Syndrome

Manifestation

Bacterial
Meningitis

Fever
Myalgia
Rash
Neck stiffness
Seizure
Mental state
Headache
Cranial nerve palsies

Diagnosis
Patient Hx
S&S
- Severe neck pain
- Confusion
- Fever and rash
Physical exam
CSF Analysis
Jolt accentuation

Microorganism

Vulnerability

Treatment

Infection Control

S. Pneumonia

50 % of all cases
75% of all adults
colonized
Fatality 26%
30% of survivors
have
long-term
neurological
problems
25% of cases
Extremes of age
Fatality 3-13%
15% of survivors with
long-term neurologic
problems
Not vaccinated

No
Chemoprophylaxis

Routine precautions

N. Meningitidis

H. Influenza

L. Monocytogenes

Viral Meningitis

Viral Encephalitis

Fever
Myalgia
Rash
Neck stiffness
Seizure
Mental state
Headache
Cranial nerve palsies
Triad: LOC, Fever,

Patient Hx
S&S
Severe neck pain
Confusion
Fever and rash
Physical exam
CSF Analysis
Jolt accentuation
Physical assessment

Vaccine (not intended

for
pneumococcal
meningitis)
Serogroup B vaccine
Chemoprophylaxis for
close contacts

Droplet precaution
Infectious period
days
befo
symptoms

Chemoprophylaxis for
close contacts
Patient education re:
vaccine

Droplet precaution

Weakened
immune
system
Extreme of age
Pregnant women

Group B Strep.

Newborns
delivery)

Enterovirus

Everyone

Antibiotics
during
labour
Antibiotic prophylaxis
after delivery
Self-limited

All ages

Acyclovir

(during

Herpex simplex (not very

transmissible)

HSV

(all

Unpasteurized food
Wash food well
Avoid deli meats
Routine precautions

Droplet precaution

headache
Seizure
Neurological deficits

Brain abscess

Pharyngitis

Muscle weakness
Flaccid paralysis
Tremor
Myoclonus
Ataxia
Neurological deficits
Very
non-specific
symptoms

Sore throat
Fever
Rash

CSF Analysis

Do lumbar puncture
look for antibodies

Arbovirus

Brain imaging

Usually bacteria
Fungi
immunocompromised

Throat culture

Otitis media
Rhino-sinusitis
Common Cold

Bacterial
pneumonia

Sinus pain
Headache
Sneezing
Rhinorrhea
Nasal congestion
Dry, scratchy throat
Malaise
Cough
NO FEVER
Fever
Chills
Congestion
Cough
Chest pain
SOB
Rust coloured sputum

Physical exam
PMH
Dx: made on X-Ray
ABG, CBC
Kidney/Liver test

in

S. Pyogenes

Mainly children
Aboriginal (rheumatic
fever)

Mostly viruses
S. Pneumo
Viral

Children

Virus
(cannot
pneumonia)

Rusty sputum
+ Neutrophils

West-Nile Virus

S. Pneumo

encephalitis
treated
with acyclovir until
another
cause
is
determine)
Supportive treatment
Prevention

Antibiotics
Surgery
(when
necessary)
Aspiration of abscess
Corticosteroids
Antibiotics if bacterial
Prevention

Supportive treatment

Adult
cause

Children
# infections drop with
increase in age

Supportive treatment

Hand washing
Routine precaution

Extremes of age
More common in fall
and winter
Infected
with
influenza
Community acquired

Antibiotics

Respiratory droplet

Atypical
pneumonia

Fever
Malaise
Headache
Sore throat
Excessive sweating
Non-productive cough

Viral pneumonia

Cough productive
Low fever
Myalgias
Sore throat
SOB
Increased RR

Tuberculosis

Breathing difficulty
Tagiue
Malaise
Weight loss
Chest pain
Night sweats
(highly
characteristic)
Wheezing
Blood in sputum
Subacute
Slow progression
Fatigue
Malaise
Chills
Night sweats
Weight loss
Back pain
New or changing heart
murmur

Endocarditis

Acute

CURB 65
Physical exam
PMH
Dx: made on X-Ray
ABG, CBC
Kidney/Liver test
CURB 65
Physical exam
PMH
Dx: made on X-Ray
ABG, CBC
Kidney/Liver test
CURB 65
Acid-fast test

Duke Criteria
Major
- Two
separate
blood
cultures
with
typical
organisms
- Evidence
of
compatible
cardiac lesion
Minor
Prediosposition
- Clinical symptoms
- Vascular

Mycoplasma pneumoniae

No seasonality
Young adults

Influenza
Parainfluenza
Respiratory syncytial

Mycobacterium
tuberculosis

Most
deaths
children
New Canadians
Aboriginals
Elderly
Crowding
Immunocompromised

Non-virulent bacteria (ex.

Viridans streptococci)

Abnormal valves

Highly virulent bacteria

Injection drug

Antibiotics

Respiratory droplet

Antivirals (must be
given early)

Droplet precaution

Airborne precauti
(very resistant
drying)

Antimicrobial therapy
Valve replacement
Risk
of
repeated
endocarditis

Quick progression
New/changing
heart
murmur
Signs of sepsis
Peripheral manifestations

Inflammatory
Cardiomyopathy
(myocarditis)
Pericarditis

phenomena
Immunologic
phenomena
Positive
blood
culture
Minor
endocardiographic
finding

Differ based on pathogen

Sharp chest pain (worsens

with lying down, deep
breath, swallowing and
coughing)
Pain improves when sitting
up or forward

Pericardial rub
Abnormal ECG
Appearance of fluid
surrounding heart
(echocardiogram)

(ex. S. Aureus)

Central IV

Mostly viral

Pediatric
patients
(due to presence of
CAR)

Mostly viral (2-3 weeks

after flu like illness)
Possibly non-infectious

Same as heart failure

Avoid NSAIDs
Analgesics (assess for
myocarditis)
Antibiotics
for
bacterial
Drain
fluid
(if
tamponade)
Remove pericardium
(if constrictive)