1
Approach to Infectious Diseases and their prevention
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2
Antibiotic stewardship practices
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3Community-Acquired Infections
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Health Care?Associated Infections
5
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Gram-Positive Bacteria (part-1)6
Gram-Positive Bacteria (part-2)
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7
Gram-Negative Bacteria (part-1)
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8Gram-Negative Bacteria (part-2)
9
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Spirochetal Diseases
10
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Diseases Caused by Atypical/Miscellaneous Bacterial Infections11
Revision-cum-exam on bacteria (Must to know type)
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12
Infections Due to DNA Viruses
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113
Infections Due to RNA Viruses (part 1)
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14
Infections Due to RNA Viruses (part 2)
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15HIV/AIDS ? part 1
16
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HIV/AIDS ? part 2
17
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Fungal Infections18
Parasitic Infections (part 1)
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19
Parasitic Infections (part 2)
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20Revision-cum-exam on Virus, Fungal, and Parasite (Must to know type)
Spirochaetales
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Leptospira species, which cause leptospirosis
Borrelia species, which cause relapsing fever and Lyme
Brachyspira species, which cause intestinal infections; and
Treponema species, which cause the diseases treponematoses
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The Treponema species include
T. pallidum subspecies pallidum, which causes venereal syphilis;
T. pallidum subspecies pertenue, which causes yaws;
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T. pallidum subspecies endemicum, which causes endemic syphilis; andT. carateum, which causes pinta
T. pallidum cannot be cultured in vitro and only known natural host is the human
Jarisch- Herxheimer reaction is always a possibility in all spirochetes
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Nearly all cases of syphilis are acquired by sexual contact with infectious lesions
(i.e., the chancre, mucous patch, skin rash, or condylomata lata)
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Others: personal contact, infection in utero, blood transfusion, and organ
transplantation
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IP ? average 21 daysRapidly penetrates intact mucous membranes or abrasions in skin and, within a few
hours, enters the lymphatics and blood to produce systemic infection
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Identification and examination of sexual contacts are most important for patientswith syphilis of <1 year's duration
The clinical appearance depends on the number of treponemes inoculated and on
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the immunologic status of the patient
Primary Syphilis - primary chancre
Secondary Syphilis - parenchymal, constitutional, and mucocutaneous manifestations
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Tertiary Syphilis ? gumma (a usually benign granulomatous lesion); cardiovascularsyphilis (usually ascending aorta and resulting in aneurysm); and neurosyphilis
(asymptomatic, meningeal, meningovascular, and parenchymatous (tabes dorsalis
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and paresis) syphilis)
Latent Syphilis - Positive serologic tests for syphilis, together with a normal CSF
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examination and the absence of clinical manifestationsCongenital Syphilis - fetal damage generally does not occur until after the fourth month
of gestation; most common clinical problem is the healthy-appearing baby born to a
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mother with a positive serologic test Routine serologic testing in early
Screening or diagnosis (RPR or VDRL)
Quantitative measurement of antibody to assess clinical syphilis activity or to monitor
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response to therapy (RPR or VDRL)
Confirmation of a syphilis diagnosis in a patient with a reactive RPR or VDRL test (FTA-
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ABS, TPPA, EIA/CIA)Persons with newly diagnosed HIV infection should be tested for syphilis; conversely, all
patients with newly diagnosed syphilis should be tested for HIV infection
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An infant should be treated at birth
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if the treatment status of the seropositive mother is unknown;
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if the mother has received inadequate or nonpenicillin therapy;?
if the mother received penicillin therapy in the third trimester; or
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?
if the infant may be difficult to follow
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Leptospirosis
Recent outbreaks on virtual y al continents (mainly in the tropics and subtropics)
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By pathogenic species, L. interrogans designated as L. interrogans sensu latoUnderappreciated problem with a broad spectrum of clinical manifestations,
varying from asymptomatic infection to fulminant, fatal disease
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Rodents, especially rats, are the most important reservoir
Transmission may follow direct contact with urine, blood, or tissue from an infected
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animal or, more commonly, exposure to environmental contamination through cuts,abraded skin, or mucous membranes
IP - 1 to 30 days
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Leptospiremic phase ? evade complement-mediated killing by binding factor HImmune phase - bacteria persist in various organs
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Mild Leptospirosis - usually presents as a flu-like il ness, with fever, conjunctivalsuffusion, pharyngeal injection, muscle tenderness, lymphadenopathy, rash,
meningismus, hepatomegaly, and splenomegaly
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Severe Leptospirosis - Weil's syndrome, encompasses the triad of hemorrhage,
jaundice, and acute kidney injury; Other syndromes include (necrotizing)
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pancreatitis, cholecystitis, rhabdomyolysis, and neurologic manifestations includingaseptic meningitis
Clinical diagnosis should be based on an appropriate exposure history combined
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with any of the protean manifestations
Definitive diagnosis is based on isolation of the organism, polymerase chain reaction
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(PCR), or seroconversion or a rise in antibody titer (by MAT/ELISA)Nonoliguric hypokalemic renal insuf iciency is characteristic of early leptospirosis
Thank you
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