadenopathy, tonsillar exudates, no cough, temperature ≥100°F/38°C

GABHS Pharyngitis Cause

Group A Streptococcus pyogenes

GABHS Pharyngitis Treatment

Antibiotics such as azithromycin

Infectious Mononucleosis Symptoms

Painful posterior cervical lymphadenopathy, splenomegaly, maculopapular rash, palatal petechiae, fever, sore throat, fatigue, malaise, anorexia

Infectious Mononucleosis Diagnosis

Monospot test

Infectious Mononucleosis Cause

Epstein-Barr virus

Infectious Mononucleosis Treatment

No specific treatment; supportive care, pain management, rest

Diphtheria Symptoms

Gray pseudomembrane, severe airway obstruction

Diphtheria Diagnosis

Clinical presentation with gray pseudomembrane

Diphtheria Cause

Corynebacterium diphtheriae

Diphtheria Treatment

Prompt antitoxin administration and airway management

Scarlet Fever Symptoms

Sandpaper-like rash on upper trunk/extremities, strawberry tongue, Pastia's lines, peeling at palms/soles, fever, headache, nausea, vomiting

Scarlet Fever Diagnosis

Clinical presentation

Scarlet Fever Cause

S. pyogenes

Peritonsillar Abscess Symptoms

Trismus, deviated uvula, muffled "hot potato" voice, severe sore throat, odynophagia

Peritonsillar Abscess Diagnosis

Needle aspiration

Peritonsillar Abscess Cause

Group A Streptococcus pyogenes

Peritonsillar Abscess Treatment

Parenteral or oral antibiotics, airway management, I&D, possible tonsillectomy

Influenza Symptoms

URI, pneumonia, bronchitis, bronchiolitis; complications include S. aureus pneumonia and Reye syndrome

Influenza Diagnosis

Not specified in study guide

Influenza Cause

Influenza virus

Pertussis Symptoms

Sneezing, anorexia, malaise, hacking nighttime cough, whooping cough

Pertussis Diagnosis

Swab culture

Pertussis Cause

Bordetella pertussis

Pertussis Treatment

Supportive care, antibiotics, vaccination for prevention

Croup Symptoms

Respiratory stridor, barking cough, hoarse voice, airway closing

Croup Diagnosis

X-ray showing steeple sign

Croup Cause

Parainfluenza, RSV, influenza

Croup Treatment

Airway management, dexamethasone, supportive care

Laryngitis Symptoms

Hoarseness, difficulty speaking; inflammation of larynx; preceded by URI

Laryngitis Diagnosis

Clinical presentation

Laryngitis Cause

Parainfluenza, rhinovirus; bacterial causes less common

Laryngitis Treatment

Supportive care and rest

Epiglottitis Symptoms

Dysphagia, possible airway obstruction, sore throat, odynophagia

Epiglottitis Diagnosis

X-ray showing thumb-shaped sign

Epiglottitis Cause

H. influenzae type B