campylobacter jejuni

2/10/2008 5:58:41 PM

This was indeed campy - a small motile, nonspore-forming, comma-shaped, gram-negative bacilli.

Treatment? How about if he was immunocompromised or if it was severe disease?

Quote :

"tapeworm?"

They are usually asymptomatic.

[Edited on February 10, 2008 at 6:05 PM. Reason : ]

2/10/2008 6:02:47 PM

in an otherwise healthy person

treatment is hydration he will get over it on his own

cipro or a zpak if its severe

if he is immunosuppressed, IV cipro


hope he doesnt get Guillain-Barre syndrome

its teh suck

[Edited on February 10, 2008 at 6:09 PM. Reason : .]

2/10/2008 6:07:49 PM

Actually there is a lot of fluoroquinolone-resistant campy, so erythromycin is the drug of choice

Here's another:

An 18-day-old female infant is brought to the pediatric emergency room by her panicked mother. The child has developed a fever and has been crying nonstop for the past 4 hours. She has fed only once today and vomited all of the ingested formula. The baby was born by vaginal delivery after an uncomplicated, full-term pregnancy to a healthy 22-year-old G1P1 woman. The mother has no history of any infectious diseases and tested negative for group B Strep prior to delivery. The immediate postpartum course was routine. The baby had a routine check-up in the pediatrician's office 3 days ago, and no problems were identified. On exam, the child has a temperature of 38.3°C (100.9°F), pulse of 140 beats per minute, and respiratory rate of 32 breaths per minute. She is not crying at the moment. She has poor muscle tone, will not regard your face or respond to loud stimuli. Her anterior fontanelle is bulging. Her mucous membranes are moist, and her skin is without rash. Her heart is tachycardic but regular, and her lungs are clear. Her white blood count is elevated, a urinalysis is normal, and a chest x-ray is clear. A Gram stain of her cerebrospinal fluid (CSF) from a lumbar puncture shows gram-positive coccobacilli.

Most likely organism?

[Edited on February 10, 2008 at 6:19 PM. Reason : ]

2/10/2008 6:16:36 PM

so she has high ICP

along with the meningitis


im totally guessing here, but apparently this is becoming a more common infant infection

listeria monocytogenes

2/10/2008 6:32:53 PM

damn, you're good

treatment?

2/10/2008 6:38:44 PM

well that depends on the sensitivity data


i know what we use for listeriosis in my neuro icu

which is trimethoprim sulfa in d5, because it crosses the blood/brain barrier better


but from what i was able to find out via good ole google, they are using ampicillin

2/10/2008 6:45:32 PM

^ interesting, yeah all i knew was amp. but they say mainly just dont use cephalosporins, right?

2/10/2008 6:58:04 PM

lawl, so far, brainysmurf has won this thread

Quote :

"hope he doesnt get Guillain-Barre syndrome its teh suck"

indeed

2/10/2008 7:02:14 PM

yeah


took care of a guy with listeria ventriculitis (he had an EVD)


so he got bactrim in d5 500ml worth of d5 twice a day
he was already in a pentobarb induced coma because of his high ICP


we would have to give him his bactrim plus mannitol and sometimes 23% hypertonic saline on top of draining CSF to control his icp while he was getting his antibiotics.


bactrim is a pain in the ass to give, but ID at duke uses it, AND it did clear up the infection.


but yeah, from what i read cephalosporins = bad

2/10/2008 7:05:19 PM