Podcast
Questions and Answers
Which of the following infections is typically transmitted vertically?
Which of the following infections is typically transmitted vertically?
- Toxoplasma gondii (correct)
- Parvovirus
- Staphylococcal infections
- Covid-19
What proportion of cases of Pyrexia of Unknown Origin (PUO) are due to infection?
What proportion of cases of Pyrexia of Unknown Origin (PUO) are due to infection?
- 20%
- 30% (correct)
- 40%
- 50%
What is the primary basis for treating MRSA infections?
What is the primary basis for treating MRSA infections?
- The results of antimicrobial susceptibility testing (correct)
- The severity of the infection
- The site of infection
- The age of the patient
Which of the following bacteria is typically found colonizing the anterior nares and skin?
Which of the following bacteria is typically found colonizing the anterior nares and skin?
Which of the following antibiotics is NOT typically used to treat milder MRSA infections?
Which of the following antibiotics is NOT typically used to treat milder MRSA infections?
What is the classic definition of Pyrexia of Unknown Origin (PUO)?
What is the classic definition of Pyrexia of Unknown Origin (PUO)?
What is the primary characteristic used to classify streptococci?
What is the primary characteristic used to classify streptococci?
What is the approximate incubation period of Covid-19?
What is the approximate incubation period of Covid-19?
Which group of streptococci is commonly associated with cellulitis in elderly, diabetic, or immunocompromised patients?
Which group of streptococci is commonly associated with cellulitis in elderly, diabetic, or immunocompromised patients?
What percentage of Pyrexia of Unknown Origin (PUO) cases are idiopathic?
What percentage of Pyrexia of Unknown Origin (PUO) cases are idiopathic?
What is the hallmark feature of scarlet fever?
What is the hallmark feature of scarlet fever?
What is the primary goal of treating scarlet fever with antibiotics?
What is the primary goal of treating scarlet fever with antibiotics?
Which of the following is a coagulase-positive staphylococcus that causes infection following dog bites?
Which of the following is a coagulase-positive staphylococcus that causes infection following dog bites?
What is the typical duration of scarlet fever?
What is the typical duration of scarlet fever?
What is the main cause of staphylococcal infections?
What is the main cause of staphylococcal infections?
What is the name of the sign characterized by residual petechial lesions in the antecubital fossa?
What is the name of the sign characterized by residual petechial lesions in the antecubital fossa?
What is the primary cause of morbidity following hospital admission associated with Staphylococcal infection?
What is the primary cause of morbidity following hospital admission associated with Staphylococcal infection?
What is the mechanism of meticillin-resistance in Staph.aureus?
What is the mechanism of meticillin-resistance in Staph.aureus?
What is the primary location for Staphylococcal biofilm formation?
What is the primary location for Staphylococcal biofilm formation?
Which of the following is NOT a type of skin infection caused by Staphylococci?
Which of the following is NOT a type of skin infection caused by Staphylococci?
What is the primary method of preventing wound infections caused by Staphylococci?
What is the primary method of preventing wound infections caused by Staphylococci?
What is the treatment for cannula-related Staphylococcal infections?
What is the treatment for cannula-related Staphylococcal infections?
What is the name of the Staphylococcal strain that is resistant to vancomycin?
What is the name of the Staphylococcal strain that is resistant to vancomycin?
What is the primary commensal organism of the skin?
What is the primary commensal organism of the skin?
Study Notes
Infection
- Chain of infection: Toxoplasma gondii, Listeria monocytogenes, Treponema pallidium, Parvovirus, HIV, Varicella zoster virus, Rubella, Cytomegalovirus (CMV), and Herpesviruses (HSV) 1 and 2 (TORCH)
Diagnosis
- Pyrexia of unknown origin (PUO): temperature above 38.0°C on multiple occasions for more than 3 weeks, without diagnosis, despite initial investigation
- Subsets of PUO: HIV-1 related, immune-deficient, or nosocomial
- Causes of PUO: Infection (30%), Connective TD (15%), Miscellaneous (30%), Malignancy (20%), Idiopathic (15%)
Bacterial Infection
- Incubation periods: 4-14 days for Covid-19
- Normal flora: Staphylococci are usually found colonizing the anterior nares and skin
- Staphylococcal infections:
- Skin infections: ecthyma, folliculitis, furuncles, carbuncles, bullous, impetigo, and scalded skin syndrome
- Wound infections: many wound infections caused by staphylococci, which may prolong post-operative hospital stays
- Cannula related infections: Staphylococcal infection associated with cannula sepsis and thrombophlebitis
- Meticillin-resistant Staph. aureus (MRSA): resistance to meticillin due to a penicillin-binding protein mutation
- Treatment: based on antimicrobial susceptibility testing, may include clindamycin, tetracyclines, co-trimoxazole, glycopeptides, linezolid, and daptomycin
Streptococcal Infections
- Streptococci: nasopharyngeal and gut commensals, classified by haemolysis and serotypes
- Skin presentations:
- Group A streptococci (GAS): major cause of cellulitis, erysipelas, and impetigo
- Groups C and G streptococci: cause cellulitis, in elderly, diabetic, or immunocompromised patients
- Group B streptococcal (GBS) infection: increasing problem at the extremes of age
- Streptococcal scarlet fever:
- Caused by Group A (or occasionally groups C and G) streptococci producing a streptococcal pyrogenic exotoxin
- Common in school age children, can occur in young adults with contact with young children
- Symptoms: diffuse erythematous rash, circumoral pallor, strawberry tongue, and residual petechial lesions in the antecubital fossa (Pastia’s sign)
- Treatment: susceptible antibiotics (Penicillin), which can prevent rheumatic fever but not Poststreptococcal Glomerulonephritis
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Description
This quiz covers the chain of infection, diagnosis of pyrexia of unknown origin, and its causes, including infections and connective tissue diseases. Test your knowledge of TORCH infections and more.
