20 articles Infectious Disease

Fungal infection of the skin: Ring worm, Athlete’s foot

Tinea corporis (ring worm): Thorough bathing with soap and water, removal of scabs and crusts, and the application of an effective topical (e.g. creams, lotions or ointments) fungicide such as miconazole 2% external cream, ketoconazole, ciclopiroxzole, econazole, naftifine, tervinafine, tolnaftate or ciclopiroxzole may be all that is needed to treat the fungus. Ketoconazole 2% topical…

Streptococcus Pharyngitis (strept throat): CENTOR Criteria

Streptococcus Pharyngitis (strept throat): CENTOR Criteria History of fever or measured temp greater than 38C or 100.4F Tonsillar swelling or exudates Tender anterior cervical lymph nodes Absence of a cough A rapid antigen detection test (RADT) can be used to rule out strep throat in patients with intermediate probability of strep pharyngitis. ***Order: [Group A…

Shingles

Shingles: (herpes zoster infection: red patches of skin with white/clear papules, typically very painful, and rash follows a dermatome) PE: Vesicles on a red base starting in center of chest, on bottom of right breast, wrapped around right side and into mid upper back. Dermatomal distribution. Tx Plan: Start Valacyclovir 1g tablets – take 1…

Otalgias: ear pain

Otalgias: ear pain Otitis media: bacterial infection requires antibiotic Augmentin Amoxicillin at a dosage of 80 to 90 mg/kg/day divided BID for 5 to 10 days is the recommended first-line antibiotic Amoxicillin 400mg/5ml (5ml = 1 teaspoon) oral suspension – Take 2 teaspoons q12hrs X 10 days. If allergic to Penicillin: Bactrim DS SMX-TMP (Bactrim) 200-40mg…

Bacteremia – pearls from Dr. Shams (VA)

Bacteremia: Blood culture contamination: Only Coagulase negative Staphylococci, Bacillus species, and Corynebacteria can be attributed to blood culture contamination if they grow in 1/2 or 1/4 culture bottles with repeat blood cultures being negative and patient has no suspicious underlying hardware (ex: pacemakers, prosthetic heart valves, or joint prostheses). Need for 2-D Echos: Order a…

Abscess

Abscess on skin: Abscess may be already draining on its own or may require I&D. Bactrim DS 1 tab bid for 10 days (20 tabs). If allergic to Bactrim (allergy to sulfa): Doxycycline 100mg PO bid or Clindamycin. Analgesic: Lortab 5 X 10 tablets. Start Sitz bathes (depending on location of abscess). Culture wound/abscess (anaerobic…