Emergency management of infectious diseases

This page intentionally left blank P1: PBU 9780521871761pre CUFX252/Chin 521 86017 May 5, 2007 21:6 Emergency Management of Infectious Diseases The diagnosis and management of infectious disease is a key component of contemporary emergency medicine, ranging from the definitive treatment and discharge of a patient with a simple abscess, to the recognition of a rare infection in a traveler, and to the resuscitation and stabilization of a patient with septic shock The changing epidemiology of infectious diseases presents a considerable challenge Acute care practitioners are sentinels for emerging outbreaks and must rapidly synthesize history and exam findings with laboratory studies, imaging results, and epidemiology Time-dependent morbidity requires practitioners to balance a high degree of suspicion for deadly diagnoses with the precision needed for high-yield diagnostic testing and appropriate care This book provides a practical, clinically oriented, systemsbased overview of infectious disease with an emphasis on emergent diagnosis and treatment It offers broad coverage of viral, bacterial, fungal, and parasitic diseases in a narrative supplemented by explanatory photos, diagnostic tables, and treatment charts It should prove an invaluable reference for practitioners confronting the spectrum of infectious disease in the acute care setting i P1: PBU 9780521871761pre CUFX252/Chin 521 86017 May 5, 2007 21:6 ii P1: PBU 9780521871761pre CUFX252/Chin 521 86017 May 5, 2007 21:6 Emergency Management of Infectious Diseases Edited by Rachel L Chin, MD University of California, San Francisco School of Medicine San Francisco General Hospital Associate Editors Michael S Diamond, MD, PhD Washington University School of Medicine Teri A Reynolds, MD, PhD Alameda County Medical Center–Highland Campus iii CAMBRIDGE UNIVERSITY PRESS Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo Cambridge University Press The Edinburgh Building, Cambridge CB2 8RU, UK Published in the United States of America by Cambridge University Press, New York www.cambridge.org Information on this title: www.cambridge.org/9780521871761 © Rachel L Chin 2008 This publication is in copyright Subject to statutory exception and to the provision of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press First published in print format 2008 ISBN-13 978-0-511-41408-4 eBook (EBL) ISBN-13 hardback 978-0-521-87176-1 Cambridge University Press has no responsibility for the persistence or accuracy of urls for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate P1: PBU 9780521871761pre CUFX252/Chin 521 86017 May 5, 2007 21:6 To my mother, who taught me that I can anything; my husband, Tom; and my wonderful daughters – the queens, Elizabeth and Katherine – who give me more than I could ever wish for – RLC For my wife, Susan, and daughter, Thisbe – MSD For Franco, who understands about work and the sound of the sea – TAR v P1: PBU 9780521871761pre CUFX252/Chin 521 86017 May 5, 2007 21:6 vi P1: PBU 9780521871761pre CUFX252/Chin 521 86017 May 5, 2007 21:6 Contents Preface Contributors PartI Systems Section A Cardiovascular Infections Infective Endocarditis Jorge A Fernandez and Stuart P Swadron Myocarditis and Pericarditis Jorge A Fernandez and Stuart P Swadron Section B Dental Infections Dental and Odontogenic Infections Preston C Maxim Section C Dermatology Systemic Diseases Causing Fever and Rash Catherine A Marco, Janel Kittredge-Sterling, and Rachel L Chin Section D Ears, Nose, and Throat Otitis Media Theresa A Gurney and Andrew H Murr Otitis Externa Theresa A Gurney and Andrew H Murr Sinusitis Theresa A Gurney and Andrew H Murr Supraglottitis Theresa A Gurney and Andrew H Murr Pharyngitis and Tonsillitis Theresa A Gurney and Andrew H Murr 10 Deep Neck Space Infections Theresa A Gurney and Andrew H Murr 11 Mumps Theresa A Gurney and Andrew H Murr Section E Gastrointestinal Infections 12 Peritonitis Ramin Jamshidi and William Schecter 13 Viral Hepatitis Ramin Jamshidi and Francis Yao 14 Infectious Biliary Diseases: Cholecystitis and Cholangitis Lan Vu and Hobart Harris 15 Acute Infectious Diarrhea Kimberly Schertzer and Gus M Garmel 16 Diarrhea in HIV-Infected Patients George Beatty Section F Genital Infections and Sexually Transmitted Diseases 17 Ulcerative Sexually Transmitted Diseases Diane Birnbaumer 18 Nonulcerative Sexually Transmitted Diseases Diane Birnbaumer 19 Vulvovaginitis Diane Birnbaumer 20 Male Genitourinary Infections Esther K Choo page xi xiii 15 21 33 37 39 43 45 47 51 53 59 65 73 83 89 97 105 111 vii P1: PBU 9780521871761pre CUFX252/Chin 521 86017 May 5, 2007 21:6 Section G Orthopedics 21 Adult Septic Arthritis James M Mok and Serena S Hu 22 Hand Infections: Fight Bite, Purulent Tenosynovitis, Felon, and Paronychia Michael Kohn 23 Osteomyelitis Melinda Sharkey and Serena S Hu 24 Open Fractures Melinda Sharkey and Serena S Hu 25 Spinal Infections James M Mok and Serena S Hu 26 Prosthetic Joint Infections James M Mok and Serena S Hu 27 Diabetic Foot Infections Melinda Sharkey and Serena S Hu 28 Plantar Puncture Wounds Rebeka Barth Section H Opthamology 29 Periocular Infections Renee Y Hsia 30 Conjunctival and Corneal Infections Renee Y Hsia 31 Uvea, Vitreous, and Retina Infections Renee Y Hsia Section I Pulmonary 32 Community-Acquired Pneumonia Bradley W Frazee and Rachel L Chin 33 Tuberculosis Adithya Cattamanchi and Payam Nahid 34 Influenza Asim A Jani and Timothy M Uyeki 35 HIV-Associated Respiratory Infections Matthew Fei and Laurence Huang Section J Rheumatology 36 Arthritis in the Acute Care Setting Jeffery Critchfield Section K Nephrology 37 Lower Urinary Tract Infection in Adults Jessica A Casey and Fredrick M Abrahamian 38 Pyelonephritis in Adults Parveen K Parmar and Fredrick M Abrahamian Section L Neurology 39 Fever and Headache: Meningitis and Encephalitis Anita Koshy 40 Fever and Focal Cerebral Dysfunction Serena S Spudich 41 Fever and Acute Weakness Localizing to the Spinal Cord Alexander C Flint 42 Altered Mental Status in HIV-Infected Patients Cheryl A Jay Section M Skin and Soft-Tissue Infection 43 Bacterial Skin and Soft-Tissue Infections Teri A Reynolds and Bradley W Frazee 117 121 127 131 135 141 143 147 151 157 163 169 175 185 193 203 211 215 221 233 241 249 257 PartII Pediatrics 263 44 265 45 46 viii Fever and Rash in the Pediatric Population Catherine A Marco, Janel Kittredge-Sterling, and Rachel L Chin Work-Up of Newborn Fever Maureen McCollough The Febrile Child Paul Ishimine 273 279 P1: JZP 9780521871761ind CUFX252/Chin 521 86017 laboratory/radiologic findings, 102t, 103 pearls/pitfalls, 103 treatment, 102t, 103 Human plague See Plague Human tetanus immune globulin (HTIG), 415t, 416–417, 417t, 418 Hydrocortisone, sepsis, 405, 407 Hydroxychloroquine sulfate (Plaquenil), 354, 356t, 359t Hypercalcemia, 56, 56t Hyperemesis gravidarum, 340–341, 347 Ibuprofen, pericarditis treatment, 12, 14t IDU See Injection drug users IDV See Indinavir IE See Infective endocarditis (IE) IM See Infectious mononucleosis (IM) Imipenem/cilastatin peripancreatic abscesses, 55, 56t peritonitis, secondary, 58t secondary peritonitis, 383t sepsis, 406t Imipenem (Primaxin) community-acquired pneumonia, 171t cautions, 501–502 infections, high-risk oncology patients, 321 properties, 502t pyelonephritis, 217t renal function dosage adjustments, 502–503 spectrum of activity, 514 Imiquimod, 102t Immune antibody therapy, West Nile encephalitis virus, 491 Immune reconstitution inflammatory syndrome (IRIS), 249 Immunocompromised patients See also HIV infection avian influenza A (H5N1), 478t bacterial diarrhea, 79t conjunctivitis treatment/prophylaxis, 158, 158t endophthalmitis, 167t febrile post-transplant, treatment, 396, 396t fungal meningitis, 226, 226t, 229 herpes, 224t infective endocarditis, injection drug users, 365t influenza, 188–189 injection drug users botulism, 370t necrotizing soft-tissue infections, 367t septic arthritis/osteomyelitis, 368t spinal epidural abscess, 369t subcutaneous abscess, 366t tetanus, 371t keratitis treatment/prophylaxis, 161t monoarthritis, 205t myocarditis/pericarditis treatment, 14t oligoarthritis, 207t otitis media, 34, 34t parasitic diarrhea, 80t parvovirus B19, 266–267 viral hepatitis, 62–63 West Nile virus, 490–491 Immunoglobulin, 345t Impetigo, 259 Index May 5, 2007 19:56 Imuran (Azathioprine, Azasan), 397t Incarcerated hernia, 56 Indinavir (Crixivan; IDV), 376t, 378t Indomethacin, 12 Infants bacterial meningitis, 221 botulism, 430, 430t, 431 fungal meningitis, 226t meningitis chemoprophylaxis, 230t Infection control airborne precautions, 529 contact precautions, 528–529 droplet precautions, 528 environmental, 527–528 gloves, 527, 528 gowns, 527, 528 hand hygiene/handwashing/hand decontamination, 527, 528 linens, 528 mask/eye protection/face shields, 527, 528 occupational health/bloodborne pathogens, 528 patient-care equipment, 527, 529 patient placement, 528, 529 patient transport, 528, 529 standard precautions, 527–528 Infectious mononucleosis (IM) clinical features, 357 laboratory/radiologic findings, 357, 359t serology testing, 520t treatment/prophylaxis, 357, 359t Infective endocarditis (IE) admission criteria, clinical features, 4t, 3–4 complications, 3–4, differential diagnosis, 4, 251t injection drug users clinical features, 364, 364t complications/admission criteria, 365 differential diagnosis, 364 epidemiology, 364 fever/disposition, 365 laboratory/radiologic findings, 364, 364t overview, 363–364 treatment/prophylaxis, 365t, 364–365 laboratory/radiologic findings, 4t, 4–5 overview, pearls/pitfalls, treatment/prophylaxis, 5–6, 6t, 260 Inflammatory bowel disease, 56, 56t Inflammatory diarrhea, 73 Influenza clinical features, 185–186, 186t complications/admission criteria, 187t, 188–189 differential diagnosis, 51, 186, 479 epidemiology, 185 infection control, 189, 189t laboratory/radiologic findings, 186t, 187t, 186–187 overview, 185 pearls/pitfalls, 190, 479 in pregnancy clinical features, 339t complications/admission criteria, 188–189 treatment/prophylaxis, 339 treatment/prophylaxis, 188, 188t vaccination, 190t, 189–190 Injection drug users botulism clinical features, 370, 370t complications/admission criteria, 371 differential diagnosis, 370 epidemiology, 370 laboratory/radiologic findings, 370, 370t overview, 370 treatment/prophylaxis, 370t, 370–371 common diseases, overview, 363 differential diagnosis, 250t infective endocarditis clinical features, 364, 364t complications/admission criteria, 365 differential diagnosis, 364 epidemiology, 364 fever/disposition, 365 laboratory/radiologic findings, 364, 364t overview, 363–364 treatment/prophylaxis, 365t, 364–365 necrotizing soft-tissue infections clinical features, 367, 367t complications/admission criteria, 367 epidemiology, 367 laboratory/radiologic findings, 367, 367t