Area/Site Condition Common Clinical Diagnosis Treatment Other Notes

Organisms Presentation
Sepsis Sepsis Staph, strep, Tachypnea, This is a clinical Fluids (30 cc/kg);
c. diff. fever, hypoxia, diagnosis. Find administer abx
tachycardia, source of within 1 hour of
hypotension. infection, CBC, sepsis
chemistries recognition. Low
(hyperkalemia), dose
lactate levels, corticosteroids
procalcitonin, help if given
imaging. before abx. For
unknown source
= vancomycin,
levo, and
ceftriaxone,
zosyn.
HEENT Conjunctivitis Mostly viral, Bacterial: Clinical diagnosis Abx if bacterial Abx therapy is
sometimes mucopurulent associated
gonococcus. discharge with quicker
Viral: redness, recovery,
watery eyes. decrease in
transmissibilit
y, and early
return to
school.
Blepharitis Chronic eyelid Eyelid hygiene,
irritation and topical or
inflammation systemic
antibiotics may
be necessary if
condition
severe.
Hordeolum Staph Pustular Warm May develop
(Stye) swelling of the compresses and into a
eyelid margin topical antibiotic chalzion
ointment
Chalzion A fibrous, Warm May require
nodular, compresses urgent optho
granulomatous referral for
swelling of the I&D
eyelid; usually
not painful
Keratitis Bacteria May present Cycloplegics for
(pseudomona with purulent pain relief and
s in those discharge topical
with contact and/or antibiotics for
lens), viruses, hypopion prophylaxis.
and UV
radiation
Herpes Herpes virus Unilateral, Topical and oral Requires
Simplex vesicular antivirals urgent
Keratitis eyelid lesions (acyclovir) referral to
optho.
Herpes Zoster Varicella virus Shingles of the Tx with antivirals Hutchinsons
Ophthalmicus eye indicated sign = a lesion
on the nose
Dacrocystitis Respiratory Inflammation Massage, warm
pathogens and swelling of compresses,
the lacrimal systemic
sac from acute antibiotics
infection (should include
MRSA coverage-
Bactrim,
doxycycline,
clindamycin,
zyvoxm
Cipro/levo)
Endophthalmi Gram positive Infection Antibiotic Organisms
tis cocci inside the eye instillation into from eye
involving the the vitreous or surgery,
vitreous aqueous humor trauma, or
and/or infected
aqueous cornea
humor
Pharyngitis Strep Absence of Rapid strep Amoxicillin, then Steroids
cough, swollen antigen Keflex, then (decadron)
cervical lymph clindamycin, are effective
nodes, fever, then macrolides and reduce
tonsillar pain by 50%
exudates, in 24 hours.
young age.
Diphtheria Fever, sore Detoxin from the
throat, CDC.
lymphadenopa
thy,
 pseudomembr
ane.
Acute Hemophilus Fever, stridor, This is a clinical Early airway
epiglottitis (decreasing in tripod, diagnosis. intervention,
numbers due drooling Thumb print sign parenteral abx
to on lateral CXR effective against
vaccinations), h. flu and
then pneumococcus
pneumococcu
s is the most
popular.
Otitis externa Pseudomonas Tenderness of Clinical diagnosis Abx ear drops May need to
and staph are external ear (ciprodex), sue earwick if
the most structures, steroids may be drops don’t
common otorrhea used in the ear. penetrate
bacteria past outer
ear.
Otitis media Strep Ear pulling in Cultures may be Amoxicillin (high
pneumo, h. kids, cloudy done but are dose), then
flu, moraxella and red TM, rare, and CT of Augmentin, then
fever the mastoid may macrolides or
be done if this cephalosporins
complication is (omnicef)
suspected.
Sinusitis Viral (95% of Pain/pressure Cultures High dose Can give abx
the time) in the cheeks (generally not amoxicillin, prescription if
and maxillary indicated due to Augmentin or symptoms
teeth viral nature), fluoroquinolone, have
coronal CT, facial macrolides are persisted for
CT w/o contrast last resort 10 days.
