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INFECTIOUS
DISEASES
MUHAMMED NIYAS,MD(Internal Medicine)
SURGICAL TREATMENT
Emergent: (same day)
Acute aortic regurgitation plus preclosure of
mitral valve
Sinus of Valsalva abscess ruptured into right
heart
Rupture into pericardial sac
CNS Infections
Tuberculous
Meningitis
Total Leucocyte
Up to 1000/L
count
Predominant cells Lymphocytes
Bacterial
Meningitis
Viral Meningitis
>100 cells/L
25500/L
Neutrophils
Lymphocytes
Sugar
<45 mg/dl
(Low)
<40 mg/dl
(very low)
Normal
Protein
100800 mg/dL
(Very high)
>45 mg/dl
(High)
2080 mg/dL
(normal or slightly
elevated)
Subacute meningitis
A)Pyogenic meningitis
B)Viral meningitis
C)Tuberculous meningitis
D)Herpes Encephalitis
UTI
Drug of Choice
For acutely ill
Lipid formulation of amphotericin B for induction
Followed by oral fluconazole.
Alternative agent for induction:
Echinocandins
Clinically stable: Oral fluconazole.
Streptococcus
pneumoniae
Gram-positive
Grow in chains or pairs
-hemolytic
Capsulated
Optochin sensitive
Bile soluble
Staphylococcus
Gram positive
Grape like clusters
Non motile
Aerobic
Facultatively anaerobic
Catalase positive
GLYCOPEPTIDES
Vancomycin
Teicoplanin,
Telavancin
Dalbavancin,
Oritavancin
Oxazolidinone
Linezolid
Tedizolid
Streptococcal infections
Enterococci
Gram-positive organisms
Usually observed as single cells, diplococci, or
short chains
Hydrolyze esculin in the presence of 40% bile
salts
Grow at high salt concentrations (6.5%)
High temperatures (46C).
Corynebacterium
diphtheriae
Gram positive
Non encapsulated
Non motile
Non sporing
Characteritic club shaped
appearance
A 42 year old man with HIV has been developing worsening disease
because of HAART resistance and worsening viremia.Over the past 6
months his CD4 count has fallen below 100/L.He has not been
taking prophylactic medication because he is tired of taking pills
Rhodococcus equi
Listeria monocytogenes
Facultatively anaerobic,
Nonsporulating,
Gram positive rod
Grows over a broad temperature
range, including refrigeration
temperatures
Clostridium tetani
Gram-positive,
Spore-forming
Bacilli
Botulism
Gas Gangrene
DIAGNOSIS
The diagnosis of CDI is based on a combination of clinical criteria:
(1) diarrhea (3 unformed stools per 24 h for 2 days) with no other
recognized cause plus
(2)Toxin A or B detected in the stool or
Toxin producing C.difficile detected in the stool by PCR or culture,
Pseudomembranes seen in the colon
Treatment
Ciprofloxacin + Doxycycline
Plus
Clindamycin/Rifampicin
Post exposure
Ciprofloxacin
Or
Doxycycline
Or
Amoxycillin
Category A
Neisseria meningitidis
Gram-negative
Aerobic
Diplococcus
Neisseria gonorrhoeae
gram-negative,
nonmotile,
non-sporeforming
organism that grows singly
and in pairs