overview, 366 presentation, 259 treatment/prophylaxis, 367, 367t pearls/pitfalls, 372 pregnancy botulism, 370t necrotizing soft-tissue infections, 367t septic arthritis/osteomyelitis, 368t spinal epidural abscess, 369t subcutaneous abscess, 366t tetanus, 371t septic arthritis/osteomyelitis clinical features, 368, 368t differential diagnosis, 368 epidemiology, 368 laboratory/radiologic findings, 368, 368t overview, 367 treatment/prophylaxis, 368t, 368–369 spinal epidural abscess clinical features, 369, 369t differential diagnosis, 369 epidemiology, 369 laboratory/radiologic findings, 369, 369t overview, 369 treatment/prophylaxis, 369t, 369–370 subcutaneous abscess clinical features, 365, 366t differential diagnosis, 366 epidemiology, 365 laboratory/radiologic findings, 366, 366t overview, 365 treatment/prophylaxis, 366, 366t tetanus clinical features, 371, 371t differential diagnosis, 371 epidemiology, 371 543 P1: JZP 9780521871761ind CUFX252/Chin 521 86017 Injection drug users (cont.) laboratory/radiologic findings, 371, 371t overview, 371 treatment/prophylaxis, 371, 371t Insect bites, differential diagnosis, 259 Interferon-α HBV HCV, 60t West Nile encephalitis virus, 491 Intra-amniotic infection See Chorioamnionitis Intracranial abscess clinical features, 234 complications/admission criteria, 237 differential diagnosis, 233, 235, 243t, 244, 251t epidemiology, 233–234 epidural brain abscesses, 235 infection control, 237 intraparenchymal brain abscess agents, 234t clinical features, 234, 234t, 235 laboratory/radiologic findings, 234t laboratory/radiologic findings, 235 pearls/pitfalls, 237 subdural empyema, 235 treatment/prophylaxis, 237t, 235–237 Intramedullary spinal abscess, 242, 243t Intravenous drug abusers See Injection drug users Invanz See Ertapenem (Invanz) Invirase (Saquinavir; SQV), 376t Iospora, 84 IRIS See Immune reconstitution inflammatory syndrome Irritable bowel disease, 73 Irritable bowel syndrome, 56, 56t Ischemic bowel, 56, 56t Isoniazid latent tuberculosis bacillus infection, 179t tuberculosis, 179t, 180t, 185, 199t tuberculosis, in pregnancy, 349t Isospora acute infectious diarrhea, 76–77, 77t, 80t treatment, 86t, 87 Itraconazole (Sporanox) cautions, 510 differences/agents, 510 febrile post-transplant patients, 395t pearls/pitfalls, 510 properties, 510 renal function dosage adjustments, 511t Ivermectin (Mectizan, Stromectol) human louse (Pediculosis), 330t pearls/pitfalls, 333–334 scabies, 326–327, 327t IVIG erythema infectiosum, 267t Kawasaki disease (mucocutaneous lymph node syndrome), 269, 270t SARS, 485 staphylococcal scalded-skin syndrome, 269t Janeway lesions, 3–4 Japanese encephalitis complex, 224t, 225 Kaletra, SARS, 484–485, 485t Kaposi’s sarcoma, 85, 197 544 May 5, 2007 19:56 Kawasaki disease (mucocutaneous lymph node syndrome) clinical features, 269, 270t, 270f differential diagnosis, 269, 291–292 treatment, 269, 270t Keflex See Cephalexin (Keflex) Kefzol See Cefazolin (Kefzol) Keratitis clinical features, 159f, 159, 160t complications/admission criteria, 160–161 differential diagnosis, 160, 164 epidemiology, 159 laboratory/radiologic findings, 160 pearls/pitfalls, 162 treatment/prophylaxis, 160, 161t Ketek See Telithromycin (Ketek) Ketoacidosis, differential diagnosis, 56, 56t Ketolides See also specific drugs cautions, 506 differences, 505–506 mechanism of action, 505 pearls/pitfalls, 506 properties, 505 renal function dosage adjustments, 505t Kwell See Lindane (Kwell) Kyasanur Forest disease virus clinical features, 462 epidemiology, 460t laboratory/radiologic findings, 462 therapeutics, developmental, 466t United States occurrence, 459 Labor, differential diagnosis, 341–342 Lamivudine (Epivir; 3TC) adverse side effects, 378t HIV infection postexposure prophylaxis, 376t Lariam (Mefloquine), 354, 359t Laryngotracheobronchitis See Bacterial tracheitis Lassa fever clinical features, 461 complications/admission criteria, 466–467 epidemiology, 460t laboratory/radiologic findings, 461 therapeutics, developmental, 466t treatment, 465t United States occurrence, 459 Latent tuberculosis bacillus infection (LTBI) clinical features, 177 laboratory/radiologic findings, 177–178 pearls/pitfalls, 182 treatment/prophylaxis, 179t, 180 Legionella pneumophila, 169 Legionella spp., infective endocarditis, Leishmaniasis, 333t Leptomeningeal carcinomatosis, 243t, 244 Levaquin See Levofloxacin (Levaquin) Levofloxacin (Levaquin) acute bacterial cholangitis, 69t acute calculous cholecystitis, 67t acute prostatitis, 217t anthrax, 426t, 427 bacteremia/sepsis, 410t bacterial diarrhea, 79t community-acquired pneumonia, 171t Chlamydia spp., 99 diarrhea/HIV-infection, 86t, 86–87 disseminated gonococcal infection, 24t epididymitis, 114t gonorrhea, 99t infections, low-risk oncology patients, 321 lower urinary tract infection, 212t nongonococcal urethritis, 100 otitis media, 34t pelvic inflammatory disease, 101t pneumonia/acute chest syndrome, sickle cell disease, 411t properties, 503–504 pyelonephritis, 217t renal function dosage adjustments, 504 urethritis, 112t Lexiva See Fosamprenavir Lice See human louse (Pediculosis) Lincosamides See also specific drugs cautions, 507 mechanism of action, 507 pearls/pitfalls, 507 properties, 506–507 renal function dosage adjustments, 507 Lindane (Kwell) human louse (Pediculosis), 330t scabies, 326–327, 327t Linezolid (Zyvox) cautions, 509 differences/agents, 509 mechanism of action, 509 pearls/pitfalls, 509–510 properties, 509 renal function dosage adjustments, 510t toxic shock syndrome, 25t Lipopeptides See also specific drugs cautions, 509 differences/agents, 509 mechanism of action, 509 pearls/pitfalls, 509–510 properties, 509 renal function dosage adjustments, 510t Listeria monocytogenes clinical features, 223f overview, 222t, 223 in pregnancy, 343 solid organ transplant patients, infections, 391–393 treatment/prophylaxis, 254t Live attenuated influenza virus (LAIV) vaccine, 187 Liver abscesses clinical features, 55, 55t laboratory/radiologic findings, 55t treatment/prophylaxis, 55t Loperamide, 78 Lopinavir ADRs, 85 Lopinavir/ritonavir ADRs, 378t Lorabid (Loracarbef), 293t Loracarbef (Lorabid), 293t Loratadine (Claritin), 34t Lower urinary tract infection (LUTI) asymptomatic bacteriuria, 213–214 clinical features, 211, 212t complications/admission criteria, 214 differential diagnosis, 211–212 epidemiology, 211 laboratory/radiologic findings, 212t, 212–213 overview, 211 Index P1: JZP 9780521871761ind CUFX252/Chin 521 86017 pearls/pitfalls, 214 treatment/prophylaxis, 212t, 213 Ludwig’s angina clinical features, 18, 18t, 47–48 differential diagnosis, 18, 43–44 epidemiology, 15 Lung infections, 234t, 237t LUTI See Lower urinary tract infection (LUTI) Lyme disease clinical features, 26, 26t, 26f differential diagnosis, 244 epidemiology, 26 laboratory/radiologic findings, 26t overview, 331t serology testing, 520t tick removal, 330, 332f treatment, 26, 27t Lyme radiculoneuropathy, 243t, 244 Lymphocytic choriomeningitis Virus (LCMV), 224t, 225 Lymphoma, 56 Lymphomatous meningitis, 251t Macrobid See Nitrofurantoin (Macrodantin, Macrobid) Macrodantin See Nitrofurantoin (Macrodantin, Macrobid) Macrolides See also specific drugs bacterial pneumonia, 199t cautions, 506 mechanism of action, 505 pearls/pitfalls, 506 pertussis, 301t pneumonia/acute chest syndrome, sickle cell disease, 411t properties, 505 renal function dosage adjustments, 505t Magic Mouthwash, 19 Malaria clinical features, 354, 354t laboratory/radiologic findings, 354t in pregnancy clinical features, 348, 348t complications/admission criteria, 349 differential diagnosis, 348 epidemiology, 348 infection control, 349 laboratory/radiologic findings, 348 overview, 348 pearls/pitfalls, 349 treatment/prophylaxis, 348, 348t treatment/prophylaxis, 356t, 354–356, 357 Malarone See Atovaquone/proguanil (Malarone) Malathion (Ovide), 330t Marburg fever clinical features, 459, 461 complications/admission criteria, 466–467 epidemiology, 460t laboratory/radiologic findings, 461 therapeutics, developmental, 466t transmission, 467 United States occurrence, 459 Mask/eye protection/face shields, 527, 528 Mastitis clinical features, 387, 387t differential diagnosis, 388 Index May 5, 2007 19:56 epidemiology, 386 laboratory/radiologic findings, 387t, 388 overview, 385 pearls/pitfalls, 389 treatment/prophylaxis, 389, 389t Maxipime See Cefepime (Maxipime) Measles (rubeola) clinical features, 27, 27t, 27f, 28f complications, 27 diagnosis, 27 epidemiology, 26–27 laboratory/radiologic findings, 27t serology testing, 520t treatment, 27, 27t Mebendazole, 70t Mechanical diarrhea, 73 Mectizan See Ivermectin (Mectizan, Stromectol) Mediterranean spotted fever, 357 Mefloquine (Lariam), 354, 358t Mefoxin See Cefoxitin (Mefoxin) Meningitis anthrax clinical features, 423 differential diagnosis, 425 treatment/prophylaxis, 426t, 427 aseptic, 223 bacterial agents, 222t, 222–223 clinical features, 221, 223f differential diagnosis, 222t, 223, 251t neonatal, 273, 274t treatment, 228–229, 229t treatment/prophylaxis, 254t chemoprophylaxis, 230t chronic clinical features, 221, 225, 226t differential diagnosis, 227 etiologies, 226–227 complications/admission criteria, 229–230 cryptococcal differential diagnosis, 251t laboratory/radiologic findings, 252t treatment/prophylaxis, 254t epidemiology, 221 fungal, 225–226, 226t immunocompromised patients, 226, 226t, 229 infection control, 230 infective endocarditis, 365 laboratory/radiologic findings CSF, 227t, 227–228, 228t lumbar puncture, 227, 227t overview, 4–5 lymphomatous, 251t oncology patients, 322 otitis media, 34 overview, 221 parasitic, 226, 227t pearls/pitfalls, 230 plague, 437, 440t Pneumococcus, 254t shunt infections, 229 skull fractures/penetrating trauma/neurosurgical procedure history, 229 syphilitic differential diagnosis, 251t laboratory/radiologic findings, 252t treatment/prophylaxis, 254t tuberculous differential diagnosis, 251t laboratory/radiologic findings, 252t overview, 226 treatment/prophylaxis, 254t viral agents/clinical features, 224t, 224–225 clinical features, 221 differential diagnosis, 225 HSV infection, 91 laboratory/radiologic findings, 228 West Nile, 490t Meningococcemia children, 279 clinical features, 23, 23t, 24f epidemiology, 23 laboratory/radiologic findings, 23t treatment, 23t Meningovascular syphilis, 251t Meropenem (Merrem) cautions, 501–502 febrile post-transplant patients, 395t infections, high-risk oncology patients, 321 peritonitis, secondary, 58t properties, 502t pyelonephritis, 217t renal function dosage adjustments, 502–503 secondary peritonitis, 383t spectrum of activity, 514 spinal epidural abscess, injection drug users, 369t Merrem See Meropenem (Merrem) Metabolic encephalopathies, 251t Methamphetamine, 250t, 333–334 See also Injection drug users Methotrexate, 315–316 Methylprednisolone, 485, 485t Methylprednisone, 397t Metronidazole (Flagyl) acute bacterial cholangitis, 69t animal/fight bites, 311 bacterial diarrhea, 79t bacterial vaginosis, 106t Clostridium difficile, 86t, 87 deep mandibular space infections, 19 diarrhea/HIV-infection, 86t, 86–87 Entamoeba histolytica, 86t, 87 gastrointestinal tract infections, oncology patients, 318t Giardia lamblia, 86t, 87 intracranial abscess, 237t liver abscesses, 55t nongonococcal urethritis, 100 oropharyngeal infections, oncology patients, 317t parasitic diarrhea, 80t pearls/pitfalls, 508 pelvic inflammatory disease, 101t peritonitis, secondary, 58t properties, 507–508 renal function dosage adjustments, 508t secondary peritonitis, 383t skin/soft-tissue infections, oncology patients, 317t tetanus, 415t, 416–417 545 P1: JZP 9780521871761ind CUFX252/Chin 521 86017 Metronidazole (Flagyl) (cont.) tetanus, injection drug users, 371, 371t trichomoniasis, 106, 106t urethritis, 112t Micafungin (Mycamine) differences/agents, 511 properties, 511t renal function dosage adjustments, 511t Miconazole, candidiasis, 108t Microbiology laboratory testing culture results interpretation, 519, 519t fecal leukocytes, 519–521 Gram stain interpretation, 518t, 518–519 limitations, 522 nucleic acid amplification testing, 521, 522t overview, 517 serology, 520t, 519–521 specimen collection procedures anaerobic culture, 518 blood cultures, 517–518 CSF cultures, 518 general, 517 stool, ova/parasite exam, 518 stool culture, 518 tissue/biopsy specimens, 518 urine cultures, 518 viral culture, 518 test ordering/specimen processing, 518 tests available blood/endocarditis, 522 body fluid, 522 bone, 522 CNS, 522 ear/eye/nose/throat, 522 gastrointestinal tract, 522 genitourinary tract/STD, 522 insect infestation, 522 respiratory system/atypicals, 522 skin, 522 systemic fever, 522 urinary tract, 522 Microsporidium, 85–86, 86t, 87 Migraines, 40, 56 Miller-Fisher syndrome, 433 Minoxidil, 10 Mites clinical features, 327, 327t, 328 differential diagnosis, 328 epidemiology, 326t laboratory/radiologic findings, 328 overview, 327 pearls/pitfalls, 333–334 treatment/prophylaxis, 327t, 328 MMR (measles, mumps, rubella) vaccine, 345t Molluscum contagiosum, 152 Monkeypox, 445 Monoarthritis clinical features, 203, 204t, 204f complications/admission criteria, 205 differential diagnosis, 203–204 epidemiology, 203 laboratory/radiologic findings, 204t, 204–205 overview, 203 pearls/pitfalls, 205 treatment/prophylaxis, 205, 205t 546 May 5, 2007 19:56 Monobactams See also Aztreonam (Azactam) cautions, 501–502 differences, 501 overview, 502t pearls/pitfalls, 502 renal function dosage adjustments, 502–503 Monoclonal antibodies, 315–316, 318f Mononucleosis See Infectious mononucleosis (IM) Moraxella catarrhalis, 169 Moxifloxacin (Avelox) animal/fight bites, 311, 312t community-acquired pneumonia, 171t fight bites, 122t otitis media, 34t pearls/pitfalls, 503–504 properties, 503–504 renal function dosage adjustments, 504 urinary tract infection, 216–217 MRI, applications, 147–148 MRSA animal/fight bites, 312t, 312–313 community-acquired (See CA-MRSA) differential diagnosis, 98 epidemiology, 257 oligoarthritis, 207t pearls/pitfalls, 261 spinal epidural abscess, 246t MRSA pneumonia, 169, 188–189 Mucocutaneous lymph node syndrome See Kawasaki disease Multifocal brain disease, 251t Mumps clinical features, 51, 52t, 224t, 225 complications/admission criteria, 52 differential diagnosis, 51 epidemiology, 51 infection control, 52 laboratory/radiologic findings, 51, 52t overview, 51 pearls/pitfalls, 52 serology testing, 520t treatment/prophylaxis, 52, 52t Murine typhus, clinical features, 355t, 357 Musculoskeletal pain, in pregnancy,341–342 Myasthenia gravis, 433 Myasthenic crisis, 243t, 244 Mycamine See Micafungin (Mycamine) Mycobacterial infection, 48 Mycobacterium avium complex (MAC) differential diagnosis, 84–85 laboratory/radiologic findings, 85–86 treatment, 86t, 86–87 Mycobacterium tuberculosis, 175 Mycobacterium tuberculosis pneumonia chest radiograph findings, 195–196, 196f clinical features, 193–194, 194t complications/admission criteria, 199, 199t differential diagnosis, 196–197, 197t, 198 epidemiology, 193 laboratory/radiologic findings, 194t, 194–195 pearls/pitfalls, 200 treatment/prophylaxis, 198–199, 199t Mycophenolate mofetil (CellCept, Myfortic), 397t Mycoplasma pneumoniae, 169 Mycoplasma serology testing, 520t Mycotic aneurysms, infective endocarditis, 3–4 Myfortic (Mycophenolate mofetil, CellCept), 397t Myiasis clinical features, 330–332, 332t differential diagnosis, 332–333, 333t epidemiology, 326t laboratory/radiologic findings, 333 overview, 330 pearls/pitfalls, 333–334 subtypes, 332t treatment/prophylaxis, 333 Myocardial depression, sepsis, 406 Myocarditis clinical course, 11 clinical presentation, 10, 10t complications/admission criteria, 13–14, 14t CXR findings, 13 differential diagnosis, 11 epidemiology/pathophysiology, infectious causes, 9, 10t laboratory/radiologic findings, 11–12 noninfectious causes, 9, 10t pearls/pitfalls, 14 rhythm disturbances in, 12f treatment, 12, 14t Myonecrosis defined, 257t Myopericarditis bacterial, 10–11 rickettsial, 11 NAAT (Nucleic acid amplification) testing, 521, 522t Nafcillin infective endocarditis, 6t, 365t intracranial abscess, 237t osteomyelitis, 127t preorbital/orbital cellulitis, 156t properties, 498–499 purulent tenosynovitis, 122 septic arthritis/osteomyelitis, injection drug users, 368t spectrum of activity, 514 spinal epidural abscess, 246t splenic abscesses, 56t staphylococcal scalded-skin syndrome, 269t vertebral osteomyelitis, 135t Naproxen, 14t National Clinicians’ Post-exposure Prophylaxis Hotline (PEPline), 378–380 Necrotizing fasciitis, 257t Necrotizing retinitis, 165, 165f Necrotizing soft-tissue infections (NSTI) clinical features, 259 complications/admission criteria, 261 defined, 257t epidemiology, 257–258, 258t injection drug users clinical features, 367, 367t complications/admission criteria, 367 epidemiology, 367 laboratory/radiologic findings, 367, 367t Index P1: JZP 9780521871761ind CUFX252/Chin 521 86017 overview, 366 treatment/prophylaxis, 367, 367t laboratory/radiologic findings, 260 pearls/pitfalls, 261 treatment/prophylaxis, 261, 261t Neisseria meningitides, 222t, 222–223, 230t Nelfinavir, ADRs, 85, 378t Neomycin, 38 Neonatal fever clinical features, 274t, 273–275 complications/admission criteria, 277 differential diagnosis, 275, 275t epidemiology, 273 laboratory/radiologic findings, 275t, 275–276 overview, 273 pearls/pitfalls, 277 seizures, 275 treatment/prophylaxis, 276 Neonatal osteomyelitis, 286 Neonates osteomyelitis, acute hematogenous, 285t plague treatment, 440t septic arthritis, 286t serious bacterial infections, 279 Tularemia treatment, 456t Neoral (Cyclosporine, Gengraf, Restasis, Sandimmune), 397t Neuraminidase inhibitors, 188t See also specific drugs Neurocysticercosis, 226, 227t New World hemorrhagic fever clinical features, 461 complications/admission criteria, 466–467 epidemiology, 460t laboratory/radiologic findings, 461 therapeutics, developmental, 466t United States occurrence, 459 NGU See Nongonococcal urethritis (NGU) NIPPV, SARS, 485–486 Nitazonxanide, 80t, 86t, 87 Nitrofurans See also specific drugs cautions, 509 differences/agents, 508 pearls/pitfalls, 509 properties, 508 renal function dosage adjustments, 509t Nitrofurantoin (Macrodantin, Macrobid) cautions, 509 cystitis/pyelonephritis, in pregnancy, 337–338, 338t differences/agents, 508 lower urinary tract infection, 212t pearls/pitfalls, 509 pediatric UTI, 293t properties, 508 renal function dosage adjustments, 509t Nitroglycerin, 14t Nitroimidazoles See also specific drugs cautions, 508 differences/agents, 508 mechanism of action, 508 pearls/pitfalls, 508 properties, 507–508 renal function dosage adjustments, 508t NNRTIs See Nonnucleoside reverse transcriptase inhibitors (NNRTIs) Nocardia asteroides, 391–393 Index May 5, 2007 19:56 Nocardia spp., 237t Non-Hodgkins lymphoma, 85 Nongonococcal urethritis (NGU) clinical features, 100 differential diagnosis, 97, 100 epidemiology, 100 infection control, 103 laboratory/radiologic findings, 100 pearls/pitfalls, 103 treatment, 100 Nonnucleoside reverse transcriptase inhibitors (NNRTIs) adverse side effects, 378t altered mental status, 249 HIV drug reactions, 29 pearls/pitfalls, 255 Nonspecific viral exanthems, 265 Norepinephrine, septic shock, 404, 406t Noroviruses, 73t, 73–74 North Asian tick typhus, 357, 358t Norvir See Ritonavir Noxafil See Posaconazole (Noxafil) NRTIs See Nucleoside reverse transcriptase inhibitors (NRTIs) NSAIDs erythema infectiosum, 267t myocarditis/pericarditis, 14t otitis media, 34t polyarthritis, 209t uric acid arthropathy (gout), 205t NSTI See Necrotizing soft-tissue infections (NSTI) Nuclear medicine studies, fetal radiation exposure, 336t Nucleic acid amplification (NAAT) testing, 521, 522t Nucleoside reverse transcriptase inhibitors (NRTIs) adverse side effects, 378t diarrhea, 85t HIV drug reactions, 29 Nursing home residents, community-acquired pneumonia, 172–173 Nystatin, candidiasis, 108t Ocular herpes simplex, 152 Oculoglandular tularemia clinical features, 453–454 complications/admission criteria, 456–457 differential diagnosis, 455 OE See Otitis externa (OE) Ofloxacin anthrax, 426t Chlamydia spp., 99 disseminated gonococcal infection, 24t enteric fever/typhoid fever, 359t epididymitis, 114t gonorrhea, 99t nongonococcal urethritis, 100 pelvic inflammatory disease, 101t prostatitis, 111t pyelonephritis, 217t urethritis, 112t Oligoarthritis clinical features, 205–206, 206t, 206f complications/admission criteria, 207 differential diagnosis, 206 epidemiology, 205 laboratory/radiologic findings, 206, 207t overview, 203 pearls/pitfalls, 207 treatment/prophylaxis, 206, 207t OM See Otitis media (OM) Omental infarction, 56 Omphalitis, neonatal, 274t, 275 Omsk hemorrhagic fever clinical features, 462 epidemiology, 460t laboratory/radiologic findings, 462 therapeutics, developmental, 466t United States occurrence, 459 Onchocerciasis, 160 Oncology patients CNS infections clinical features, 318 differential diagnosis, 320t laboratory/radiologic findings, 318 treatment/prophylaxis, 318, 318t fungemia clinical features, 316, 316t, 316f, 318f laboratory/radiologic findings, 316t gastrointestinal tract infections clinical features, 318, 318t differential diagnosis, 320t laboratory/radiologic findings, 318t treatment/prophylaxis, 318t Herpes Simplex Virus 1/2, 322 meningitis, 322 oropharyngeal infections clinical features, 316–317, 317t differential diagnosis, 319t laboratory/radiologic findings, 317t treatment/prophylaxis, 317t respiratory tract infections clinical features, 317, 317t differential diagnosis, 320t laboratory/radiologic findings, 317t skin/soft-tissue infections clinical features, 317, 317t differential diagnosis, 319t pearls/pitfalls, 322 treatment/prophylaxis, 317t thrush, 322 