(azithromycin/cli
ndamycin)
CNS Bacterial Strep Fever/hypothe Kernig’s and Ceftriaxone,
meningitis pneumo, rmia, Brudzinski’s penicillin G,
neiserria headache, stiff signs (present in ampicillin
meningitidis, neck, about 50% of (covers listeria),
listeria, h. flu confusion, adults), lumbar corticosteroids
lethargy, puncture, head before first dose
malaise, CT of abx if possible
seizures,
vomiting,
petechiae
 Viral Virus Fever, stiff Lumbar Antivirals. HSV, No tx for
meningitis neck, malaise, puncture, PCR, VZV- acyclovir enteroviruses
vomiting, etc. serologic assays IV; CMV- or
ganciclovir. flaviviruses.
Encephalitis Mumps, HSV, Fever, altered Acyclovir should
CMV, VZV, mental status, be initiated in all
listeria, TB, seizures pts.
fungi
Brain abscess Strep, Increased ICP, MRI Vancomycin,
bacteroides, fever, neck ceftriaxone, and
enterobacteri rigidity, metronidazole
aceae, staph seizures
Cranial Strep, staph, Headache, MRI Ceftazidime, May result
epidural and fever, nausea cefepime, or from
abscess anaerobes meropenem is meningitis or
pseudomonas is sinusitis
suspected.
Surgical drainage
Subdural Altered LOC, MRI From
empyema seizures, paranasal
elevated ICP sinuses,
hematogenou
s spread,
neurosurgery
GU UTI e. coli, staph, Dysuria, History, PE, and Males: 7-14 days For FQ =
enterococcus frequency, UA/urine culture of FQ levo/Cipro.
urgency, Uncomplicated Moxi does not
suprapubic women: Bactrim, penetrate
pain. When macrobid, FQ. into kidney.
upper tract Pregnant
involvement women: No macrobid
then fever, macrobid, in
nausea and Keflex, then pyelonephritis
vomiting. phosphomyocin. b/c it doesn’t
Complicated penetrate
women: 10-14 kidney.
days of un-failed
therapy.
Prostatitis e. coli, Fever, chills, A clinical FQ, ceftriaxone, Use FQ and
klebsiella, dysuria, cloudy diagnosis, UA aminoglycoside. Bactrim for
VRE, urine, outpt
gonorrhea, dribbling, settings.
chlamydia anuria.
STI Urethritis Gonorrhea, Dysuria w/o UA, swab Gonorrhea: Test sexual
chlamydia, urgency or ceftriaxone, if partners,
mycoplasma, frequency, allergy
trich, HSV pyuria, gentamicin OR
urethral azithromycin
discharge. Chlamydia:
azithromycin, if
allergy
doxycycline
Trich:
metronidazole
PID STI Uterine Elevated WBC Broad spectrum;
tenderness, (in 44% of must cover
cervical women), gonorrhea and
tenderness, transvaginal chlamydia.
fever, ultrasound, Outpt: doxy AND
discharge endometrial metronidazole
biopsy Inpt: clindamycin
AND gentamicin
Herpes Pain or itching, Viral culture or Acyclovir
simplex virus vesiclular direct
lesions fluorescent
antibody
Syphilis Lymphogranul Rapid plasma Penicillin G, if
oma = painless regin or VDRL PCN allergy then
(vereneal doxy,
disease research ceftriaxone, or
lab) azithromycin.
Chancroid Ulcers are May be isolated Macrolide then
painful on special ceftriaxone
media,
expensive and
not done
commonly.
HPV Virus Condylomas or Histology and Cryosurgery,
dysplasia cytology, blood electrodesiccatio
tests n, surgical
excision,
ablation with
laser, topical
antimetabolites.
