- Botulism
- Chlamydia
- COVID-19
- Meningitis
- Osteomyelitis
Botulism
Rapid Review
- Background
- Botulism is a neuro-paralytic disease caused by the ingestion, injection, or inhalation of a pre-formed toxin produced by Clostridium botulinum.
- The toxin can be found in incorrectly canned/preserved foods and honey
- Signs/Symptoms
- Facial paralysis, descending weakness, respiratory arrest
- Diagnosis
- Clinical diagnosis based on history and physical exam
- Confirmation of diagnosis requires identification of toxin in serum, stool, vomit, or food sources (may take 1-6 days)
- Treatment
- Early ventilatory management and wound debridement
- Heptavalent antitoxin
Pearls
Deep Dive
Chlamydia
Rapid Review
- Background
- Chlamydia is the most common sexually transmitted infection in the US caused by the baceteria Chlamydia trachomatis. It is a leading cause of infertility.
- Can affect the cervix, urethra, salpinges, uterus, and epididymis.
- Signs/Symptoms
- Dysuria, mucopurulent urethral discharge, +/- fever
- Over 50% of infected individuals are asymptomatic
- Diagnosis
- NAAT (urine or vaginal swab)
- Treatment
- Ceftriaxone IM + Azithromycin PO
- Provide prescription for expedited partner treatment
Pearls
Deep Dive
COVID-19
Rapid Review
- Background
- Acute respiratory illness caused by the novel SARS-CoV-2 virus
- Often causes pulmonary, cardiac, and neurological complications
- Signs/Symptoms
- Range from mild cold-like symptoms to respiratory failure
- Most common symptoms include fever, dry cough, fatigue, and SOB.
- Associated with cardiac complications and thromboembolic phenomenon.
- Diagnosis
- Viral testing (Rapid antigen and/or RT-PCR testing)
- Treatment
- Pulmonary support (O2, NIPPV, Intubation)
- Consider Dexamethasone and Remdesivir for moderate-severe infections
Pearls
Deep Dive
Meningitis
Rapid Review
- Background
- Inflammation of the meninges and subarachnoid space. May be bacterial (most lethal), viral (most common), or in rare cases due to fungal or tuberculosis infection.
- Bacterial meningitis is most commonly caused by Streptococcus pneumoniae
- Signs/Symptoms
- Fever, headache, nuchal rigidity, photophobia
- (+) Brudzinski sign, (+) Kernig Sign
- Diagnosis
- Lumbar puncture w/ CSF fluid analysis
- Treatment
- Broad-spectrum antibiotics (ex. Ceftriaxone + Vancomycin) and corticosteroids (ex. Dexamethasone)
- If viral, treat with Acyclovir
Pearls
Deep Dive
Osteomyelitis
Rapid Review
- Background
- Infection of the bone with persistent inflammatory destruction. Most commonly caused by bacteria (Staph aureus, pasteurella multocida, pseudomonas aeruginosa), but can also be caused by fungi.
- Signs/Symptoms
- Localized bony tenderness w/ warmth, swelling, erythema
- May experience weight loss, fatigue, and fever.
- Diagnosis
- X-ray (will show bony erosions, regional osteopenia, periosteal elevation)
- Radiography may be normal the first 2-3 weeks of symptoms. CT/MRI will provide earlier detection.
- Treatment
- Empiric broad-spectrum antibiotics (ex. Vancomycin + Piperacillin/Tazobactam)
- Obtain bone cultures prior to initiating antibiotics
Pearls
Deep Dive
Latest posts by Brandon Simpson, PA-C (see all)