urinary tract infections, 318 Open fractures clinical features, 131, 131f, 132f complications/admission criteria, 133 differential diagnosis, 131 epidemiology, 131 Gustilo classification, 132t overview, 131 pearls/pitfalls, 133 treatment/prophylaxis, 131–132, 132t Open fractures, in children classification, 284t clinical features, 283 complications/admission criteria, 284 epidemiology, 283 laboratory/radiologic findings, 283 overview, 283 pearls/pitfalls, 284 treatment/prophylaxis, 283–284, 284t 547 P1: JZP 9780521871761ind CUFX252/Chin 521 86017 Orbital cellulitis clinical features, 154t, 155f complications/admission criteria, 155 differential diagnosis, 152, 154 epidemiology, 153–154 laboratory/radiologic findings, 154–155 pearls/pitfalls, 155 Oriental spotted fever, 357 Oropharyngeal/gastrointestinal tularemia clinical features, 454 complications/admission criteria, 456–457 differential diagnosis, 455 Oropharyngeal infections, oncology patients clinical features, 316–317, 317t differential diagnosis, 319t laboratory/radiologic findings, 317t treatment/prophylaxis, 317t Oseltamivir (Tamiflu) avian influenza A (H5N1), 478, 478t, 479 community-acquired pneumonia, 171t differences/agents, 513 influenza, 188, 188t mechanism of action, 513 pearls/pitfalls, 513–514 properties, 513 renal function dosage adjustments, 514t Osler nodes, 3–4 Osmotic diarrhea, 73 Osteomyelitis acute hematogenous, in children clinical features, 285, 285t differential diagnosis, 285 epidemiology, 285 laboratory/radiologic findings, 285, 285t overview, 284 pearls/pitfalls, 286 treatment/prophylaxis, 285, 285t clinical features, 127t, 127–128, 128f, 129f, 136f, 147 complications/admission criteria, 19, 129 diabetic foot infections, 145 differential diagnosis, 128 epidemiology, 127 injection drug users clinical features, 368, 368t differential diagnosis, 368 epidemiology, 368 laboratory/radiologic findings, 368, 368t overview, 367 treatment/prophylaxis, 368t, 368–369 laboratory/radiologic findings, 127t, 128, 147–148 neonatal, 286 otitis externa, 37–38 overview, 127 pearls/pitfalls, 129, 145–146 pressure ulcers, 129 sickle cell disease (See Sickle cell disease (SCD)) subacute hematogenous, in children, 286 treatment/prophylaxis, 127t, 128–129, 149t vertebral (See Vertebral osteomyelitis) Otitis externa (OE) clinical features, 37t, 37–38 548 May 5, 2007 19:56 complications/admission criteria, 38 differential diagnosis, 38, 48 epidemiology, 37 infection control, 38 laboratory/radiologic findings, 37t, 38 overview, 37 pearls/pitfalls, 38 treatment/prophylaxis, 37t, 38 Otitis media (OM) causes/agents, 33 children, treatment, 281t clinical features, 33, 33t complications/admission criteria, 34 differential diagnosis, 33–34, 48 epidemiology, 33 laboratory/radiologic findings, 33t, 34 neonatal, 274t, 275 pearls/pitfalls, 34 treatment/prophylaxis, 34, 34t Ovarian/gonadal torsion, 56, 56t Ovide (Malathion), 330t Oxacillin childhood diskitis, 287t intracranial abscess, 237t osteomyelitis, acute hematogenous, 285t septic arthritis, in children, 286t spinal epidural abscess, 246t staphylococcal scalded-skin syndrome, 269t toxic shock syndrome, 25t Oxazolidinones See also specific drugs cautions, 509 differences/agents, 509 mechanism of action, 509 pearls/pitfalls, 509–510 properties, 509 renal function dosage adjustments, 510t Oxymetazoline, 34t Pancreatitis clinical features, 55 differential diagnosis, 56 peripancreatic abscesses (See Peripancreatic abscesses) Parainfluenza, 51 Parapharyngeal abscess, 20 Parasitic cholangitis, 69–70, 70t, 70f, 70–71 Parasitic infections, 395t Paromomycin, 86t, 87 Parvovirus B19 clinical features, 207–208, 265–267, 267f differential diagnosis, 208, 344–345 laboratory/radiologic findings, 208 pearls/pitfalls, 209 serology testing, 520t Patient-care equipment, infection control, 527, 529 Patient placement, infection control, 528, 529 Patient transport, infection control, 528, 529 PCNSL See Primary CNS lymphoma (PCNSL) Pediatric diskitis See Childhood diskitis Pediatric epiglottitis See Epiglottitis Pediatric fever/rash diseases See also specific diseases complications/admission criteria, 271 differential diagnosis, 270 epidemiology, 265 infection control, 271 laboratory/radiologic findings, 270–271 overview, 265 pearls/pitfalls, 271 Pediatric pneumonia clinical features, 303, 304t complications/admission criteria, 305 differential diagnosis, 303–304 epidemiology, 303 infection control, 305 laboratory/radiologic findings, 280–281, 304 pearls/pitfalls, 305 treatment/prophylaxis, 281, 281t, 304t, 304–305 Pediatric SARS clinical features, 482t epidemiology, 481 laboratory/radiologic findings, 482t, 483t, 483, 484 pathogenesis, 482–483 prognosis, 487 Pediatric UTIs See Urinary tract infections (UTIs), pediatric Pediculosis See human louse (Pediculosis) Pelvic inflammatory disease (PID) admission criteria, 101 clinical features, 100, 101t complications, 101 differential diagnosis, 56, 56t, 101 epidemiology, 100 infection control, 103 laboratory/radiologic findings, 101, 101t pearls/pitfalls, 103 postabortion, 385 in pregnancy, 340–341 treatment, 101, 101t Penetrating head trauma brain abscess, 234t, 237t Penicillin G anthrax, 427 deep mandibular space infections, 19 intracranial abscess, 237t Lyme disease, 27t properties, 496–498 renal function dosage adjustments, 498t septic arthritis, in children, 286t spectrum of activity, 514 syphilis, 28, 93, 94t syphilitic meningitis, 254t tetanus, 416–417 Penicillin VK dentoalveolar infections, 19 pericoronitis, 19 periodontal disease, 19 properties, 496–498 renal function dosage adjustments, 498t Penicillins See also specific penicillins acute bacterial cholangitis, 69t acute calculous cholecystitis, 66–67, 67t antistaphylococcal cautions, 498–499 differences, 498 pearls/pitfalls, 498–499 properties, 499t botulism, injection drug users, 370t cautions, 499 cystitis/pyelonephritis, in pregnancy, 337–338, 338t Index P1: JZP 9780521871761ind CUFX252/Chin 521 86017 fight bites, 122t Lyme disease, 27t meningococcemia, 23t open fractures, 284t pericarditis, 10 properties, 496–498 renal function dosage adjustments, 498t syphilis, 23t, 93, 94t Pentamidine, 199t PEP See Postexposure prophylaxis PEP resources, 379–380 PEPline, 378–380 Peptic ulcers clinical features, 54, 54t epidemiology, 53 laboratory/radiologic findings, 54t treatment/prophylaxis, 54t Periapical abscess clinical features, 15t, 16t complications, 19 differential diagnosis, 18 treatment/admission criteria, 19 Pericarditis bacterial, 10–11 clinical course, 11 clinical presentation, 10, 10t complications/admission criteria, 13–14, 14t differential diagnosis, 11 ECG, 12f epidemiology/pathophysiology, infectious causes, 10, 10t laboratory/radiologic findings, 11–12 noninfectious causes, 10, 10t pearls/pitfalls, 14 treatment, 12, 14t tuberculous, 10, 11 Pericoronitis clinical features, 16, 16t differential diagnosis, 18 laboratory/radiologic findings, 18–19 loss of teeth, 19 pearls/pitfalls, 20 treatment/admission criteria, 19 Peridex (Chlorhexidine gluconate), 19 Periocular disorders, 151 See also specific disorders Periodontal disease clinical features, 16, 16t differential diagnosis, 18 epidemiology, 15 treatment/admission criteria, 19 Peripancreatic abscesses clinical features, 55 laboratory/radiologic findings, 55, 56t treatment/prophylaxis, 55, 56t Peritonitis clinical features, 53t, 53–54, 54t differential diagnosis, 56 epidemiology, 53 imaging, 57t, 57–58 infection control, 57 laboratory/radiologic findings, 54t, 56–57 overview, 53 pearls/pitfalls, 57–58 secondary, antibiotics, 383t treatment/prophylaxis, 57, 57t, 80t Peritonsillar abscess, 47–48 Index May 5, 2007 19:56 Permethrin (Elimite) human louse (Pediculosis), 330t scabies, 326–327, 327t Pertussis clinical features, 301, 301t complications/admission criteria, 302 differential diagnosis, 301 epidemiology, 301 infection control, 302 laboratory/radiologic findings, 301, 301t pearls/pitfalls, 302 treatment/prophylaxis, 301t, 302 Pestis minor, 437 Pharyngitis clinical features, 45, 45t complications/admission criteria, 46 differential diagnosis, 45–46 epidemiology, 45 infection control, 46 laboratory/radiologic findings, 45t, 46 overview, 45 pearls/pitfalls, 46 plague, 437 treatment/prophylaxis, 45t, 46 Phenylephrine, 406t Phenytoin focal encephalitis, 239t intracranial abscess, 236–237 Phosphenytoin focal encephalitis, 239t intracranial abscess, 236–237 PI See Protease inhibitors PID See Pelvic inflammatory disease (PID) Piperacillin cautions, 499 cystitis/pyelonephritis, in pregnancy, 338t endometritis, 389t Piperacillin/tazobactam (Zosyn) acute bacterial cholangitis, 69t acute calculous cholecystitis, 66–67, 67t acute prostatitis, 217t appendicitis, in pregnancy, 340t community-acquired pneumonia, 171t deep neck space infections, 47t diabetic foot infections, 144t differences, 499 epidural abscesses, 138t infections, high-risk oncology patients, 321 necrotizing soft-tissue infections, 261t necrotizing soft-tissue infections, injection drug users, 367t open fractures, 132t overview, 499 pearls/pitfalls, 499–500 peritonitis, secondary, 58t preorbital/orbital cellulitis, 156t pyelonephritis, 217t renal function dosage adjustments, 500 secondary peritonitis, 383t sepsis, 406t septic arthritis/osteomyelitis, injection drug users, 368t spectrum of activity, 514 spinal epidural abscess, injection drug users, 369t spontaneous bacterial peritonitis, 57t treatment, 118t Piperazine citrate, 70t Plague as biological weapon, 435 bubonic clinical features, 436, 437t, 437f complications/admission criteria, 437t, 439 differential diagnosis, 438 laboratory/radiologic findings, 437t pearls/pitfalls, 441 transmission, 437t clinical features, 436 complications/admission criteria, 439 differential diagnosis, 438 infection control, 439–441 laboratory/radiologic findings, 439 meningitis, 437, 440t natural reservoirs, 435 overview, 435 pearls/pitfalls, 441 pestis minor, 437 pharyngitis, 437 pneumonic clinical features, 436, 436t complications/admission criteria, 436t, 439 differential diagnosis, 438 laboratory/radiologic findings, 436t pearls/pitfalls, 441 transmission, 436t postexposure prophylaxis, 439 septicemic clinical features, 436, 438f, 438t complications/admission criteria, 438t differential diagnosis, 438–439 laboratory/radiologic findings, 438t transmission, 438t transmission, 435 treatment, 439, 440t United States occurrence, 436 vaccination, 439 worldwide occurrence, 435–436 Plantar puncture wounds clinical features, 147 complications/admission criteria, 148–149 epidemiology, 147 evaluation, 147 laboratory/radiologic findings, 147–148 overview, 147 pearls/pitfalls, 149 treatment/prophylaxis, 148, 149t Plaquenil (Hydroxychloroquine sulfate), 354, 356t, 358t PML See Progressive multifocal leukoencephopathy (PML) Pneumococcus meningitis, 254t