Term
| What organism causes Lyme disease? |
|
Definition
|
|
Term
| What are the stage 1 symptoms of Lyme disease? |
|
Definition
| Erythema migrans (target or bulls-eye lesion), fever, arthralgias, myalgias, and lymphadenopathy |
|
|
Term
| What are the stage 2 symptoms of Lyme disease? |
|
Definition
| Myocarditis, +/- AV block, bell's palsy (unilateral or bilateral), peripheral neuropathy, and meningitis. |
|
|
Term
| What are the stage 3 symptoms of Lyme disease? |
|
Definition
| Arthritis and possibly by chronic neurologic symptoms |
|
|
Term
| How is Lyme disease diagnosed? |
|
Definition
| Western Blot or PCR to confirm clinical diagnosis. |
|
|
Term
| How is Lyme disease treated? |
|
Definition
Doxycycline or amoxicillin
IF cardiac/neuro symptoms; Ceftriaxone |
|
|
Term
| What causes Ehrlichiosis? |
|
Definition
| Ehrilichia and Anaplasma bacteria |
|
|
Term
| How does Ehrlichiosis present? |
|
Definition
| Nonspecific symptoms including fever, chills, malaise, headache, and myalgias with no physical exam findings |
|
|
Term
| How do you diagnose Ehrlichiosis? |
|
Definition
Serology or PCR
Labs may show thrombocytopenia, leukopenia, and elevated transaminases |
|
|
Term
| How is Ehrlichiosis treated? |
|
Definition
|
|
Term
|
Definition
| Babesia organism infects RBCs |
|
|
Term
| How does Babesiosis prese38.3nt? |
|
Definition
Nonspecific symptoms tht include fever, chills, fatigue, and myalgias.
Travel history to Cape Cod, Nantucket, or Martha's Vinyard |
|
|
Term
| How do you diagnose Babesiosis? |
|
Definition
|
|
Term
| How is Babesiosis treated? |
|
Definition
|
|
Term
| What is neutropenic fever? |
|
Definition
Most commonly occurs after chemotherapy.
Single temp of >101.3 (38.3)
OR Sustained >100.4 (38) for more than an hour in a neutropenic patient (ANC=PMNs + bands <500) |
|
|
Term
| How to you examine people with neutropenic fever? |
|
Definition
Check the skin for cellulitis, line infection.
DO NOT do DRE unless perirectal abscess is suspected. |
|
|
Term
| What labs should be ordered in neutropenic fever? |
|
Definition
Get CBC with diff, CMP, amylase, lipase, CXR, Cultures (urine, blood sputum and stool)
ONLY do LP if neurologic symptoms are present |
|
|
Term
| How do you treat neutropenic fever? |
|
Definition
Empiric antimicrobials to cover Pseudomonas (Cefepime or carbapenem IV)
Consider Vancomycin in pts with Hx of MRSA infections, hypotension, persistent fever on empiric therapy or skin or catheter site infections
Think about FUNGAL infections (esp Candida and aspergillus) if more than 5 days fever and begin amphotericin B or voriconazole |
|
|
