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microbiology - djyoti
#1
-iv drug abuser with malaise fever hemoptysis pleuritis splenomegaly new murmur--dx

2.25 shortness of breath hx of uri ankle edema /aso negative -coxsackie in serumdx

3. 35 fever non productive cough chest pain supine more chest pain increase jvp on inspiration--esr increased/ldh incresed diffuse st elevation / pr segmentatdepression --/cpk mb normalname the virus causing it --what are other causes




4. 64 progressive dyspnea and fever with a hx of orothopnea frohy sputum had had biprosthetic valve pe -suggestive of aortic insufficiency -

name the organism
mention the rx
imaging finding





5. 25 yr old f c/o low grde fever and myelgia of 3 week duration
hpi- rhd/ one month ago had dental extration --didnot take antibioti prescribed by the doctor

o/e --petechial hemorrhage with nodules
small tender nodule in finger an dtoe nail pads

subungal linear streaks

petechial hemorrage in conjunctiva

mild splenomegaly

diastolic murmur fundus oval retinal hemorrage


what are thosee findings --name them

what is the organism

what is the rx

which valve in echo

diagnostic criteria









54 with a hx of ca operated with lymph node dissection has a swelling and sign of inflammation raised margin borders ill defined

dx

rx

name organism in this case

what are other organism








15 yr painful rash and fever was on a camping

oe warm erythematous plaqe like rash extending across cheeks and face bilaterally with sharp distict border and facial swelling
neutrophillia esr raised

dx

rx

predisposing factors









6 yr with golden yellow crusted lesion around his mouth an behind his ears

fever

dx

lab finding

rx





30 yr male homosexual nonpruritic skin reuption in trumk anogenital

dome shaped umbilicated --palms soles spared


what test you will like to order

finding in biopsy

name of organism

rx
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#2
.infective endocarditis.

2.pericarditis?

3.ACUTE pericarditis,viral,t.b neoplasm,drugs,IDIOPATHIC MCC,trauma,conect tisuue dz.

4.

5.o/e --petechial hemorrhage with nodules,,splinter h,mmge
small tender nodule in finger an dtoe nail pads ..osler nodule

subungal linear streaks ...janeway lesion

petechial hemorrage in conjunctiva..roth spot

mild splenomegaly

diastolic murmur fundus oval retinal hemorrage


what are thosee findings --name them

what is the organism...native valve..strep viridian(mutans)

what is the rx....emperic is...naficillin and gentamycin

which valve in echo...most commonly MITRAL

diagnostic criteria..sensitive==TEE...specific=CULTURE.

2 major and i minor...or 1 major with 2 minor
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#3
iv drug abuser with malaise fever hemoptysis pleuritis splenomegaly new murmur--dx
INFECTIVE ENDOCARDITIS----S.aureua
2.25 shortness of breath hx of uri ankle edema /aso negative -coxsackie in serumdx

3. 35 fever non productive cough chest pain supine more chest pain increase jvp on inspiration--esr increased/ldh incresed diffuse st elevation / pr segmentatdepression --/cpk mb normalname the virus causing it --what are other causes

Acute pericarditis---viral


4. 64 progressive dyspnea and fever with a hx of orothopnea frohy sputum had had biprosthetic valve pe -suggestive of aortic insufficiency -

name the organism Staph epidermidis-----immediately after surgery.Staph virudans 10- 20yafter
mention the rx
imaging finding staph aureus





5. 25 yr old f c/o low grde fever and myelgia of 3 week duration
hpi- rhd/ one month ago had dental extration --didnot take antibioti prescribed by the doctor

o/e --petechial hemorrhage with nodules
small tender nodule in finger an dtoe nail pads

subungal linear streaks

petechial hemorrage in conjunctiva

mild splenomegaly

diastolic murmur fundus oval retinal hemorrage


what are thosee findings --name them

what is the organism strepto.mutans or strep.virudans

what is the rx

which valve in echo mitral

diagnostic criteria









54 with a hx of ca operated with lymph node dissection has a swelling and sign of inflammation raised margin borders ill defined

dx

rx

name organism in this case

what are other organism








15 yr painful rash and fever was on a camping

oe warm erythematous plaqe like rash extending across cheeks and face bilaterally with sharp distict border and facial swelling
neutrophillia esr raised

dx ?rocky mounten

rx

predisposing factors









6 yr with golden yellow crusted lesion around his mouth an behind his ears

fever

dx

lab finding

rx





30 yr male homosexual nonpruritic skin reuption in trumk anogenital

dome shaped umbilicated --palms soles spared


what test you will like to order

finding in biopsy

name of organism

rx



Reply
#4
well


answers are here

iv drug abuser has got bacterial endocarditis


--25 yr old guy with shortness of breath aso negative and coxsackie virus positive has coxsackie myocrditis


--35 year old with supinal chest pain and jvp raised in inspiration and myocardial enzyme normal and ldh high esr high and aproductive cough is having viral pericarditis and
other causes of pericarditis --are bacterial -diptheria/tb
viral coxsackie hiv/ebv
protozoa
autoimmune-sle
inflammatory--rhematoid arthritis
toxin--uremia
tumour infiltration
postoperative-dressler's syndrome


64 yr old with a prosthetic valve with frothy spitum and with aortic insufficiency --will have staphylococcus epidermis affecting his valve and and echo finding will be vegation for left ventricular hypertrophy and incresed volume
rx is cefotaxime


24 yr with a hx of RHD has fever myelgia splenomegaly and all those vasculitis and autoimmune based skin finding and with a hx of dental exraction one month back noncompliant with his antibiotic has subacute endocarditis in diseaesd native valve

janeway lesion--petechial painless
oslers node
streaks --splinter hemorrage
eyes --roth's spot
murmur

organism is streptococcus viridans or streptococcus mutans

antibiotic -


diagnostic major criteria--culture positive and echo-vegitations

minor are other 5 criteria

valve commonest involved --mitral valve



the 25 who went to camp and got red bilateral erythematous swelling in the face has erysipelas streptococcal infection-predisposing factor may e scratch or cut in the wood





honey crusted lesion in the vicinity of the corner of lip is -- impetigo -more due to streptococcus infection


homosexual with umbilicated lesion in the trunk face and palm and sole is spared has pox virus infection called molluscum contagiosum -biopsy will show the viral laden inclusion body
treatment is curettage or podophyllin --it is infectious--commoner with hiv/ also occur in children

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#5
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