Pneumocystis carinii, 391–393, 395t Pneumocystis pneumonia chest radiograph findings, 195–196, 196f, 197f clinical features, 193–194, 194t complications/admission criteria, 199, 199t differential diagnosis, 196–197, 197t, 198 epidemiology, 193 laboratory/radiologic findings, 194t, 194t, 194–195 549 P1: JZP 9780521871761ind CUFX252/Chin 521 86017 Pneumocystis pneumonia (cont.) oncology patients, 322 pearls/pitfalls, 200 treatment/prophylaxis, 198–199, 199t Pneumonia community-acquired (See Community-acquired pneumonia (CAP)) differential diagnosis, 56 fungal, 322 laboratory/radiologic findings, 4–5 neonatal, 274t, 275, 305 pediatric clinical features, 303, 304t complications/admission criteria, 305 differential diagnosis, 303–304 epidemiology, 303 infection control, 305 laboratory/radiologic findings, 280–281, 304 pearls/pitfalls, 305 treatment/prophylaxis, 281, 281t, 304t, 304–305 in pregnancy clinical features, 339, 339t differential diagnosis, 339 treatment/prophylaxis, 339 Pseudomonas aeruginosa, 197 in SARS, 484, 485t, 487 in sickle cell disease (See Sickle cell disease (SCD)) surgical site infections, 382 treatment/prophylaxis, 281, 281t, 304t, 304–305, 339, 484 viral, 188–189 Pneumonia severity index (PSI), 171–172, 174t Pneumonic plague clinical features, 436, 436t complications/admission criteria, 436t, 439 differential diagnosis, 438 laboratory/radiologic findings, 436t pearls/pitfalls, 441 transmission, 436t Pneumonic tularemia clinical features, 453 complications/admission criteria, 453, 456–457 differential diagnosis, 454–455 laboratory/radiologic findings, 453 transmission, 453 Pneumothorax, 193–194 Podofilox, 102t Podophyllin resin, 102t Polio, 224t, 225 Poliomyelitis, 242, 243t Polyarthritis clinical features, 207t, 207–208 complications/admission criteria, 209 differential diagnosis, 208 epidemiology, 207–208 laboratory/radiologic findings, 208, 208t overview, 203 pearls/pitfalls, 207, 209 treatment/prophylaxis, 208–209, 209t Polyenes See also specific drugs cautions, 512 differences/agents, 511 550 May 5, 2007 19:56 mechanism of action, 511 pearls/pitfalls, 512 properties, 512t renal function dosage adjustments, 512t Polymyxin B dacryocystitis, 153t otitis externa, 38 Porphyria, 56, 56t Posaconazole (Noxafil) cautions, 510 differences/agents, 510 pearls/pitfalls, 510 properties, 510 renal function dosage adjustments, 511t Postexposure prophylaxis anthrax, 427 botulism, 433 emergency contraception, 379 Hepatitis A virus, 379 Hepatitis B virus, 375t, 375–377 HIV infection adverse drug interactions, 378t adverse side effects, 378, 378t discontinuation, 377–378 emergency contraception/STD, 379 expert consultation, 378–379 failure, 378 nonoccupational, 377, 377t occupational, 376t overview, 377 plague, 439 resources, 379–380 sexually transmitted diseases, 379–380 smallpox, 447 Tularemia, 456, 456t viral hemorrhagic fevers, 465 Postneurosurgery brain abscess, 234t, 237t Post-WNV Infection Syndrome, 490t Postinfectious transverse myelitis, 243t, 244 Postoperative infections, 137 Postpartum/postabortion infections See also specific diseases differential diagnosis, 387 infection control, 389 overview, 385 pearls/pitfalls, 389 Pott’s disease (Spinal TB), 242, 243t Praziquantel, 70t Prednisone mechanism of action/adverse effects, 397t Pneumocystis pneumonia, 199t uric acid arthropathy (gout), 205t Preeclampsia, 347 Pregnancy abruption, differential diagnosis, 341–342 acute calculous cholecystitis, 68 anthrax, 423, 426t, 427 appendicitis clinical features, 340, 340t complications/admission criteria, 341 differential diagnosis, 340–342, 347 epidemiology, 340 laboratory/radiologic findings, 340t, 341 pearls/pitfalls, 341 treatment/prophylaxis, 340t, 341 avian influenza A (H5N1), 478t bacterial vaginosis, 106t, 108 community-acquired pneumonia, 171t candidiasis, 107 chancroid treatment, 96t cytomegalovirus clinical features, 344 complications/admission criteria, 345–346 epidemiology, 343–344 infection control, 346 laboratory/radiologic findings, 345t treatment/prophylaxis, 345t Ebola/Marburg fever, 459 ectopic, 56, 56t, 101 endophthalmitis, 167t fever (See fever/pregnancy) hemorrhagic fever with renal syndrome, 471t hepatitis clinical features, 347, 347t complications/admission criteria, 347 differential diagnosis, 340–341, 347 epidemiology, 346–347 infection control, 347–348 laboratory/radiologic findings, 347 treatment/prophylaxis, 347, 347t HIV infection postexposure prophylaxis, 378–379 HSV 1/2 clinical features, 344 complications/admission criteria, 345–346 epidemiology, 344 infection control, 346 laboratory/radiologic findings, 345t treatment/prophylaxis, 345t infective endocarditis treatment, 6t influenza clinical features, 339t complications/admission criteria, 188–189 treatment/prophylaxis, 339 injection drug users botulism, 370t necrotizing soft-tissue infections, 367t septic arthritis/osteomyelitis, 368t spinal epidural abscess, 369t subcutaneous abscess, 366t tetanus, 371t keratitis treatment/prophylaxis, 161t labor, 341–342 Lassa fever, 461 lower urinary tract infection, 212t, 213 malaria clinical features, 348, 348t complications/admission criteria, 349 differential diagnosis, 348 epidemiology, 348 infection control, 349 laboratory/radiologic findings, 348 overview, 348 pearls/pitfalls, 349 treatment/prophylaxis, 348, 348t musculoskeletal pain, 341–342 myocarditis/pericarditis treatment, 14t New World hemorrhagic fever, 461 parvovirus B19, 266–267 plague treatment, 440t Index P1: JZP 9780521871761ind CUFX252/Chin 521 86017 pneumonia clinical features, 339, 339t differential diagnosis, 339 treatment/prophylaxis, 339 pyelonephritis clinical features, 337t complications/admission criteria, 338 differential diagnosis, 337, 340–342 laboratory/radiologic findings, 337 pearls/pitfalls, 338 treatment/prophylaxis, 217t, 337–338, 338t respiratory tract infections clinical features, 339, 339t complications/admission criteria, 339–340 differential diagnosis, 339 epidemiology, 338–339 infection control, 340 laboratory/radiologic findings, 339 pearls/pitfalls, 340 treatment/prophylaxis, 339 rickettsial infections, treatment, 357t round ligament pain, 340–341 Rubella clinical features, 344 complications/admission criteria, 345–346 epidemiology, 343 infection control, 346 laboratory/radiologic findings, 345t treatment/prophylaxis, 345t septic abortion, 340–341 syphilis treatment, 23t, 94t tetanus, 416–418 toxoplasmosis clinical features, 344 complications/admission criteria, 345–346 epidemiology, 343 infection control, 346 laboratory/radiologic findings, 345t treatment/prophylaxis, 345t trichomoniasis treatment, 106t tuberculosis clinical features, 349 complications/admission criteria, 349 differential diagnosis, 349 epidemiology, 349 infection control, 349 laboratory/radiologic findings, 349 pearls/pitfalls, 349–350 treatment/prophylaxis, 349, 349t tularemia treatment, 456t varicella-zoster virus clinical features, 344 complications/admission criteria, 345–346 differential diagnosis, 339 epidemiology, 343 infection control, 346 laboratory/radiologic findings, 345t pearls/pitfalls, 340 treatment/prophylaxis, 345t West Nile virus, 490–491 Preorbital/orbital cellulitis clinical features, 154t, 154f complications/admission criteria, 155 differential diagnosis, 154 Index May 5, 2007 19:56 epidemiology, 153–154 laboratory/radiologic findings, 154–155 pearls/pitfalls, 155 treatment/prophylaxis, 155, 156t Pressure equalization tubes, otitis media, 34 Pressure ulcers, osteomyelitis, 129 Prevotella intermedia, 15 Primaquine malaria, 354, 356t, 357t Pneumocystis pneumonia, 199t Primary CNS lymphoma (PCNSL) clinical features, 253 differential diagnosis, 251t laboratory/radiologic findings, 252t Primaxin See Imipenem (Primaxin) Probiotics, 78 Procaine penicillin syphilis, 23t syphilitic meningitis, 254t Prograf (Tacrolimus/FK-506, Protopic), 397t Progressive multifocal leukoencephalopathy, 254t Progressive multifocal leukoencephopathy (PML) clinical features, 253 differential diagnosis, 251t laboratory/radiologic findings, 252t Prostaglandin E1, 275 Prostatitis clinical features, 111t, 114 complications/admission criteria, 115 differential diagnosis, 115 epidemiology, 114 laboratory/radiologic findings, 111t, 115 pearls/pitfalls, 115 treatment, 111t treatment/prophylaxis, 115 Prosthetic joint infection clinical features, 141, 141t complications/admission criteria, 142 differential diagnosis, 141–142 epidemiology, 141 laboratory/radiologic findings, 141t, 142 overview, 141 pearls/pitfalls, 142 treatment/prophylaxis, 141t, 142 Protease inhibitors See also specific drugs adverse drug interactions, 378t diarrhea, 85, 85t HIV drug reactions, 29 Protopic (Tacrolimus/FK-506, Prograf), 397t Pseudoephedrine, 34t Pseudomembranous croup See Bacterial tracheitis Pseudomonas aeruginosa pneumonias, 197 PSI (pneumonia severity index), 171–172, 174t Pubic lice See human louse (Pediculosis) Pulmonary embolus, 395 Pulpitis clinical features, 15, 15t complications, 19 differential diagnosis, 18 treatment/admission criteria, 19 Pulse corticosteroid therapy, SARS,485, 485t Puncture wounds, to feet See Plantar puncture wounds Purine analogues, 315–316 Purple pustules, persistent, 333t Purulent tenosynovitis clinical features, 122, 123f complications/admission criteria, 123 differential diagnosis, 122–123 laboratory/radiologic findings, 122 overview, 122 pearls/pitfalls, 125 treatment/prophylaxis, 122, 123 Pyelonephritis clinical features, 215t, 215–216 complications/admission criteria, 217–218 differential diagnosis, 56, 56t, 216 epidemiology, 215 laboratory/radiologic findings, 215t, 216 overview, 215 pearls/pitfalls, 218 in pregnancy clinical features, 337t complications/admission criteria, 338 differential diagnosis, 337, 340–342 epidemiology, 336–337 laboratory/radiologic findings, 337 pearls/pitfalls, 338 treatment/prophylaxis, 217t, 337–338, 338t treatment/prophylaxis, 216–217, 217t Pyomyositis, 243t, 244 Pyramethamine, 237t Pyrantel pamoate, 70t Pyrazinamide tuberculosis, 179t, 180t, 185, 199t tuberculosis, in pregnancy, 349t Pyrethrin/Piperonyl butoxide (RID, A-200), 330t Pyrimethamine cerebral toxoplasmosis, 254t toxoplasmosis, in pregnancy, 345t Q fever, 357, 520t QuantiFERON-TB Gold, 178, 182 Queensland tick typhus, 357, 358t Quinidine gluconate, 356t Quinine sulfate, 356t Rabies clinical features, 399–400, 400t complications/admission criteria, 400 differential diagnosis, 400 epidemiology, 399 infection control, 402 laboratory/radiologic findings, 400, 400t overview, 399 pearls/pitfalls, 402 postexposure prophylaxis, 400–402 treatment, 400 Rabies immunoglobulin (RIG), 400–402 Rabies vaccine, 400–402 Racemic epinephrine, 297t, 297–298 Radiography, 147–148, 336t Ramsey-Hunt Syndrome, 37–38 Rapamune (Sirolimus), 397t Rapidly progressive outer retinal necrosis (RPORN), 165 Rat mite, 327t, 328 