Term
| diabetes assoc. skin pathogens |
|
Definition
| S. aureus, Group B strep, anaerboces, GN bacilli |
|
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Term
| cirrhosis asooc. skin pathogens |
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Definition
| campylobacter fetus, coliforms, vibrio vulnificus, capnocytophaga canimorsus |
|
|
Term
| neutropenia assoc. skin pathogens |
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Definition
|
|
Term
| human bite assoc. skin pathogens |
|
Definition
|
|
Term
| cat bite assoc. skin pathogens |
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Definition
|
|
Term
| dog bite assoc. skin pathogens |
|
Definition
| p. multocida, C. canimorsus |
|
|
Term
| rat bite assoc. skin pathogens |
|
Definition
| streptobacillus moniliformis |
|
|
Term
| hot tub exposure assoc. skin pathogens |
|
Definition
|
|
Term
| fish tank exposure assoc. skin pathogens |
|
Definition
|
|
Term
| iv drug use assoc. skin pathogen |
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Definition
|
|
Term
| fresh water exposure assoc. skin pathogen |
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Definition
|
|
Term
| crusty surface infections |
|
Definition
impetigo (G+ cocci)
superficial dermatophytes
systemic dimorphic fungi infection
cutaneous leishmaniasis (Middle E and S. America)
cutaneous tuberculosis
nocardiosis |
|
|
Term
|
Definition
superficial, only involves stratum corneum
usually Group A strep or Staph aureus
outbreaks in summer
facial in kids, heals w/o scar
tx: oral or topical abx |
|
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Term
|
Definition
varicella (chickenpox)
herpes zoster (shingles)
herpes simplex virus 1 an 2 (oral-labial or genital)
coxsackie A 16 (hand-foot-mouth disease)
variola (smallpox)
orf (veterinarians and sheep handlers) |
|
|
Term
|
Definition
early - dew drop on rose petal
later - red, can get 2* infection |
|
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Term
|
Definition
staphylococcal scalded skin syndrome
necrotizing fasciitis
gas gangrene - clostridrial spp.
vibrio spp. infection (prone to w/ liver disease) |
|
|
Term
|
Definition
usually purplish bullae
really sick and need rapid tx or else high mortality |
|
|
Term
| staph scalded skin syndrome |
|
Definition
toxin producing strain of s. aureus
difficult to ddx from drug related toxic epidermal necrolysis
both give nikolsky sign
dx: skin biopsy |
|
|
Term
|
Definition
involves dermal layer
only by Strep pyogenes
abrupt fiery, red swelling on face or extremeties
well-demarcated margins and induration
responds well to short course tx |
|
|
Term
|
Definition
often preceded by skin irritation or trauma
dermal and subcutaneous involved
borders diffuse, non-elevated
may spread via lymphatics
MOST COMMON INF OF SKIN
dx: history, risk factors
tx: elevation, penicillin, antistaph Pen, for 1st gen cephalosporin
2* mild tx: doxy or TMP/SMX
2* severe tx: vanco, linezolid, daptomycin |
|
|
Term
|
Definition
group A strep [more likely to spread through lymphatics)
s. aureus
Group C, G, and B strep
[erysipelothrix] - sea water assoc.
[aeromonas] - fresh water assoc.
[vibrio] - hx of liver disease, bullae
[v. vulnificants] - sea or fresh water |
|
|
Term
|
Definition
infection of hair follicles, involves single or few
Agents: S. aureus, P. aeruginosa if diffuse, Schitosoma if swimming
Tx: topical agents |
|
|
Term
|
Definition
arises from folliculitis
deep pus collection w/ surrounding cellulitis
Risks: DM, obesity, steroids, poor PMN fx
Agent: S. aureus
Tx: drainage, heat, +/-abx |
|
|
Term
| necrotizing fasciitis, type 1 |
|
Definition
mild to moderate fever and systemic toxicity
little to no diffuse pain and mild-to-moderate localized pain
MILD TO MODERATE GAS IN TISSUES
portal of entry usually obvious
higher risk w/ DM
MIXED INFECTION (s. aureus, group B strep, anaerboces, GN bacilli) |
|
|
Term
| necrotizing fasciitis, type 2 |
|
Definition
moderate to severe fever
little to no diffuse pain and SEVERE LOCALIZED PAIN
SEVERE SYSTEMIC TOXICITY
NO gas in tissue
portal of entry not obvious in 50%
GROUP A STREPTOCOCCI
TX: prompt debridement, pen G + clinda, pooled IVIG if severe or progresssive |
|
|
Term
| necrotizing fasciitis, type 2 tx explanation |
|
Definition
Pen G to kill
Clinda to reduce toxin production |
|
|
Term
| progression of necrotizing fasciitis |
|
Definition
early - pain or unexplained fever
progress - dark red induration, bullae with purple fluid
later - skin bluish/maroon/black, extensive thrombosis of vessels supplying dermal layer, extension to deep fascia, rapid spread long fascia planes/veins/lymphatics, toxic shock and multiorgan failure |
|
|
Term
|
Definition
surgical wound infection related
used to tampons 15 years ago
superantigen mediated process |
|
|
Term
|
Definition
necrotizing fasciitis or independent process
superantigen mediated |
|
|
Term
|
Definition
supportive + abx
surgical debride of tissue suspicious for necrosis or fluid accumulation
pooled IVIG to neutralize toxin |