Cardio Endocarditis Staph and Fever, new Guided by Duke For native valve: Damage to
strep heart murmur, criteria; blood unasyn + tricuspid
septic emboli, cultures, CXR, gentamicin valve
renal echocardiogram Vancomycin (for
involvement, (may see MRSA or
osler’s nodes vegetations on someone w/
(painful), valve) PCN allergy) +
subungal gentamicin OR
hemorrhages, ciprofloxacin.
janeway For prosthetic
lesions (non- valve:
painful), roth’s vancomycin +
spots (on gentamicin OR
funduscopic rifampin
exam)
Myocarditis From ECG Biopsy is gold Supportive care;
preceding abnormailites, standard (via vasopressors
virus acute dilated cath), cardiac and positive
cardiomyopath biomarkers (CK, inotropic agents
y troponin)
Pericarditis Viral infection Fever, malaise, ECG changes, CK Pericardiocentes
myalgia, beck’s and troponin is
triad, pleuritic markers are
chest pain elevated,
echocardiogram
(may show
effusion,
tamponade,
myocardial
dyskinesia),
MRI/CT
Skin and Cellulitis Staph (usually Warm, Clinical findings Oral outpt: If localized,
Soft MRSA) and erythematous, and PE. Labs: Keflex + Bactrim give PO abx,
Tissue strep regional cultures (if FQ severe should
lymphadenopa wound present), Doxycycline/ be tx w/ IV
thy, may have CBC, BMP/CMP, minocycline abx.
sharply CRP and sed Clindamycin
defined border rate. If pt IV abx:
appears ill, then Vancymycin +
order blood zosyn/unasyn
cultures and FQ + flagyl (if
lactate. Order bad cellulitis)
creatinine kinase
if suspect NF.
Necrotizing Type 1 NF: Type 1 NF: H&P. Labs Surgical Type 1 NF:
Fasciitis gram commonly (creatine debridement, polymicrobial
positives after surgical phosphokinase, vancomycin + generally.
(strep, staph, procedure, in aspartate zosyn/unasyn + Type 2 NF:
enterococci), diabetics, or in aminotransferas clindamycin monomicrobi
gram negative PAD pts. e, serum al
(e. coli, Type 2 NF: can creatinine. CXR,
klebsiella, occur at any CT, and MRI will Legs and
pseudomonas age group and show soft tissue other
, in people w/o swelling, may extremities
Enterobacter, comorbidities. show gas (subq are most
proteus), emphysema) common
anaerobes Rapid onset, locations.
(peptpstrepto erythematous, Ludwig’s
, bacteroides, edema, severe angina occurs
clostridium). and when neck is
Type 2 NF: unremitting edematous
strep, vibrio, pain, and
clostridium, hemorrhagic compresses
staph bullous lesions, neck tissue.
necrosis, Fournier’s
crepitus. gangrene is
NF of perineal
area
Myonecrosis Anaerobes Sudden onset May see gas in Penicillins,
(clostridium) of severe pain, tissues on CXR, tetracyclines,
and gram pale skin, CT, MRI, or felt metronidazole,
positives. tender skin, upon PE. Culture cephalosporins.
bullae, subq bacteria. Aggressive and
emphysema. thorough
debridement.
Burns Chemical, Depends on w/ any burn give Use topical Dehydration
electrical, UV degree of 4cc/kg x body antibiotics if and infection
exposure, etc. burn; infection surface area of closed, then if it are 2 big
of burn site burn (infuse half get infected use problems w/
Infection looks like in first 8 hrs, broad spectrum burns;
usually starts progression of then half over abx then switch circumferenti
at gram burn, change next 16 hrs). to narrow al burn on
positives then in wound topical spectrum based hand and
are replaced color, antibiotics. on C&S reports. >10% area =
by gram subeschar Culture and refer to burn
negatives hemorrhage, treat. center.
(due to rapid eschar
hospital separation.
 environment).
Staph,
pseudo,
candida,
aspergillus,
mucor,
rhizopus.
Impetigo Staph or strep Honey-colored This is a clinical Topical
(more crust; diagnosis; mupirocin (if its
commonly commonly confirmed by small); Keflex,
strep) found on the laboratory test amoxicillin,
face, below (which is not Augmentin, then
nostrils, but usually done b/c tetracyclines.
could occur it’s the skins
anywhere; flora) Don’t use
pain, macrolides (they
surrounding are 50%
erythema, resistant)
regional
adenopathy is
common.