Raxibacumab (ABthrax), 427 Reiter’s syndrome, 100 Relapsing hepatitis A, 60–61 Renal failure, sepsis, 406–407 551 P1: JZP 9780521871761ind CUFX252/Chin 521 86017 Respiratory protection, infection control, 529 Respiratory syncytial virus (RSV), 280–281, 302–303 Respiratory tract infections oncology patients clinical features, 317, 317t differential diagnosis, 320t laboratory/radiologic findings, 317t in pregnancy clinical features, 339, 339t complications/admission criteria, 339–340 differential diagnosis, 339 epidemiology, 338–339 infection control, 340 laboratory/radiologic findings, 339 pearls/pitfalls, 340 treatment/prophylaxis, 339 Restasis (Cyclosporine, Gengraf, Neoral, Sandimmune), 397t Retinitis clinical features, 164, 164f, 165t complications/admission criteria, 165 differential diagnosis, 164 epidemiology, 163–164 laboratory/radiologic findings, 164 necrotizing, 165, 165f overview, 163 pearls/pitfalls, 166 treatment/prophylaxis, 164–165 Retropharyngeal abscess (RPA) clinical features, 295t, 299–300 complications/admission criteria, 300 differential diagnosis, 296–300 epidemiology, 299 infection control, 301 laboratory/radiologic findings, 295t, 300 pearls/pitfalls, 301 treatment/prophylaxis, 295t, 300 Retropharyngeal space infections, 47–48 Retrovir See Zidovudine Reyataz (Atazanavir; ATV), 376t, 378t Reye syndrome, 188–189, 190 Rheumatoid arthritis clinical features, 207–208 complications/admission criteria, 209 differential diagnosis, 208 laboratory/radiologic findings, 208, 208t treatment/prophylaxis, 209t, 208–209 Ribavirin hemorrhagic fever with renal syndrome, 471t, 472 SARS, 484–485, 485t viral hemorrhagic fevers, 465, 465t, 466–467 West Nile encephalitis virus, 491 Rickettsia rickettsii, 222t, 223 Rickettsial infections clinical features, 357, 357t laboratory/radiologic findings, 357t, 358t treatment/prophylaxis, 357t Rickettsial pox, 357, 357t Rifabutin, 179t, 180t, 185 Rifampin latent tuberculosis bacillus infection, 179t meningitis chemoprophylaxis, 230t meningococcemia, 23t pediatric fever/rash diseases, 271 552 May 5, 2007 19:56 purulent tenosynovitis, 122 tuberculosis, 179t, 180t, 185 tuberculosis, in pregnancy, 349t Rift Valley fever clinical features, 461 complications/admission criteria, 466–467 epidemiology, 460t laboratory/radiologic findings, 461 therapeutics, developmental, 466t United States occurrence, 459 RIG (rabies immunoglobulin), 400–402 Rimantadine (Flumadine) avian influenza A (H5N1), 478, 478t, 479 differences/agents, 513 influenza, 188t mechanism of action, 513 pearls/pitfalls, 513–514 properties, 513 Ritonavir (Norvir; RTV) ADRs, 85 adverse side effects, 378t HIV infection postexposure prophylaxis, 376t Ritter’s disease See Staphylococcal scalded-skin syndrome Rituxumab, 315–316 RMSF See Rocky Mountain Spotted Fever (RMSF) Rocephin See Ceftriaxone (Rocephin) Rocky Mountain Spotted Fever (RMSF) clinical features, 25, 25f, 26t, 357, 358t complications/admission criteria, 333 diagnosis, 25 epidemiology, 25, 330 laboratory/radiologic findings, 26t overview, 331t treatment, 26t Roseola infantum, 265, 267f Rotavirus, 73t, 73–74 Roth spots, 3–4 Round ligament pain, in pregnancy,340–341 RPA See Retropharyngeal abscess (RPA) RPORN (rapidly progressive outer retinal necrosis), 165 RSV (respiratory syncytial virus), 280–281, 302–303 RTV See Ritonavir Rubella (German measles) clinical features, 27–28, 28t, 28f complications, 28 laboratory/radiologic findings, 28t in pregnancy clinical features, 344 complications/admission criteria, 345–346 epidemiology, 343 infection control, 346 laboratory/radiologic findings, 345t treatment/prophylaxis, 345t serology testing, 520t treatment, 28, 28t Rubeola See Measles (rubeola) SAH (Subarachnoid hemorrhage), 222t Salmonella bacteremia, 279 Salmonella spp., 391–393 Salmonelliosis acute infectious diarrhea, 74, 75t, 79t, 78–79 diarrhea/HIV-infection, 87 pearls/pitfalls, 87 treatment, 86t, 87 Salt water exposure, skin or soft-tissue infection risk factors/pathogens, 258t Sandimmune (Cyclosporine, Gengraf, Neoral, Restasis), 397t Saquinavir (Invirase; SQV), 376t Sarcoidosis, 51 SARS See Severe acute respiratory syndrome (SARS) SARS-Coronavirus, 186, 481 See also Severe acute respiratory syndrome (SARS) SBP See Spontaneous bacterial peritonitis (SBP) Scabies clinical features, 325, 326t complications/admission criteria, 333 differential diagnosis, 333t epidemiology, 326t laboratory/radiologic findings, 326 pearls/pitfalls, 333–334 treatment/prophylaxis, 326–327, 327t SCD See Sickle cell disease (SCD) Scleritis, 160, 164 Scrub typhus, 357, 358t Secretory diarrhea, 73 Sepsis ARDS, 406, 406t in children, 409–410, 410t, 413–414 clinical features, 403, 403t, 410, 410t complications/admission criteria, 406 diarrhea/HIV-infection, 87 differential diagnosis, 4, 203–204, 403, 410 epidemiology, 403 infection control, 407 laboratory/radiologic findings, 403, 405t, 410 myocardial depression, 406 organ dysfunction, 404t overview, 403 pearls/pitfalls, 407 renal failure, 406–407 SIRS, 403t, 404t treatment/prophylaxis activated protein C, 406 antibiotics, 405, 406t, 410, 410t early goal-directed therapy, 404 euglycemia, 406 fluid resuscitation, 404 respiratory support, 404 steroids/relative adrenal insufficiency, 405 vasopressors, 404, 406t Septic abortion, in pregnancy, 340–341 Septic arthritis clinical features, 117, 118f, 118t complications/admission criteria, 118 differential diagnosis, 117, 118t epidemiology, 117 evaluation, 118t injection drug users clinical features, 368, 368t differential diagnosis, 368 epidemiology, 368 Index P1: JZP 9780521871761ind CUFX252/Chin 521 86017 laboratory/radiologic findings, 368, 368t overview, 367 treatment/prophylaxis, 368t, 368–369 laboratory/radiologic findings, 118t, 117–118 overview, 117 pearls/pitfalls, 119 sickle cell disease (See Sickle cell disease (SCD)) treatment/prophylaxis, 118, 118t Septic arthritis, in children clinical features, 286, 286t differential diagnosis, 286–287 epidemiology, 286 laboratory/radiologic findings, 286t, 287 overview, 286 pearls/pitfalls, 287 treatment/prophylaxis, 286t, 287 Septic pelvic thrombophlebitis clinical features, 386–387 differential diagnosis, 387–388 epidemiology, 386 laboratory/radiologic findings, 387, 388 overview, 385 pearls/pitfalls, 389 treatment/prophylaxis, 389 Septic shock See also Sepsis clinical features, 403t pearls/pitfalls, 407 treatment/prophylaxis, 404, 406t Septicemic plague clinical features, 436, 438f, 438t complications/admission criteria, 438t differential diagnosis, 438–439 laboratory/radiologic findings, 438t transmission, 438t Septicemic tularemia See Typhoid (septicemic) tularemia Septra See Trimethoprim-sulfamethoxazole (TMP-SMX, Bactrim, Septra) Serious bacterial infections children, laboratory/radiologic findings, 280–281 clinical features, 279–280 neonates, 279 Serology testing, 520t, 519–521 Severe acute respiratory syndrome (SARS) community-acquired pneumonia treatment, 484, 485t clinical features, 481–482, 482, 482t, 482f complications/admission criteria, 481–482 differential diagnosis, 483 epidemiology, 481 infection control, 486–487 laboratory/radiologic findings, 482t, 483, 483t, 484, 484f, 485f overview, 481 pathogenesis, 482–483 pearls/pitfalls, 487 pediatric clinical features, 482t epidemiology, 481 laboratory/radiologic findings, 482t, 483, 483t, 484 pathogenesis, 482–483 prognosis, 487 Index May 5, 2007 19:56 prognosis, 486t, 487 risk assessment, 486–487 risk factors, 481 treatment/prophylaxis antivirals, 484–485, 485t convalescent plasma, 485 corticosteroids, 485, 485t invasive mechanical ventilation, 486 IVIG, 485 NIPPV, 485–486 overview, 484, 485t Sexually transmitted diseases (STDs) See also specific diseases differential diagnosis, 45–46, 84, 89–90, 92, 95 infection control, 103 overview, 89, 97 pearls/pitfalls, 103 postexposure prophylaxis, 379–380 Shiga-toxin-producing Escherichia coli (STEC), 75t, 76, 79t, 78–79 Shigella spp acute infectious diarrhea, 74–75, 75t, 78–79, 79t differential diagnosis, 84 treatment, 86t, 87 Shingles See Varicella-zoster virus Sickle cell disease (SCD) bacteremia/sepsis clinical features, 410, 410t differential diagnosis, 410 treatment/prophylaxis, 410, 410t cholecystitis/cholangitis differential diagnosis, 413 epidemiology, 413 laboratory/radiologic findings, 413 complications/admission criteria, 413 differential diagnosis, 56, 56t, 409 epidemiology, 409 history/physical examination, 409 osteomyelitis/septic arthritis clinical features, 412, 412t differential diagnosis, 412–413 laboratory/radiologic findings, 412t, 413 overview, 412 treatment/prophylaxis, 412t, 413 overview, 409 pearls/pitfalls, 413–414 pneumonia/acute chest syndrome clinical features, 411, 411t differential diagnosis, 411 laboratory/radiologic findings, 411, 411t overview, 410–411 treatment/prophylaxis, 411t, 412 Sin Nombre virus (SNV), 469 See also Hantavirus cardiopulmonary syndrome (HCPS); Hemorrhagic fever with renal syndrome (HFRS) Sinusitis agents, 234t clinical features, 39, 39t, 40t complications/admission criteria, 41 differential diagnosis, 40, 48, 222t epidemiology, 39 fungal, 40 laboratory/radiologic findings, 40, 40t overview, 39 pearls/pitfalls, 41 treatment/prophylaxis, 40t, 40–41, 237t Sirolimus (Rapamune), 397t SIRS (Systemic Inflammatory Response Syndrome), 403t, 404t ă Sjogrens syndrome, 51 Skin/soft-tissue infections clinical features, 258 complications/admission criteria, 261 definitions, 257t differential diagnosis, 259 epidemiology, 257 infection control, 261 laboratory/radiologic findings, 259 oncology patients clinical features, 317, 317t differential diagnosis, 319t pearls/pitfalls, 322 treatment/prophylaxis, 317t overview, 257 pearls/pitfalls, 261 treatment/prophylaxis, 260 SLE See Systemic lupus erythematosus (SLE) Smallpox as biological weapon, 443 clinical features, 444 complications/admission criteria, 448 differential diagnosis, 445–446, 446t flat-type (malignant), 445 hemorrhagic clinical features, 445 differential diagnosis, 445–446 pearls/pitfalls, 448–449 immunity/prior vaccination, 447 infection control, 448 laboratory/radiologic findings, 446–447 modified, 445 natural reservoirs, 443 overview, 443 pearls/pitfalls, 448–449 postexposure prophylaxis, 447 risk assessment, 445, 446t transmission, 443, 448–449 treatment, 447 United States occurrence, 444 vaccination, 447–448 Variola major, 444–445, 445t Variola minor, 445 Variola sine eruption, 445 worldwide occurrence, 443 Smoking, 43, 169 SNV (Sin Nombre virus), 469 See also Hantavirus cardiopulmonary syndrome (HCPS); Hemorrhagic fever with renal syndrome (HFRS) Solid organ transplant patients, infections clinical features, 392t, 391–393 complications/admission criteria, 398 differential diagnosis, 394 infection control, 398 laboratory/radiologic findings, 395 overview, 391 pearls/pitfalls, 398 treatment/prophylaxis, 