Infectious Diseases

During this rotation, resident is expected to:

  •  learn how to order, and interpret the results of immunologic, serologic and microbiologic testing including:

    • Serologic antigen and antibody testing 

    • Cultures and sensitivities

    • Gram stains, fungal stains, acid-fast stains

    • Antimicrobial drug levels

  • Demonstrate understanding of the major antibiotic classes, their use & common side effects.

Helpful Links:

Central nervous system infection

  • Microbiology of bacterial meningitis

  • Diagnostic work up. When to consider CT head before LP.

  • Understand how to properly interpret the CSF analysis

  • What are the antibiotics used for empiric treatment of bacterial meningitis and why?

  • What are the common causes of aspetic meningitis

  • Definition of encephalitis, what are the common viruses, how to diagnose and treat.

  • Diagnosis and treatment of focal CNS infections ( brain and spinal epidural abscess).

 

Pneumonia:

  • Differentiate  between CAP and HCAP

  • What are the common organisms causing CAP ( including atypical: Legionella and coccidioides)

  • Know the diagnostic work up that should be performed for CAP, HCAP, and VAP

  • Understand the choice for Antibiotic therapy for each.

 

Urinary tract infections:

  • Definition of uncomplicated UTI ( acute cystitis ) – everything else is complicated.

  • Microbiology, diagnosis and antibiotic therapy for uncomplicated vs complicated UTIs.

  • Definition and treatment options for recurrent UTIs.

  • Microbiology and treatment of prostatitis.

  • Indications for treating asymptomatic bacteruria.

  • Diagnosis and treatment of catheter associated urinary tract infections.

  • Differential diagnosis of sterile pyruia ( TB, Legionella, leptospirosis).

Week One

 

Skin and soft tissue infections:

  • Know the microbiology of cellulitis, including community acquired MRSA, common  presentation and treatment.

  • Know the microbiology, common  presentation and treatment of necrotizing fasciitis.

  • Know the microbiology and treatment of diabetic foot infections.

  • Know the clinical presentation, diagnosis and treatment of toxic shock syndrome.

 

Osteomyelitis:

  • Classification and microbiology of Osteomyelitis.

  • What are the diagnostic methods and treatment options for Osteomyelitis.

  • Evaluation and Management of Diabetes–Associated Osteomyelitis

  • Evaluation and Management of Vertebral Osteomyelitis

 

Infectious arthritis:

  • Know how to interpret synovial fluid analysis

  • Know your different etiologies of infectious arthritis including gram positive, non gonococcal gram negative and disseminated gonococcal, lyme and viral arthritis. Understand the diagnostic and therapeutic measures.

  • Diagnosis and pharmacologic and surgical management of prosthetic joint infections.

 

Infectious Diarrhea and C- diff colitis:

  • What organisms causes diarrhea with and without fever

  • What organisms causes pseudo appendicitis ( yersinia, Capmylobacter and RMSF).

  • When should you send for stool culture and O&P.

  • Recognize the clinical spectrum of C-diff and diagnosis tests

How to treat initial, first and subsequent recurrences of C-diff infections.

Week Two

 

Week Three

Blood stream infections:

  • When must you remove central venous line in documented blood stream infections.

  • What is the significance of Staph aureus isolated in blood culture.

  • When to get an Echocardiogram.

  • What is the significance and how to treat of Gram negative bacteremia including ESBL.

  • What is the significance of candida isolated in blood stream and what are the risk factors of developing candidemia in ICU and non-ICU patients.

 

Infective endocarditits:

  • Know the microbiology of native and prosthetic valve endocarditis.

  • How to diagnose and treat endocarditis.

  • What are the HACEK organisms and how are they isolated.

  • What are the indications for surgical valve replacement.

  • What are the indications for prophylactic antibiotics.

 

Neutropenic fever:

  • What is the definition of chemotherapy induced neutropenic fever.

  • Understand the gram negative bacterial translocation mechanism of acquiring the infection.

  • What are your antibiotic coverage options.

  • What are the indications to start Vanc.

  • When to consider antifungal.

 
 

Sexually transmitted diseases:

  • What is the differential diagnosis of sexually transmitted genital ulcers?

  • Recognize the different phases of syphilis, and definition of latent infection.

  • How to diagnose syphilis, difference between specific and non specific antibody testing, and in which phase each are expected to be positive.

  • What is the treatment of primary, secondary, latent and neurosyphilis.

  • When to treat genital syphilis and when to give prophylactic therapy.

  • Know the common etiology, diagnosis and treatment of urethritis, cervcitis and PID.

 

HIV:

  • Understand the serologic testing for HIV, and who should be screened.

  • Recognize the clinical presentation and method of diagnosis for acute retroviral syndrome. 

  • What are the indications for initiation HAART. And what are the indications for immediate cessation of HAART.

  • What are the indications for prophylaxis, what antibiotics and at what CD4 level.

  • Recognize the clinical presentation, diagnostic methods and treatment for PJP, MAC, Toxoplasmosis and cryptococcal meningitis.

 

Tuberculosis:

  • Criteria for diagnosing latent TB in various risk groups.

  • How to treat latent TB.

  • Who should be placed in respiratory isolation and Criteria for diagnosis of active TB

  • What is Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis.

Week Four