Folliculitis Staph, Circumcised, Warm Good hygiene
possibly superficial, compresses and is the best
pseudomonas pustular topical antibiotic way to
(from hot- infection of therapy will prevent this
tubs) the hair suffice. type of
follicle; Tetracyclines infection
typically found work.
on the head,
back, buttocks,
extremities,
face, neck,
groin.
Furunculosis A bacterial May expel pus; Warm
folliculitis; this is a clinical compresses,
infection of diagnosis based incision and
the follicle that on history and drainage. Abx
has spread. PE are usually not
needed if an I&D
is performed.
Bite Wounds Pasturella, Marks, Clinical diagnosis Augmentin (if Human bites
strep, staph, erythema, based on H & PE; PCN allergy, are
peptostrepto may need to considered
 (for human pain, puncture culture to then Bactrim more serious
bites) wounds, etc. ensure abx and clindamycin) due to risk of
therapy works infection.
against the If animal is able
pathogen (if it’s to be observed,
getting worse on then wait 10
abx) days to see if
you need rabies.
If animal is
unobservable,
then give rabies
prophylactically
(except if
opossum or
squirrel bites)
Pulmonar CAP If 5-25: strep Fever, cough, CXR (PA and OUTPT CAP: COPD exac. =
y pneumo and pleuritic chest lateral); then 0-5 yo = azithromycin
atypicals; if pain, sputum cultures amoxicillin OR + doxycycline
older (like chills/rigors, may be helpful if augmentin OR
50): then dyspnea, you can get a cefidinir. Covers MRSA
strep tachycardia, good sample. 5+ = = vancomycin,
pneumo; tachypnea. Urine test for azithromycin OR linezolid
strep and doxycycline
legionella, and If suspected Covers
mycoplasma strep pneumo = pseudomonas
antigen screen. azithromycin OR = zosyn,
ABG (would doxycycline + carbapenem
show respiratory amoxicillin OR (imi/mero),
acidosis), CBC, Augmentin OR aztreonam,
BMP cefdinir gentamicin/to
If allergy, bramycin, FQ
intolerance then (levo/moxi),
try moxifloxacin cefepime,
OR levofloxacin. ceftazidime.
INPT CAP:
Azithromycin OR Add in
doxycycline + azithromycin
ceftriaxone OR or doxycycline
unasyn. to cover
If allergy, then atypicals.
levofloxacin.
HAP/HCAP: If pneumonia
Vancomycin + and diarrhea
cefepime = legionella.
 Legionella:
Azithromycin,
then FQ, then
tetracyclines.
Tuberculosis Mycobacteriu May be Positive PPD skin Poor compliance All organ
m asymptomatic, test; acid-fast due to the systems may
tuberculosis pleural smear; length of tx be affected.
effusion, hilar quantiferon is a needed.
or mediastinal whole blood test Isoniazid,
adenopathy, (has to be Rifampin,
fever, night processed within Pyrazinamide,
sweats, weight 12 hours); then Ethambutol.
loss, weakness, drug
cough. susceptibility
testing.
Viral Varicella Virus Pain, itching, Clinical Antiviral tx is Chickenpox &
Illnesses zoster virus paresthesias, diagnosis; H&PE; marginally varicella
dysesthesias, Tzank smear; cell effective in zoster
unilateral culture; younger; if pts (shingles);
maculopapular serology. >60 and have there are
eruption- ophthalmic vaccines
follows zoster and (varivax,
dermatomes ramsay-hunt proquad,
(lesions are syndrome zostavax); pts
infectious until (lesions in hear who are
scabbed over) and have neuro immunocomp
defects); tx romised- may
started within observe them
48-72 hrs; for a few
valcyclovir and hours on IV
famicyclovir. Tx acyclovir.
for a week or
until healing
occurs in
immunocompro
mised pts.