|
|
Term
|
Definition
HIV ELISA and Western Blot
CD4 count
Viral load
HIV genotype
CBC, CMP
Fasting lipid panel
RPR
GC/CT testing
Viral hepatitis screening
Toxoplasmosis IgG
UA
PPD
Pap and pelvice
Opthamalogoty exam if CD4<100 |
|
|
Term
|
Definition
6-8 years
low viral load
decreasing CD4 count |
|
|
Term
|
Definition
total 35 million
adults 31.8 million
women 16 million
children <15y/o 3.2 million |
|
|
Term
|
Definition
total 2.1 million
adults 1.9 million
children 240 thousand |
|
|
Term
|
Definition
sub-Saharan 24.7 million
Asia and pacific 3.8 million
latin America 1.6 million |
|
|
Term
|
Definition
MSM
heterosexual
IV drug abuse
IV drug + MSM |
|
|
Term
|
Definition
dyspnea on exertion (low O2 sat)
subacute - weeks of sickness
fever
cough
diffuse reticulonodular pattern on CXR
tx: TMP/SMX + prednisone |
|
|
Term
|
Definition
| wide dissemination of virus and seeding of lymphatic organs |
|
|
Term
| >500/mm^3 CD4 count complications |
|
Definition
acute retroviral syndrome, candida vaginitis
persistent general adenopathy; Guillain-Barre, myopathy, aseptic meningitis |
|
|
Term
| 200-500/mm3 CD4 count complications |
|
Definition
pneumococcal/bacterial pneumonia, pulmonary tuberculosis, herpes zoster, thrush, Kaposi's, cryptosporidiosis, oral hairy leukoplakia
cervical intraepithelial neoplasa (cervical cancer), lymphoid interstitial pneumonitis, B-cell lymphoma, anemia, mononeuritis, multiplex, idiopathic thrombocytopenia, Hodgkin's lymphoma |
|
|
Term
| <200/mm3 CD4 count complications |
|
Definition
PCP, disseminated histo and coccidiomycosis, military and extrapulmonary tuberculosis, progressive multifocal leukoencephalopathy
wasting, peripheral neuropathy, HIV-assoc. dementia, non-Hodgkin's lymphoma, cardiomyopathy, progressive polyradiculopathy
START ON SMX PROPHYLAXIS |
|
|
Term
| <100/mm3 CD4 count complications |
|
Definition
| HSV, toxoplasmosis encephalopathy, Crytococcosis , Cryptosporitidiois meningitis, microspondiosis, candida esophagitis |
|
|
Term
| <50/mm3 CD4 count complications |
|
Definition
dissemeninated CMV, disseminated mycobacterium avium
central nervous system lymphoma
AZITHROMYCIN PROPHYLAXIS |
|
|
Term
|
Definition
80% of 20y/o live to 40s
increased risk of CVD, bone disease, and some non AIDS defining cancers |
|
|
Term
| exception to CART immediately |
|
Definition
cryptococcal meningitis and mycobacterial disease
delay 8wks to prevent IRIS |
|
|
Term
|
Definition
VL drop by 1 log 4-6weeks if >90% adherence on good drugs for their HIV strain
VL<200 copies/ml by 24wks
TREATMENT INTERUPTIONS NOT RECOMMENDED |
|
|
Term
|
Definition
emtricitabine (FTC)
tenofovir (TDF) |
|
|
Term
|
Definition
|
|
Term
|
Definition
atazanavir (ATV)
darunavir (DRV)
ritonavir (RTV) |
|
|
Term
|
Definition
|
|
Term
|
Definition
2 NRTIs + boosted PI, NNRTO, or Integrase inhibitor
TDF + FTC + ATVorRTVorDRV or EFV or RAL |
|
|
Term
|
Definition
most from mother - 92%
progress more rapidly in child
AIDS w/in months of birth
developmental delay and impaired cognitive fx
ART tx of mothers reduces transmission risk to 1-2% |
|
|
Term
| rapidly progressive pediatric HIV |
|
Definition
25-30% of cases
infected in utero or early perinatal
severe IMC in year 1
early presentation - first 6mo |
|
|
Term
| slowly progressive pediatric HIV |
|
Definition
50-60% of cases
symptoms in first 3 years
mild-moderate IMC
asymptomatic or few symptoms |
|
|
Term
| long-term surviving pediatric HIV |
|
Definition
2-25%
live beyond 8yrs
late presentation of symptoms
similar to adult presentation |
|
|
Term
|
Definition
<12mo tx with HIV meds and prophylaxed with TMP/SMX to prevent PCP no matter the CD4
6wks AZT postpartum
no breast feeding in US, Africa do breast feede |
|
|
Term
|
Definition
avoid in first tri, little risk of transmission in utero
more risk at delivery
standard of care regardless of CD4 count
VL>400 --> cART during delivery
VL>1000 --> C-section |
|
|
Term
| acute retroviral syndrome |
|
Definition
80-90% of acute HIV infections
2-4wks after exposure
2wks duration
missed in 75% of presenting pts
Fever, myalgia, rash, night sweats, arthralgia
Hx: homosexual, exposure or report above sxs |
|
|
Term
| acute HIV infection fingings |
|
Definition
Generalized LAD, thrombocytopenia, elevated protein
oropharyngeal candidiasis, oral/genital herpes,l gingivitis/peridonititis, oral hairy leukoplakia
seborrheic dermatitis, dermatomal zoster in young person, superficial fungal inf, warts
recurrent sinusitis, CA-pneumonia, tuberculosis |
|
|
Term
|
Definition
| ELISA, RNA PCR, confirm with western blot |
|
|
Term
|
Definition
HIV(-) takes HIV med prior to exposure
Tenofovir/Entricitabine (Truvada) taken once daily for IV drug users
level of protection correlate to adherence
regularly test for virus
44% additional protectionin MSM, reduced inf 62% in heterosexual men/women
Concerns: adherence, resistance, cost
Side effect: bone, renal, metabolic
Advantage: prevents HepB infection too |
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