395t, 397t, 396–398 553 P1: JZP 9780521871761ind CUFX252/Chin 521 86017 Specimen collection procedures anaerobic culture, 518 blood cultures, 517–518 CSF cultures, 518 general, 517 stool, ova/parasite exam, 518 stool culture, 518 tissue/biopsy specimens, 518 urine cultures, 518 viral culture, 518 Spectinomycin, 24t, 99t Spinal epidural abscess clinical features, 241–242, 242t complications/admission criteria, 245 differential diagnosis, 243t, 242–244 epidemiology, 241 infection control, 246 infective endocarditis, 365 injection drug users clinical features, 369, 369t differential diagnosis, 369 epidemiology, 369 laboratory/radiologic findings, 369, 369t overview, 369 treatment/prophylaxis, 369t, 369–370 laboratory/radiologic findings, 244–245 overview, 241 pearls/pitfalls, 246 pregnancy, injection drug users, 369t treatment/prophylaxis, 245, 246t Spiramycin, 345t Splenic abscesses clinical features, 55–56, 56t laboratory/radiologic findings, 56t treatment/prophylaxis, 56t Spondyloarthritis complications/admission criteria, 209 laboratory/radiologic findings, 207t, 208, 208t treatment/prophylaxis, 207t, 209t, 208–209 Spontaneous bacterial peritonitis (SBP) clinical features, 54t, 53–54 laboratory/radiologic findings, 54t overview, 53 treatment/prophylaxis, 57t Sporanox See Itraconazole (Sporanox) Spotted fevers, clinical features, 357, 358t SQV (Saquinavir; Invirase), 376t SSSS See Staphylococcal scalded-skin syndrome St Louis encephalitis virus clinical features, 224t, 225 differential diagnosis, 490–491 Staphylococcal scalded-skin syndrome (SSSS; Ritter’s disease) clinical features, 268, 269f differential diagnosis, 268 treatment/prophylaxis, 269t, 268–269 Staphylococcus species culture interpretation, 519 S aureus, S epidermidis, Stavudine (Zerit; d4T) adverse side effects, 378t HIV infection postexposure prophylaxis, 376t 554 May 5, 2007 19:56 STDs See Sexually transmitted diseases (STDs) Steroids anthrax, 426t bacterial meningitis, 228–229 epiglottitis, 295t pericarditis treatment, 12, 14t Stevens Johnson syndrome, clinical features, 30, 30t Straw itch mite, clinical features, 327t, 328 Streptococcus pneumoniae, 169, 222, 222t, 223f, 279, 519t Streptococcus viridans group culture interpretation, 519t infective endocarditis, Streptomycin plague, 440t tuberculosis, in pregnancy, 349t Tularemia, 455–456, 456t Stroke, 251t Stromectol See Ivermectin (Mectizan, Stromectol) Subarachnoid hemorrhage (SAH), 222t Subcutaneous abscess injection drug users clinical features, 365, 366t differential diagnosis, 366 epidemiology, 365 laboratory/radiologic findings, 366, 366t overview, 365 treatment/prophylaxis, 366, 366t pregnancy, injection drug users, 366t Subdural empyema, clinical features, 235 Sublingual infection clinical features, 17t, 18, 18t differential diagnosis, 18, 43–44 Submandibular infections clinical features, 17t differential diagnosis, 18 Submental infections clinical features, 17, 17t differential diagnosis, 18, 43–44 Sulfacetamide, 158t Sulfadiazine cerebral toxoplasmosis, 254t intracranial abscess, 237t toxoplasmosis, in pregnancy, 345t Sulfonamides, 337–338, 338t See also specific drugs Supraglottitis clinical features, 43, 44t complications/admission criteria, 44 differential diagnosis, 43–44, 48 epidemiology, 43, 295 infection control, 44 laboratory/radiologic findings, 44, 44t overview, 43 pearls/pitfalls, 44 treatment/prophylaxis, 44, 44t Suprax See Cefixime (Suprax) Surgical site infections anastomotic leak risk, 382t classification, 381t clinical features, 381–382 colitis, 382 complications/admission criteria, 383 deep, 381–382 differential diagnosis, 382 epidemiology, 381 infection control, 384 laboratory/radiologic findings, 382–383 operation sterility classification, 381t organ/space, 381–382 overview, 381 pearls/pitfalls, 384 pneumonia, 382 secondary peritonitis, antibiotics, 383t superficial, 381–382 thrombophlebitis, 382 treatment/prophylaxis, 383 urinary tract infections, 382 Swimmer’s ear See Otitis externa (OE) Sylvatic typhus, 357, 358t Symmetrel See Amantadine (Symmetrel) Syphilis clinical features, 21, 22t, 28, 92, 92t, 92f, 93f complications/admission criteria, 93 differential diagnosis, 45–46, 92, 243t, 244 epidemiology, 91 infection control, 93 laboratory/radiologic findings, 22t, 22f, 92t, 92–93 meningovascular, 251t pearls/pitfalls, 94, 95–96 in pregnancy, 344–345 serology testing, 520t treatment, 22t, 23t, 93, 94t Syphilitic meningitis differential diagnosis, 251t laboratory/radiologic findings, 252t treatment/prophylaxis, 254t Systemic embolization, Systemic Inflammatory Response Syndrome See SIRS (Systemic Inflammatory Response Syndrome) Systemic lupus erythematosus (SLE) clinical features, 31, 31t, 31f complications/admission criteria, 209 diagnosis, 31, 31t laboratory/radiologic findings, 208, 208t treatment, 31, 31t treatment/prophylaxis, 209t, 208–209 Tachydysrrythmias, 14t Tacrolimus/FK-506 (Prograf, Protopic), 397t Taenia solium, 226, 227t Tamiflu See Oseltamivir (Tamiflu) 3TC See Lamivudine Td (adult tetanus and diphtheria toxoids vaccine adsorbed), 417, 417t, 418 Tdap (tetanus-diphtheria-acellular pertussis vaccine adsorbed), 417, 417t, 418 TDF See Tenofovir Telithromycin (Ketek) properties, 505 renal function dosage adjustments, 505t TEN See Toxic epidermal necrolysis (TEN) Tenofovir (Viread; TDF) adverse side effects, 378t HIV infection postexposure prophylaxis, 376t Tequin See Gatifloxacin (Tequin) Terconazole, 108t Testicular torsion, 114 Tetanospasmin (tetanus toxin), 415 Tetanus clinical features, 415t, 415–416 Index P1: JZP 9780521871761ind CUFX252/Chin 521 86017 complications/admission criteria, 417 differential diagnosis, 243t, 244, 416 epidemiology, 415 infection control, 418 injection drug users clinical features, 371, 371t differential diagnosis, 371 epidemiology, 371 laboratory/radiologic findings, 371, 371t overview, 371 treatment/prophylaxis, 371, 371t laboratory/radiologic findings, 415t, 416 overview, 415 pearls/pitfalls, 418 postexposure prophylaxis, 417, 417t, 418 treatment/prophylaxis, 415t, 416–417 Tetanus-acellular pertussis vaccine adsorbed (DTaP), 417, 417t, 418 Tetanus toxoid, 371t, 415t Tetracyclines See also specific drugs anthrax, 426t cautions, 506 cystitis/pyelonephritis, in pregnancy, 337–338 differences/agents, 506 malaria, 356t mechanism of action, 506 pearls/pitfalls, 506 properties, 506 renal function dosage adjustments, 506t rickettsial infections, 357t RMSF, 26t syphilis, 23t, 93, 94t Thai tick typhus, 357, 357t Thrombophlebitis, 382 Thrush, 322 Tiaconazole, 108t Ticarcillin/clavulanate acute bacterial cholangitis, 69t acute calculous cholecystitis, 67t acute prostatitis, 217t appendicitis, in pregnancy, 340t endometritis, 389t peritonitis, secondary, 58t pyelonephritis, 217t secondary peritonitis, 383t Tick-borne disease, 357, 358t Tick-borne encephalitis virus, 224t, 225 Ticks See also specific diseases complications/admission criteria, 333 diseases, common, 331t epidemiology, 326t overview, 330 removal, 330, 332f Tigecycline (Tygacil) differences/agents, 506 properties, 506 renal function dosage adjustments, 506t Tindamax See Tinidazole (Tindamax) Tinidazole (Tindamax) diarrhea/HIV-infection, 86t, 86–87 Entamoeba histolytica, 86t, 87 nongonococcal urethritis, 100 properties, 507–508 renal function dosage adjustments, 508t trichomoniasis, 106, 106t urethritis, 112t Index May 5, 2007 19:56 TMP-SMX See Trimethoprim-sulfamethoxazole (TMP-SMX, Bactrim, Septra) Tobramycin bacterial meningitis, 229t community-acquired pneumonia, 171t differences, 504 febrile post-transplant patients, 395t keratitis, 161t properties, 504 renal function dosage adjustments, 505t spinal epidural abscess, 246t Tonsillitis clinical features, 45, 45t complications/admission criteria, 46 differential diagnosis, 45–46, 48 epidemiology, 45 infection control, 46 laboratory/radiologic findings, 45t, 46 overview, 45 pearls/pitfalls, 46 treatment/prophylaxis, 45t, 46 TORCH infections clinical features, 344 complications/admission criteria, 345–346 differential diagnosis, 344–345 epidemiology, 343–344 infection control, 346 laboratory/radiologic findings, 345t pearls/pitfalls, 346 treatment/prophylaxis, 345t Toxic epidermal necrolysis (TEN) clinical features, 25f, 30, 30t laboratory/radiologic findings, 30t treatment, 30t Toxic shock syndrome clinical features, 24, 25t laboratory/radiologic findings, 25t treatment, 24–25, 25t Toxoplasma gondii, 197 Toxoplasmosis cerebral clinical features, 253 differential diagnosis, 251t laboratory/radiologic findings, 252t pearls/pitfalls, 255 treatment/prophylaxis, 254t in pregnancy clinical features, 344 complications/admission criteria, 345–346 epidemiology, 343 infection control, 346 laboratory/radiologic findings, 345t treatment/prophylaxis, 345t serology testing, 520t Trauma abdominal, 56 differential diagnosis, 203–204 Trench mouth See Acute necrotizing ulcerative gingivostomatitis Triamcinolone, 205t Trichloroacetic acid (TCA), 102t Trichomoniasis clinical features, 106, 106t, 108t complications/admission criteria, 107 differential diagnosis, 108 epidemiology, 106 infection control, 107 laboratory/radiologic findings, 106t, 105–106 pearls/pitfalls, 108 treatment, 106, 106t Triclabendazole, 70t Trimethoprim-sulfamethoxazole (TMP-SMX, Bactrim, Septra) acute paronychia/felon, 124t acute prostatitis, 217t animal/fight bites, 311 bacterial diarrhea, 79t bacterial meningitis, 254t cautions, 507 cystitis/pyelonephritis, in pregnancy, 338t differences/agents, 507 febrile post-transplant patients, 395t Isospora, 86t, 87 lower urinary tract infection, 212t mechanism of action, 507 parasitic diarrhea, 80t pearls/pitfalls, 507 pediatric UTI, 292t, 293t pertussis, 301t plague, 440t Pneumocystis pneumonia, 199t properties, 507 prostatitis, 111t purulent tenosynovitis, 122 pyelonephritis, 217t renal function dosage adjustments, 508t subcutaneous abscess, injection drug users, 366t treatment/prophylaxis, 149t Trimethoprim sulfate, 153t Tuberculoma, 251t Tuberculosis clinical features, 176, 176t complications/admission criteria, 181–182 differential diagnosis, 84–85, 177 drug monitoring/ADRs, 180t, 185 drug resistant, 181 epidemiology, 175 extrapulmonary clinical features, 177 laboratory/radiologic findings, 178–179 treatment/prophylaxis, 181 infection control, 182 laboratory/radiologic findings, 176t, 177, 178 latent tuberculosis bacillus infection (LTBI) clinical features, 177 laboratory/radiologic findings, 177–178 pearls/pitfalls, 182 treatment/prophylaxis, 179t, 180 meningitis (See Tuberculous meningitis) osteomyelitis (See Tuberculosis osteomyelitis) overview, 175 pathogenesis/risk factors, 175–176 pearls/pitfalls, 182 in pregnancy clinical features, 349 complications/admission criteria, 349 555 P1: JZP 9780521871761ind CUFX252/Chin 521 86017 Tuberculosis (cont.) differential diagnosis, 349 