Epstein-Barr Virus Posterior Normal to Supportive care; With mono
virus cervical chain moderately analgesia you get
adenopathy; elevated WBC (Tylenol/ibuprof splenomegaly
sore throat, count; increased en), rest, avoid and hepatitis.
fever, total number of vigorous activity, When Alt
exudative lymphocytes; corticosteroids. (alkaline
tonsillitis, Can do In phosphatase)
splenomegaly monospot, immunocompro and AST
 heterophile mised pts it can (aspartate
antibody; cause aminotransfer
ultrasound to lymphomas ase) elevated
detect (Burkitt’s) and then look into
splenomegaly. hairy tongue. mono; with
elevated
levels, then
do high sugar,
low fat diet.
Hantavirus Virus spread Cough, GI Thrombocytope Supportive care; Usually
by voles, manifestations nia, elevated fluid support; caused by
mice, rates, , tachypnea, hematocrit, ABG recovery occurs inhalation of
etc.; sin tachycardia, shows low PaO2 if pt can get past virus via
nombre virus postural (hypoxia) and ARDS. (high feces; can
(MCC of HPS) hypotension, low PaCO2; mortality rate- have
fever, chills, immunofluoresc 40% w/ HPS) hemorrhagic
myalgias, ence assay, IgM fever w/ renal
headaches, and IgG. syndrome
nausea/vomiti (HFRS) or
ng, malaise, hantavirus
sweats. pulm
syndrome
(HPS).
Influenza Virus Respiratory Clinical Vaccination for A (in humans,
signs and diagnosis, WBC prevention; mammals,
symptoms, of 4,000 (rarely antiviral and birds), B
cough, elevated), viral medications (only in
malaise, culture, (oseltamivir and humans), C
sweats, etc. serology, rapid zanamivir for (only in
antigen testing those who are humans)
(nasal swab), old, young, and strains;
RT-PCR, and IFA immunocompro Normally we
mised) test for Flu A
and B
Herpes Virus Tingling, Viral cultures, Acyclovir, Can use meds
simplex burning polymerase valcyclovir, prophylactical
infections sensation, chain reaction, famcyclovir. ly if pt is
pain, vesicular Tzank smear, having lots of
lesions, fever, agent specific breakouts,
malaise, immunoglobulin etc. meds can
headache testing be used for
cold sores
too.
 Cytomegalovi Virus Sore throat Always depends Ganciclovir, 20-30% of
rus (red throat), on lab foscarnet, mono is
exudative confirmation cidofovir. caused by
tonsillitis, and cannot CMV;
lymphocytosis make clinical These tx not complications
diagnosis alone; used for the in
direct antigen primary immunosuppr
tests using infection in essed
monoclonal immunocompet (interstitial
antibody; PCR ent host. pneumonia
and
meningoence
phalitis-
headache,
photophobia,
lethargy)
The Fever Due to Shivering, Take Antipyretics Delirium,
febrile pt pyrogens vasoconstrictio temperature, (acetaminophen febrile
increasing n, tachycardia, H&PE and ibuprofen) convulsions
levels of look ill
prostaglandin
s, virus
Fever of Unknown Shivering, H&PE, labs, CBC, Avoid shotgun Infections,
unknown (temp >101 sweating chemistries, therapy. malignancies,
origin on several (when broke), ANAs, CMV, autoimmune
occasions, tachycardia, chest x-ray, Antipyretics conditions,
fever >3 look ill serologies, CT, (acetaminophen misc. may all
weeks), technetium Tc is preferred), be causes.
medication, 99m, tissue time Can be
virus sampling of anything.
lymph nodes
Infections Neutropenia Mild 1000- Recurrent CBC (to get Empiric Put the pt
in 1500 infections, neutrophil antibiotic into reverse
immunoc Moderate must check count) therapy (combo isolation (we
ompromis 500-1000 oral cavity and of 2 or more abx gown up to
ed pts Severe less mucous is gold protect pt
(chemo than 500 membranes, standard); 3rd/4th from our
and HIV cells; may be skin, perirectal gen germs)
pts) from and genital cephalosporin
infection, areas, and OR carbapenem
drugs/chemic lungs, GI, and (mero) OR
als, bloodstream; antipseudomona
nutritional, do not see l penicillin
immune, or classic signs of (+beta-
 congenital; infection like lactamase inhib)
endogenous swelling and +
bacterial flora heat; aminoglycoside
are the most reactivation of or +
common HSV and VZV glycopeptide
pathogens infection,
(staph, GN fungal
from GI, GU. infections.
