Академический Документы
Профессиональный Документы
Культура Документы
CNS Infections
Meningitis Encephalitis Focal infections of the CNS Transverse myelitis, Guillaine-Barre Syndrome Spongiform Encephalopathy
Local Infection
Bacteremia
MENINGITIS
Neonates: Group B streptococcus, Gram negative enterics, Herpes simplex Older child: Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae type B, Viral Sickle disease: S. pneumoniae Asplenia: S. pneumoniae, N. meningitidis, Salmonella sp. T-cell defects: Listeria monocytogenes
Nematodes
Toxocara species Trichinella spiralis Angiostrongylus cantonensis
Cestodes
Taenia solium
Protozoan infection
Toxoplasma gondii Trypanosoma Acanthamoeba species
Others
Leptospira species Treponema pallidum Borrelia burgdorferi
Meningitis: Diagnosis
Lumbar puncture (LP) CSF indices: cell count, protein, glucose CSF gram stain and culture Contraindications to LP:
Viral
Bacterial TB Neonate
2-2000
5-5000 5-2000 0-32
< 50
> 60 < 50 < 60
> 60
< 45 < 45 > 60
30-80
> 60 > 60 20-170
Meningitis: Treatment
Bacterial meningitis
<2weeks of age: Ampicillin and Gentamicin 2 wks-3 mos of age: Ampicillin and Cefotaxime > 3 months of age: Cefotaxime or Ceftriaxone
Encephalitis
Neonate: Acute vs. Congenital Beyond the neonatal period: Virus (Enterovirus, Herpes simplex virus, Epstein Barr virus, and Arbovirus California encephalitis), Bacteria (Bartonella henslae) Postinfectious: Varicella zoster virus, Mycoplasma
Staphylococcus aureus Staphylococcus epidermidis Streptococcus pneumoniae Other Gram negative and positive bacteria Anaerobic bacteria
Eye Infections
Conjunctivitis: Viral
Adenoviral Conjunctivitis
Conjunctivitis: Bacterial
Gonococcal conjunctivitis
Pneumococcal conjunctivitis
Chorioretinitis: Toxoplasmosis
Bacteria
Staph aureus
Viruses
Fungi
Parasite
Strep pneumoniae
H. Influenzae GC, Chlamydia* Neisseria meningitidis Herpes simplex Measles Varicella zoster Fusarium AcanthaAspergillus moeba
*Usually occurs in less than 3 months of age ** Can cause pharyngoconjunctival fever
Bacteria
Viruses
Fungi
Parasite
GC HSV C. trachomatis Candida Aspergillus HSV, VZV CMV, HSV Histoplasma Toxoplasma VZV C. Immitis Candida sp. Toxocara
Endophthalmitis S. aureus Pseudomonas Other Gm neg Iridocyclitis Chorioretinitis Treponema pallidum M. tuberculosis
Diagnostic approach
Gram stain Culture Immunofluorescent stain Serologic tests Blood cultures Ophthalmologic evaluation and slit lamp exam
Management
Topical antimicrobial agents Specialized treatment including systemic therapy
Infection of the kidneys and its pelvis: Pyelonephritis Infection of the bladder: Cystitis Infection of the urethra: Urethritis
UTI: Pathogenesis
Bacteria ascend from perineal flora Sexual activity can displace bacteria Catheterization increases risk Young women most commonly affected
Pyelonephritis
Fever Flank Pain
Prostatitis
High Fever and signs of cystitis
Diagnosis of UTI
Collection of sterile urine Clean-voided midstream urine Microscopic examination
Management of UTI
Guided by results of culture and antimicrobial susceptibility tests Most common pathogen: Escherichia coli Empiric antibiotic choices include: