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Infectious diseases lessons: HCAP/VAP/Nosocomial

http://id-lessons.blogspot.com/2009/05/health-care-acquired-pneumonia.html

Risk factors for MDR pathogens:. Antimicrobial therapy in proceeding 90 d. Current hospitalization of 5 days or more. High frequency of antibiotic resistance in the community or in the specific hospital unit. Risk factors for HCAP:. Hospitalization for 2 days or more in the preceding 90 d. Residence in a NH or extended care facility. Chronic dialysis within 30 d. Family member with MDR pathogen. Immunosuppressive disease and/or therapy. If risk factrors for MDR pathogens exist:. Posted by Nabil Khoury MD.

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Infectious diseases lessons: West Nile Virus

http://id-lessons.blogspot.com/2009/05/west-nile-virus.html

West Nile virus infection is a flavivirus-induced, mosquito-borne illness that occurs in Africa, ME, Asia, australia and parts of Europe. . Incubation period: 2-15 days. A mild form of disease, a flu-like illness, "West Nile Fever", develops in approximately 20% of infected individuals. . A more severe form of West Nile virus, neuroinvasive disease, is evident in less than 1% of infected persons, particularly males, elderly, alcoholic, diabetic, immunosuppressed, and hypertensive. Fever and Jaundice case.

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Infectious diseases lessons: Acinetobacter baumannii Infections

http://id-lessons.blogspot.com/2009/05/acinetobacter-baumannii-infections.html

Causes bacteremia, endocarditis, pneumonias, wound infection, urine tract infections and meningitis. Aerobic gram negative bacilli, oxidase negative, catalse positive. MDR resistant A. baumanii is defined as resistance to carbapenem or to 3 different class of antibiotics. Carbapenem: still drug of choices. Intra-thecal Amikacin for meningitis. Consider aersolozied colistin for VAP. Consider combination with Rifampin. Posted by Nabil Khoury MD. Pet bird-associated with flu-like syndrome. New Fever in ICU.

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Infectious diseases lessons: Neisseria

http://id-lessons.blogspot.com/2009/05/neisseria.html

Posted by Nabil Khoury MD. Pet bird-associated with flu-like syndrome. Pet bird-associated diseases as skin problems. Pet bird-associated infx with GI syndrome. Fever and Jaundice case. New Fever in ICU. Gram-Negative Cocci and Bacilli. Staphylococcus and related organisms. Enterococcus and Other Gram positive Cocci. Listeria, Erysipelothrix, and other gram-positive . Vibrio, Aeromonas, Plesimonas. Pseudomonas and Related Organisms. Bordetella, Francisella, and Brucella. American Journal of Medicine.

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Infectious diseases lessons: Disseminated Gonorrhea

http://id-lessons.blogspot.com/2009/05/disseminated-gonorrhea.html

A case presentation: . 32 year old man, presented to the ER with a 2 day history of skin lesions on his hands and feet. The lesions accompanied by fever(102.9F), malaise, diffuse arthralgias and 1 episode of vomiting. . Physical: 5-6 purpuric papules, each with a central area of necrosis or pustule formation, located on the palmar and dorsal aspects of his hands and feet, and a well defined plaque on his right ankle. . This patient claimed to be in monogamous relation. . Rocky Moutain Spotted fever.

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Infectious diseases lessons: Pet bird-associated infx with GI syndrome

http://id-lessons.blogspot.com/2009/05/pet-bird-associated-diseases-with.html

Pet bird-associated infx with GI syndrome. Blood culture if bacteremia or non gi infection. Diarrhea is usually self-limited. Abx increases carrier state. Cipro, Ceftriaxone, or TMP/SMX. Stool culture (selective media needed, request testing specifically for campylobacter). Disease is usually self limited. Azithromycin, Clarithromycin, and erythromycin quinolones. Disease is usually self limited. Tinidazole, nitazoxanide, paromomycin. Posted by Nabil Khoury MD. Pet bird-associated with flu-like syndrome.

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Infectious diseases lessons: Campylobacter and Helicobacter

http://id-lessons.blogspot.com/2009/05/campylobacter-and-helicobacter.html

Posted by Nabil Khoury MD. Pet bird-associated with flu-like syndrome. Pet bird-associated diseases as skin problems. Pet bird-associated infx with GI syndrome. Fever and Jaundice case. New Fever in ICU. Gram-Negative Cocci and Bacilli. Staphylococcus and related organisms. Enterococcus and Other Gram positive Cocci. Listeria, Erysipelothrix, and other gram-positive . Vibrio, Aeromonas, Plesimonas. Pseudomonas and Related Organisms. Bordetella, Francisella, and Brucella. American Journal of Medicine.

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Infectious diseases lessons: Non-resolving Pneumonias:

http://id-lessons.blogspot.com/2009/05/non-resolving-pneumonias.html

1- Consider non infectious etiologies. BOOP, Wegner's granulomatosis, CHF, PE, drug related, PE, Cancer. 2-Underlying poor host status. Smoker, alcoholism, COPD, bronchiectasis, HIV/AIDS, Cystic fibrosis, chronic steroid use, diabetics, asplenia. Wrong target or resistant bugs. Review all differential again of HCAP, unknown HIV infection/AIDS, endemic fungal infections, aspiration, Tuberculosis and MAC, resistant bacterias such as Pseudomonas and MRSA. Consider Histoplasmosis in the Midwest. Vibrio, Aero...

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Infectious diseases lessons: Influenza

http://id-lessons.blogspot.com/2009/05/influenza.html

All subtypes of influenza A virus can infect birds (influenza B virus cannot). Avian influenza viruses affecting birds and humans called "avian flu". Person to person transmission has been very rare, limited and unsustained. Suspect it in people who have been exposed to sick poultry or wild birds. With highly pathogenic viruses such as H5N1, the disease can progress very rapidly from onset to death. Posted by Nabil Khoury MD. Pet bird-associated with flu-like syndrome. Fever and Jaundice case.