Infections in Environmenta Broad spectrum Call the
transplant pts l exposures antimicrobial transplant
(TB, systemic therapy; be surgeon and
mycoses, and aware of notify them!!!
strongyloides transplant
stercoralis, medication drug
aspergillus); to drug
nosocomial interactions!
(opportunistic
infections)
GI Acute Bacterial (c. Low grade Infer about diet, Anti-diarrheals Toxic
diarrhea diff), viral temp, travel, used sparingly. megacolon
(rotovirus, tachycardia, exposures, with c. diff.
norovirus), hypotensive, medications Treat based on
parasites tachypnic, dry (metformin, origin.
mucous abx), fecal occult
membranes, blood testing,
tender CBC (normal,
abdomen, may see high
hyperactive WBC with c.
bowel sounds, diff), stool
examination,
Acute Nausea, Self-limiting
bacterial toxin vomiting,
ingestion cramping,
diarrhea
(symptoms
begin 1-8 hrs
after
ingestions w/
abrupt onset)
Viral Direct food Self-limiting
gastroenteriti contact but
s food can be
source when
handled by
 someone who
has virus
Norovirus 12-48 hr Lasts for 1-3
incubation, days; self-
abrupt onset limiting
of nausea,
vomiting,
watery
diarrhea
Rotavirus Most common Mean duration is
and dangerous 6 days; self-
in children; limiting
fever, diarrhea
Microbial Ingestion of Self-limiting
neurotoxin stable,
exposure preformed
toxins
produced by
bacteria or
protozoa.
Botulism Improperly
handled,
contaminated
food products
Ciguatera Red algae;
begins w/
nonspecific
gastrointestina
l symptoms,
neuropathy,
cold, allodynia,
headache,
ataxia
Scombroid Caused by Antihistamines
spoiled fish;
acute onset of
headache,
flushing,
tachycardia,
and
occasionally
diarrhea and
nausea.
Small Nontoxigenic Vilous-
intestinal organisms producing
infection bacteria, fluid
hypersecretion
, impaired
absroption
Inflammatory Nonspecific
diarrhea diffuse
Salmonella, gastroenteritis,
shigella, e. nausea,
coli vomiting, low
volume stools
with blood or
pus
Dysentery Refers to
colonic
infection
presenting
with tenesmus
ad bloody or
mucousy,
small volume
stools, fever,
discomfort
Hemorrhagic Begins w/ O157:H7
colitis cramps, strain of e.
watery coli
diarrhea
progressing to
frankly bloody
stools.
Enteric fever Transmitted Abx if doesn’t
(salmonella) through food resolve on own
and water;
consider in
travelers
Listeriosis Ingestions of
unpasteurized
cheese or
contaminated
cold cuts,
apple ciders;
nonspecific
 diarrhea illness
that could
cause
endocarditis or
meningitis
Yersina E RLQ pain, Oral rehydration
(from pork) vomiting, therapy using
presents as a pedialite;
nonspecific antimolility
inflammatory agents;
enterocolitis, antispasmodics;
can cause antiemetics;
mesenteric antihistamines;
adenitis and amntimicrobial
can mimic therapies for
acute foodborne
appendicitis or illnesses (maybe)
chron disease.