epidemiology, 349 infection control, 349 laboratory/radiologic findings, 349 pearls/pitfalls, 349–350 treatment/prophylaxis, 349, 349t pulmonary clinical features, 176 laboratory/radiologic findings, 178 spinal (See Pott’s disease (Spinal TB)), treatment/prophylaxis, 179t, 179–180, 180t, 181, 185 tuberculin skin test results criteria, 178, 178t Tuberculosis osteomyelitis clinical features, 137f differential diagnosis, 136 overview, 137 Tuberculous meningitis differential diagnosis, 251t laboratory/radiologic findings, 252t overview, 226 treatment/prophylaxis, 254t Tuberculous peritonitis, 53 Tubo-ovarian abscess, 56, 340–341 Tularemia as biological weapon, 451 clinical features, 453, 453f, 454f complications/admission criteria, 456–457 differential diagnosis, 454 glandular/ulceroglandular clinical features, 453, 453t complications/admission criteria, 453t, 456–457 differential diagnosis, 455 laboratory/radiologic findings, 453t transmission, 453t infection control, 457 laboratory/radiologic findings, 455 natural reservoirs, 451 oculoglandular clinical features, 453–454 complications/admission criteria, 456–457 differential diagnosis, 455 oropharyngeal/gastrointestinal clinical features, 454 complications/admission criteria, 456–457 differential diagnosis, 455 overview, 331t, 451 pearls/pitfalls, 457 pneumonic clinical features, 453 complications/admission criteria, 453, 456–457 differential diagnosis, 454–455 laboratory/radiologic findings, 453 transmission, 453 postexposure prophylaxis, 456, 456t transmission, 451–452 treatment, 455–456, 456t typhoid (septicemic) clinical features, 454 complications/admission criteria, 454 differential diagnosis, 455 laboratory/radiologic findings, 454 556 May 5, 2007 19:56 transmission, 454 United States occurrence, 452 vaccination, 456 worldwide occurrence, 452 Tungiasis, 326t Tygacil See Tigecycline (Tygacil) Typhlitis, 56, 56t Typhoid (septicemic) tularemia clinical features, 454 complications/admission criteria, 454 differential diagnosis, 455 laboratory/radiologic findings, 454 transmission, 454 Typhus fevers, 357, 358t Ulceroglandular/glandular tularemia clinical features, 453, 453t complications/admission criteria, 453t, 456–457 differential diagnosis, 455 laboratory/radiologic findings, 453t transmission, 453t Ultrasonography,applications, 147–148 Unasyn See Ampicillin/sulbactam (Unasyn) Upper respiratory infection (URI), 43–44 See also Respiratory tract infections Ureidopenicillin, 66–67, 67t Uremia, 56, 56t Urethritis clinical features, 111, 111t complications/admission criteria, 112 differential diagnosis, 111–112 epidemiology, 111 infection control, 112 laboratory/radiologic findings, 111t, 112 NGU (See Nongonococcal urethritis (NGU)) pearls/pitfalls, 112 treatment/prophylaxis, 112, 112t Uric acid arthropathy (gout), 205t, 207 Urinary tract infections (UTIs) laboratory/radiologic findings, 215t, 216 lower (See Lower urinary tract infection (LUTI)) neonatal, 274t, 275 oncology patients, 318 pediatric clinical features, 279–280, 291, 292t complications/admission criteria, 293 differential diagnosis, 291–292 epidemiology, 291, 291t laboratory/radiologic findings, 291, 292, 292t, 302–303 overview, 291 pearls/pitfalls, 293 risk factors, 291 treatment, 281t treatment/prophylaxis, 292t, 292–293, 293t in pregnancy, 336–337, 337t surgical site infections, 382 treatment/prophylaxis, 216–217 Urine culture, 213 Urine dipstick testing, 212 Urine microscopy, 212–213 Urolithiasis, 56, 56t Uveitis clinical features, 164, 165t complications/admission criteria, 165 differential diagnosis, 164 epidemiology, 163–164 laboratory/radiologic findings, 164 overview, 163 pearls/pitfalls, 166 treatment/prophylaxis, 164–165 Vaccination anthrax, 427 botulism, 433 plague, 439 smallpox, 447–448 tetanus, 417, 417t, 418 Tularemia, 456 viral hemorrhagic fevers, 465–466 viral hepatitis, 63 West Nile encephalitis virus, 491 yellow fever, 465–466 Vaccinia immunoglobulin (VIG), 448 Valacyclovir (Valtrex) differences/agents, 512 herpes genitalis, 91t keratitis, 161t pearls/pitfalls, 513 properties, 512 renal function dosage adjustments, 513t Valganciclovir (Valtrex) cautions, 512 differences/agents, 512 pearls/pitfalls, 513 properties, 512 renal function dosage adjustments, 513t Valtrex See Valacyclovir (Valtrex); Valganciclovir (Valtrex) Vancomycin abscesses/cellutitis, 260t bacteremia/sepsis, 410t bacterial meningitis, 229t, 254t bacterial tracheitis, 298t breast abscess/mastitis, 389t community-acquired pneumonia, 171t cautions, 502 CNS infections,oncology patients, 318 diabetic foot infections, 144t differences, 502 endophthalmitis, 166t, 167t epidural abscesses, 138t febrile child treatment, 281t febrile post-transplant patients, 395t infections, oncology patients, 322 infective endocarditis, 6t, 364–365, 365t intracranial abscess, 237t mechanism of action, 502 monoarthritis, 205t necrotizing soft-tissue infections, 261t, 367t oligoarthritis, 207t osteomyelitis, 127t pearls/pitfalls, 503 pneumonia/acute chest syndrome, sickle cell disease, 411t preorbital/orbital cellulitis, 156t properties, 502 purulent tenosynovitis, 122, 124t renal function dosage adjustments, 503 sepsis, 406t septic arthritis/osteomyelitis, injection drug users, 368t Index P1: JZP 9780521871761ind CUFX252/Chin 521 86017 skin/soft-tissue infections, oncology patients, 317t spinal epidural abscess, 246t, 369t splenic abscesses, 56t staphylococcal scalded-skin syndrome, 269t subcutaneous abscess, injection drug users, 366t toxic shock syndrome, 25t treatment, 118t vertebral osteomyelitis, 135t Varicella-zoster immune globulin, 345t Varicella-zoster virus clinical features, 224t, 267–268, 268f differential diagnosis, 238–239, 251t, 445, 446t HIV infection, 29 NSTI presentation, 259 in pregnancy clinical features, 344 complications/admission criteria, 345–346 differential diagnosis, 339 epidemiology, 343 infection control, 346 laboratory/radiologic findings, 345t pearls/pitfalls, 340 treatment/prophylaxis, 345t serology testing, 520t treatment/prophylaxis, 254t, 268, 268t, 317t vaccine, 268 Variola major, 444–445, 445t Variola minor, 445 Variola sine eruption, 445 Variola virus See Smallpox Vasculitic neuropathy, 243t, 244 Vasopressin, septic shock, 406t Ventriculoencephalitis, 251t, 252t Vertebral osteomyelitis clinical features, 135, 135t, 136f complications/admission criteria, 137 differential diagnosis, 136 epidemiology, 135 laboratory/radiologic findings, 135t, 136 overview, 135 pearls/pitfalls, 137 special considerations, 137 treatment/prophylaxis, 135t, 136–137 Vfend See Voriconazole (Vfend) Vibrio spp., 75t, 76, 78–79, 79t Vidarabine, 161t Videx See Didanosine Viral/bacterial conjunctivitis, 152 Viral hemorrhagic fevers See also specific diseases agents/overview, 459 as biological weapon, 459 clinical features, 459 complications/admission criteria, 459, 462t, 466–467 differential diagnosis, 462, 464 epidemiology, 459, 460t infection control, 467, 467t laboratory/radiologic findings, 459, 465 Index May 5, 2007 19:56 pearls/pitfalls, 467–468 postexposure prophylaxis, 465 therapeutics, developmental, 466t transmission, 467 treatment, 465, 465t United States occurrence, 459 vaccination, 465–466 Viral hepatitis See also specific types under Hepatitis heading acute clinical features, 59–60, 60t complications/admission criteria, 63 differential diagnosis, 61–62 imaging, 63 laboratory/radiologic findings, 60t, 62 treatment/prophylaxis, 60t, 63 chronic, 60, 63 clinical features, 60–61 epidemiology, 59 fulminant hepatic failure clinical features, 60, 60t laboratory/radiologic findings, 60t pearls/pitfalls, 63 treatment/prophylaxis, 60t infection control, 63 overview, 59 pearls/pitfalls, 63 Viral infection differential diagnosis, 38 pharyngitis/tonsillitis, 45 post-transplant patients, treatment/prophylaxis, 395t systemic, 26 Viral laryngotracheobronchitis clinical features, 297, 297t complications/admission criteria, 298 differential diagnosis, 43–44, 297 epidemiology, 297 infection control, 298 laboratory/radiologic findings, 297, 297t pearls/pitfalls, 298 treatment/prophylaxis, 297t, 297–298 Viral meningitis agents/clinical features, 224t, 224–225 clinical features, 221 differential diagnosis, 225 HSV infection, 91 laboratory/radiologic findings, 228 Viral myelitis differential diagnosis, 242, 243t laboratory/radiologic findings, 244–245 Viread See Tenofovir Voriconazole (Vfend) cautions, 510 differences/agents, 510 febrile post-transplant patients, 395t pearls/pitfalls, 510 properties, 510 renal function dosage adjustments, 511t Vulvovaginitis See also specific diseases clinical features, 108t overview, 105 pearls/pitfalls, 108 Wasp stings, 259 Waterhouse-Friderichsen Syndrome (Acute fulminant meningococcemia), 23, 23t West Nile Acute Flaccid Paralysis, 490t West Nile encephalitis virus (WNV) clinical features, 224t, 225, 490t, 489–490 complications/admission criteria, 491–492 differential diagnosis, 238–239, 490–491 epidemiology, 489 infection control, 492 laboratory/radiologic findings, 490, 490t, 491t overview, 489 pearls/pitfalls, 492 transmission, 490t, 492 treatment, 491 vaccination, 491 West Nile fever, 490t West Nile meningitis, 490t Whitewater Arroyo virus, 467–468 Whooping cough See Pertussis WNV See West Nile encephalitis virus (WNV) Wound botulism See Botulism, wound Xanthogranulomatous pyelonephritis, 217–218 Yellow fever clinical features, 461–462 complications/admission criteria, 466–467 epidemiology, 460t laboratory/radiologic findings, 461–462 therapeutics, developmental, 466t United States occurrence, 459 vaccination, 465–466 Yersinia enterocolitica, 75t, 76, 78–79, 79t See also Diarrhea, acute infectious Yersinia pestis, 435 See also Plague Zanamavir cautions, 513 differences/agents, 513 mechanism of action, 513 pearls/pitfalls, 513–514 properties, 513 renal function dosage adjustments, 514t Zanamivir avian influenza A (H5N1), 478, 478t, 479 influenza, 188t ZDV See Zidovudine Zerit See Stavudine Zidovudine (Retrovir; ZDV; AZT) adverse side effects, 378t HIV infection postexposure prophylaxis, 376t Zithromax See Azithromycin (Zithromax) Zoster See Herpes Zoster Zosyn See Piperacillin/tazobactam (Zosyn) Zovirax See Acyclovir (Zovirax) Zyvox See Linezolid (Zyvox) 557 ... CUFX252/Chin 521 86017 May 5, 2007 21:6 Emergency Management of Infectious Diseases The diagnosis and management of infectious disease is a key component of contemporary emergency medicine, ranging from... Assistant Professor of Clinical Pharmacy University of California, San Francisco School of Pharmacy San Francisco, CA William Mallon, MD Associate Professor of Emergency Medicine Keck School of Medicine... Professor of Emergency Medicine University of California, San Francisco School of Medicine San Francisco General Hospital San Francisco, CA Maureen McCollough, MD, MPH Associate Professor of Emergency