Causes: Bacterial infection is the most common cause of endocarditis, specifically viridans group strep, Staphylococcus aureus, HAECK group organisms (Haemophilus species, Aggregatibacter actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae), or Enterococcus. Endocarditis can also be caused by fungi, such as Candida. Some weird fastidious bacteria show up too, like Bartonella, Brucella, Coxiella burnetii (causes […]
Infectious Disease
Sinus Troubles: When Should I See My Doctor
We’ve all had sinus troubles before and it’s sometimes hard to tell if it’s a bacterial infection, a virus, or allergies. Your physician probably even has a hard time. Here are some tips on when to see your physician, and when you should visit your local pharmacy for some home remedies. Viral Sinusitis If you’ve […]
Pneumonia
Community Acqired Pneumonia (CAP) CAP is usually caused by S. pneumonia, H. influenza, S. aureus, legionella (usually more severe), mycoplasma and Chlamydophila (less severe), and pseudomonas and Enterobacteriaceae sometimes isolated You don’t usually do cultures in CAP. Chest infiltrate and cough/sputum are diagnostic. Don’t go by procalcitonin to diagnose or to discontinue therapy. For CAP, there are a […]
COVID-19 mRNA EUA Vaccine FAQs
There have been a lot of questions about the COVID-19 mRNA vaccines. I thought I would put together an easy FAQ with some referenced answers. I’ll keep adding to it as I get more questions. I have a FAQ about the Johnson and Johnson vaccine too. Is it Going to Alter my DNA? If you […]
Clostridium/Clostridiodes Difficile
Clostridiodes difficile is a pretty big problem, causing quite a bit of morbidity and mortality every year, and it’s becoming more and more common. It can be pretty tricky to treat. C. diff is an anaerobic, spore-forming rod and it makes a toxin that contributes to the severity of the disease. It causes diarrhea and […]
Sinusitis
Sinusitis is usually viral. Only use antibiotics if signs and symptoms are greater than 10 days or purulent discharge with a fever greater than 102 degrees. Viral is quick, usually lasting less than a week. Bacterial often has double sickening and purulent discharge. Do not do imaging unless immunocompromised or orbital cranial involvement. Only symptomatic relief for […]
Respiratory Syncytial Virus
Treatment: Mostly supportive care Ribavirin – only in select patients (complicated congenital heart disease, chronic lung disease, bronchopulmonary dysplasia, immunocompromised patients) Beta-agonists or race epinephrine – not usually used Corticosteroids, hypertonic saline or antibiotics are also not usually used. Prophylaxis: Palivizumab: 15 mg/kg/dose; prophylaxis is not recommended if > 29 weeks gestation (risk factors not considered) Neonates […]
Meningitis
Signs and Symptoms: Brudzinski sign and Kernig Sign Fever, altered mental status, neck, stiffness, seizures, neurological deficits Treatment: <1-month-old – ampicillin (listeria coverage) and cefotaxime or gentCommon pathogens: Group B Strep, E. coli, K. pneumoniae, Enterobacter, Listeria monocytogenes 1-23 months old – vancomycin and ceftriaxone or cefotaximeCommon pathogens: S. pneumoniae, N. meningitidis, H. influenzae 18-50 years – vancomycin […]
Otitis Media
Analgesia: APAP, NSAIDS, rarely opioids. Avoid ASA in kids. Antihistamines and decongestants are not usually recommended. Antibiotics only if: Bulging tympanic membrane, perforation or otorrhea Delay unless fever or otalgia > 48-72 hours in kids > 2 years. Not usually for otitis media with effusion, only if greater than 3 months Not for the persistence of […]
Sexually Transmitted Disease
Syphilis: Pen G x 1 or doxycycline In more severe cases may treat weekly for 3 weeks. For neurosyphilis, PenG infusion for 10-14 days. Treat all sex partners within last 90 days. If a patient with neurosyphilis is allergic to PCN, desensitization is best. Neurosyphilis is not as vulnerable to doxy. Chlamydia: Azithromycin X 1 Doxy […]