Peritonitis Staph, strep, Rapid scoring Paracentesis Empiric abx
gram negative system with ascetic fluid therapy
analysis
Pyogenic liver Amoebae Fever and Leukocytosis, Parenteral abx, Pink =
abscess (when travel abdominal hyperbilirubine percutaneous amoebic
to edemic pain mia, elevated drainage (CT Brown =
area) or alanine guided) bacterial
bacterial transaminase
and alkaline
phosphatase
Cholecystitis Gallstones, Fat, fertile, 40, Ultrasound and Cholecystectomy During
sludge, or female. RUQ cholescintigraph (laparoscopic cholecystecto
spasm pain, epigastric y (HIDA scan- approach). my DO NOT
pain, biliary checks EF of TOUCH
colic. gallbladder) are If not a surgical common bile
Tachycardia, used most often candidate, then duct (high 5-
fever, tx conservatively year mortality
murphy’s sign with abx and rate if
(deep breath hope for the damaged)
and deep best
palpation of Choledocholit
RUQ) hiasis (stone
in bile duct)
Helicobacter H. pylori Dyspepsia Invasive: PPI + clarithro + Usually in
pylori (burning in endoscopy with amox (use metro antral/fundus
 epigastric biopsy, PCR, if PCN allergic)- of stomach;
area), worse or rapid urea test, triple therapy can lead to
relieved with H. pylori adenocarcino
meals, chronic antibody (blood PPI + bismuth ma. Stomach
GERD, NSAID test) subsalicylate + ulcers get
use. Noninvasive: metro + worse w/
serology, urea tetracycline – eating;
breath test, quadruple duodenal
stool antigen therapy ulcers get
test (gold better with
standard if no Rifabutin +amox eating.
endoscopy) + Cipro – salvage
therapy
Viral hepatitis Hepatitis A Jaundice, RUQ AST, ALT, Supportive Spread by
pain bilirubin, IgM measures, avoid oral-fecal
and IgG contaminated route;
food/water, contaminated
passive foods
immunization, (seafood,
active vegetables)/w
immunization ater
Hepatitis B Jaundice, RUQ Can clear it; high Usually
pain; can clear calorie diet, high needle/blood
on own sugar diet. exposure;
mom to baby.
For chronic
hepatitis B: Screening
pegylated blod
interferon, products,
lamivudine, screen
telbivudine, pregnant pts,
entecavir, Hep B vaccine
adefovir,
tenofovir.
Hepatitis C Liver failure; Antibody test, IFNa and
can clear quantitative ribavirin; specific
assays of hep C tx regimens
RNA may be based on viral
used for genotype
diagnosis
Diverticulitis e. coli, LLQ pain, CT of abdomen Conservative Complications
bacteroides sometimes and pelvis w/ IV management; include
RLQ pain, contrast Outpt: FQ + perforation,
fever, metro; abscess; clear
 diarrhea, Augmentin; liquid diet for
nausea moxifloxacin 72 hrs or until
Inpt: unasyn, pain free,
zosyn, IV FQ + then full
metro, liquid diet for
ertapenem 24 hrs then
BRAT diet
(bananas,
rice,
applesauce,
toast) for 24
hrs and back
to normal
diet. Avoid
dairy for 2
weeks.
