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Archive for the 'Infectious Diseases' Category

Questions: What are the clinical settings and risk factors associated with Candida infections?

Wednesday, September 10th, 2008

Answer: Chronic mucocutaneous infections: defects in T-lymphocyte immunity, congenital (e.g., chronic mucocutaneous candidiasis) or acquired (e.g., AIDS) Deeply invasive, disseminated infections: peripheral neutrophil count < 500/mm3; mucosal barrier breakdown (burn, cytotoxic agents, GI surgery, IV catheter sites); candidal overgrowth (broad-spectrum antibiotics) Colonization of a catheter, with fever: indwelling catheter The difference between the first two [...]

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Question: Which drugs are most commonly associated with causing fever?

Monday, September 8th, 2008

Answer: Amphotericin B Neuroleptics Sulfonamides Antiretrovirals Anticonvulsants Anesthetics NSAIDs Rifamycins Reference: Mandell GL, Bennett JE, Dolin R (eds): Principles and Practice of Infectious Diseases, 5th ed. New York, Churchill Livingstone, 2000.

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Question: Infective endocarditis due toPseudomonas aeruginosa occurs almost always in what risk group?

Sunday, September 7th, 2008

Answer: P. aeruginosa causes infective endocarditis on native heart valves in IV drug abusers. Rarely, it is a cause of prosthetic valve endocarditis. The occurrence of P. aeruginosa endocarditis varies regionally. The source of the organism is thought to be standing water that contaminates drug paraphernalia. Reference: Mandell GL, Bennett JE, Dolin R (eds): Principles [...]

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Question: Among immunocompetent adults, what are the major etiologic agents for community-acquired pneumonia (CAP)?

Saturday, September 6th, 2008

Answer: No etiologic agent is identified in over half the cases of CAP. When an etiology is found the major organisms include: S. pneumoniae Mycoplasma pneumoniae Chlamydia pneumoniae Anaerobic bacteria H. influenzae Legionella pneumophila Respiratory viruses Staphylococcus aureus Reference: Gorbach SL, Bartlett JG, Blacklow NR (eds): Infectious Diseases, 3rd ed. Philadelphia, Lippincott Williams & Wilkins, [...]

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Question: Postsplenectomy sepsis is caused by what organisms?

Thursday, September 4th, 2008

Answer: Splenectomy predisposes patients to sepsis by encapsulated organisms, including: Streptococcus pneumoniae Haemophilus influenzae Neisseria meningitidis Escherichia coli Occasional cases due to S. aureus and Capnocytophaga canimorsus (DF-2) have been described. Reference: Mandell GL, Bennett JE, Dolin R (eds): Principles and Practice of Infectious Diseases, 5th ed. New York, Churchill Livingstone, 2000.

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Question: What is Vincent’s angina?

Wednesday, September 3rd, 2008

Answer: This is a necrotizing pharyngitis caused by a mixture of anaerobes and spirochetes. Streptococcus pyogenes and Staphylococcus aureus may also play a role. Symptoms include an extremely sore throat, fever, and foul breath. Physical examination reveals pharyngeal ulcerations that are covered with a purulent exudate. Treatment with penicillin is curative. Reference: Gorbach SL, Bartlett [...]

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Question: What are the most common causes of drug-induced aseptic meningitis?

Tuesday, September 2nd, 2008

Answer: Nonsteroidal anti-inflammatory drugs (NSAIDs) Antibiotics (especially trimethoprim/sulfamethoxazole) Intravenous immunoglobulin OKT3 antibodies Reference:  Morris G, et al: The challenge of drug-induced aspetic meningitis. Arch Intern Med 159: 1185-1194, 1999.

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