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Animal-Borne Illness - Dr. Cox

3/2/2017

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Picture
​Cat Scratch Disease:
  • Clinical diagnosis!
  • Think Lymphadenopathy… then fever and constitutional symptoms
  • Usually self-limited, can treat with azithromycin x5days
  • http://pedemmorsels.com/cat-scratch-disease/
 
Toxoplasmosis
  • Immunocompetent: Vast majority asymptomatic
  • Immunocompromised
    • Toxoplasmic Encephalitis
      • Most common CNS infection  in AIDS pt  not on ppx
Presumptive Dx:
  • CD4+ <100
  • Not on appropriate PPx
  • Compatible clinical syndrome
  • T. gondii IgG Ab positive
  • Ring enhancing lesions on imaging
    • MRI preferred (more sensitive)
  • Tx: Pyrimethamine, Sulfadiazine, Leucovorin x 6 wks
 
Bites:
  • Check vaccination status of patient and animal
  • HIGH PRESSURE, COPIOUS irrigation
  • Dogs:
    • Close bites if <12 hours old, <24 hours on face
  • Cats: DO NOT CLOSE (unless terrible cosmetic injury)
  • PPx:           
    • ALL CAT BITES
    • Dog bites if:
      • >8hours old
      • Face, genitals
      • Tendon, joints, bone
      • Immunocompromised, poor wound healing
    • Tx: Augmentin x3-5days
  • Bad Pathogens:
    • Pasteurella = CAN’T use 1st gen cephalosporins or clindamycin
      • Tx: Augmentin, Unasyn, Zosyn
    • Capnocytophaga = Bad hombre           
      • Immunocompromised
      • Asplenic
      • Hepatic disease
      • Tx: IV Zosyn, cephalosporins, carbapenems
 
Toxocariasis:
  • Think Children, sandboxes, exposure to feces
  • Spectrum of disease: asymptomatic -> organ failure
  • 2 flavors:
    • Visceral Larva Migrans
    • Ocular Larva Migrans: vision loss
    • (3rd flavor is Cutaneous Larva Migrans. Caused by Ancylostoma)
  • Tx: VLM: Albendazole x5 days, +/- prednisone
       OLM: Prednisone (slow taper), Albendazole x2-4weeks
 

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  • RESIDENCY
    • About CMC
    • Curriculum
    • Benefits
    • Explore Charlotte
    • Official Site
  • FELLOWSHIP
    • EMS
    • Global EM
    • Pediatric EM
    • Toxicology >
      • Tox Faculty
      • Tox Application
    • (All Others)
  • PEOPLE
    • Program Leadership
    • PGY-3
    • PGY-2
    • PGY-1
    • Alumni
  • STUDENTS/APPLICANTS
    • Medical Students at CMC
    • EM Acting Internship
    • Healthcare Disparities Externship
    • Resident Mentorship
  • #FOAMed
    • EM GuideWire
    • CMC Imaging Mastery
    • Pediatric EM Morsels
    • Blogs, etc. >
      • CMC ECG Masters
      • Core Concepts
      • Cardiology Blog
      • Dr. Patel's Coding Blog
      • Global Health Blog
      • Ortho Blog
      • Pediatric Emergency Medicine
      • Tox Blog
  • Chiefs Corner
    • Top 20
    • Current Chiefs
    • Schedules >
      • Conference/Flashpoint
      • Block Schedule
      • ED Shift Schedule
      • AEC Moonlighting
      • Journal Club/OBP/Audits Schedule
      • Simulation
    • Resources >
      • Fox Reference Library
      • FlashPoint
      • Airway Lecture
      • Student Resources
      • PGY - 1
      • PGY - 2
      • PGY - 3
      • Simulation Reading
      • Resident Wellness
      • Resident Research
      • Resume Builder
    • Individualized Interactive Instruction