C. diff c. diff Mucousy Stool test for PO vanco, flagyl
stools, post- antigen (if 1 has increased
abx therapy, positive then resistance, then
exposure send for PCR), dificid, then
high WBC, CT fecal transplant
(pseudomembra
ne or toxic
megacolon)
Parasites Malaria Plasmodium Fever, anemia, Blood smear Rehydration, Global
falciparum, p. splenomegaly, correct eradication
malariae, p. jaundice, hypoglycemia, program;
vivax and hypoglycemia correct anemia,
ovale, p. correct acidosis,
knowlesi treat fever,
monitor urine
production, treat
seizures;
artesunate
Chagas Parasite Swelling Nifurtimox,
Disease around eye benznidazole
(Romana’s
sign)
Helminth Ascaris, Lactose Stool smear for
Infection trichuris, intolerance, ova and
hookworm vitamin A parasites
malabsorption,
intestinal
obstruction,
 colitis,
intestinal
blood loss,
iron-deficiency
anemia,
protein
malnutrition
Leishmaniasis Tissue Pentavalent
specimens, antimonial
culture, compounds,
serologic testing liposomal
amphortericin B,
miltefosine
Lyme Disease Ticks; borrelia Erythema Clinical Doxycycline;
burgdorferi migrans, diagnosis; lyme high dose
malaise, titers (for amoxicillin for
headache, antibodies); B. kids, rocephin
fever and burgdoferi in will work
chills, culture
myalgias/arthr
algias, nausea,
anorexia,
dizziness
Babesia Flu like Seeing Mild (azithro +
symptoms, intraerythrocytic atovaquone)
hepatospleno parasites Severe
megaly and (clindamycin)
anemia may
occur
Rickettsia Tickborne; Maculopapular Blood smear Tetracyclines for
rocky rash, petechial microscopy; all; will give it to
mountain rash, nausea, serologic testing; kids
spotted fever; vomiting, history
human abdominal
monocytotro pain, fever;
pic; human may turn into
granulocytotr renal failure,
opic; ehrlichia myocarditis,
ewingii meningoencep
infection halitis,
hypotension,
acute
respiratpry
distress
 Bartonella Bartonella Isolated Labs are usually Self-limiting Cats are
henselae lymphadenopa normal, disease that major
thy, fever intradermal skin resolves within reservoir
test, PCR, 2-6 months;
serologic testing rifampin, Cipro,
gent, and
Bactrim are
effective in
order of
increasing
effectiveness
HIV HIV Human Fever, malaise, ELISA testing; Antiretroviral Recommende
immunodefici anorexia or viral load agents d
ency virus weight loss, testing; general immunization
infection myalgias, leukopenia with s (hepatitis B,
athralgias, CD4+ hepatitis A,
headaches, lymphopenia influenza,
rash, diffuse and atypical strep
lymphadenopa lymphocytosis; pneumo)
thy, mild
oral/vaginal/a thrombocytopen
nal ulcers ia; abnormal
LFTs
AIDS AIDS defining
clinical
conditions
(invasive
cervical
cancer,
esophageal
candidiasis,
disseminated
herpes
simplex,
kaposi’s
sarcoma,
burkitt’s
lymphoma, TB,
salmonella
septicemia,
disseminated
coccidioidomy
cosis,
encephalopath
 y,
dissmeniated
histoplasmosis,
pneumocystis
jiroveci
pneumonia
PCP Primary Bactrim
prophylaxis is prophylaxis
CD4 count is
<200 or after
an episode of
PCP
Toxoplasmosi Primary Bactrim
s prophylaxis if prophylaxis
CD4 count is
<100;
secondary
prophylaxis
Mycobacteriu Primary Azithromycin,
m other than prophylaxis if rifabutin
TB CD4 count is prophyaxis
<50
TB Primary Isoniazid
prophylaxis if prophylaxis
skin induration
exceeds 5mm
with a 5-U skin
test
Cryptococcosi Primary Fluconazole
s prophylaxis if prophylaxis
CD4 count is
<50; secondary
prophylaxis
after an
episode
Lung diseases Bacterial
linked to HIV pneumonia,
PCP, TB,
Kaposi’s
sarcoma,
interstitial
lymphoid
pneumonia
GI diseases Oral (thrush,
linked to HIV leukoplakia,
aphthous
ulcers);
esophagus
(candida,
esophagitis,
ulcers and
erosions);
stomach
(gastritis);
small
intestine
(diarrhea,
malignant
lymphoma,
cholangitis);
liver
(hepatitis);
colon (colitis)
CNS Cerebral
involvement toxoplasmosis
in HIV , primary
cerebral
lymphoma,
progressive
multifocal
leukoencepha
lopathy,
cryptococcal
meningitis,
aseptic
meningitis,
CMV
encephalitis
Skin disease Oral
in HIV leukoplakia,
kaposi’s
sarcoma,
bacillary
angiomatosis,
herpes zoster,
seborrheic
dermatitis,
acute
condylomata,
molluscum
contagiosum,
herpes
simplex,
prurigo
nodularis