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Bacterial Meningitis (highest incidence 1st mont of life)
Infants = non-specific
- Altered consciousness
- nuchal rigidity
- lumbar puncture:
- 1) pleocytosis (neutrophils--- WBC> 5000)
- 2) Low CSF glucose
- 3) increased CSF protein
- 4) postivie Gram stain
Positive blood culture
CT scan - brain abscess w/ neurological findings
Bacterial Meningitis Treatment:
Newborns = ampicillin + aminoglycosides or 3rd gen cepalosporin
Infant (1-3months) = ampicillin + or 3rd gen cepalosporin -- (consider Vancomycin)
Older > 3 months = 3rd Gen cephalosporin ( consider Vancomycin)
Corticosteroids - given before 1st dose of antibiotics
a blanching, non-pruritic, generalized maculopapular rash that Ian developed this morning.
Fifth Disease (erythmum infectiousum)
(Parvovirus B19) is characterized by a "slapped cheek" appearance
red lips, a strawberry tongue and a light-red sandpaper rash.
- cough, coryza and conjunctivitis, as well as Koplik's spots on the buccal mucosa.
- maculopapular rash and fever combined.
- E. Coli (gram -)
- Staphylococcus saphrolyticius (coag -)
Tx: TMP sulfa , ciprofloxacin
Gram negative bacteria