Showing 61-80 of 106 for: Essential Evidence Topics > Infectious disease 
- Mumps
Essential Evidence Topics, 12-Nov-2019
Overall Bottom Line: Physical examination typically reveals salivary gland pain and swelling, most often in the parotid gland, that may be unilateral or bilateral. Malaise, fever, and orchitis in males are common. Mumps is best prevented by vaccination;
- Necrotizing fasciitis
Essential Evidence Topics, 17-Apr-2019
Overall Bottom Line: Suspect necrotizing fasciitis (NF) when a patient presents with cellulitis and pain out of proportion to the severity of the lesion, signs of systemic toxicity (hypotension, tachycardia, and hyperthermia), bullae, patches of cutaneou
- Needlestick injury
Essential Evidence Topics, 28-Jun-2019
Bottom-Line: Engineering and environmental interventions reduce the incidence of needlestick injuries. Test the exposed person and source patient for HIV antibody by enzyme immunoassay, hepatitis B surface antigen (HBsAg), and anti-hepatitis C virus (HCV
- Nocardiosis
Essential Evidence Topics, 15-Aug-2019
Overall Bottom Line: Suspect nocardiosis when a patient presents with a brain, soft tissue, or cutaneous abscess and a recent or current radiographic pneumonia, particularly if immunocompromised. Perform Gram stain, acid-fast staining, culture, and anti
- Osteomyelitis
Essential Evidence Topics, 18-Dec-2019
Overall Bottom Line: MRI is more accurate than technetium-99m bone scanning, plain radiography, and white cell studies in the diagnosis of osteomyelitis of the foot and ankle. PET scanning may be helpful for chronic osteomyelitis. A parenteral antibio
- Parvovirus B19 infection
Essential Evidence Topics, 13-Mar-2019
Overall Bottom Line: Suspect erythema infectiosum in children with prodromal fever, coryza, headache, and nausea followed by erythema of the cheeks. Consider confirmatory testing for immunocompetent pregnant patients with serum IgM enzyme immunoassay,
- Pelvic inflammatory disease
Essential Evidence Topics, 3-May-2019
Overall Bottom Line: Treat suspected pelvic inflammatory disease (PID) empirically pending the results of cultures. Treat PID based on Centers for Disease Control and Prevention (CDC) recommendations; most patients can be treated as outpatients. Co
- Peritonitis (spontaneous bacterial)
Essential Evidence Topics, 31-Jul-2019
Overall Bottom Line: Rapid diagnostic paracentesis, cell counts, and initiation of broad spectrum antibiotics are critical to reduce morbidity and mortality. Diagnosis is made by ascitic fluid neutrophil count >250/mm3 . Give empiric antibiotics (i
- Peritonsillar abscess
Essential Evidence Topics, 10-Sep-2019
Overall Bottom Line: Peritonsillar abscess is a suppurative complication of acute tonsillitis usually seen in children through young adults. Typical presentation consists of severe throat pain, trismus, and tender submandibular lymphadenopathy. Diagnosi
- Pertussis (whooping cough)
Essential Evidence Topics, 25-Feb-2019
Overall Bottom Line: A 5-dose series of acellular pertussis vaccine is recommended for children , and the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) booster is recommended once for adolescents at ages 11 to 12 years, and f
- Plague
Essential Evidence Topics, 15-May-2019
Overall Bottom Line: Suspect plague when clinical symptoms, including fever and lymphadenopathy, are present in a person who resides in or has recently traveled to a plague-endemic area. Antibiotics should be initiated without delay in suspected cases o
- Pneumonia (eosinophilic)
Essential Evidence Topics, 8-Apr-2019
Overall Bottom Line: Evaluate for secondary causes of eosinophilic pneumonia (EP) once an initial diagnosis is made. Idiopathic acute eosinophilic pneumonia (IAEP) presents as acute lung injury or acute respiratory distress syndrome (ARDS); peripheral
- Pneumonia (Legionnaires')
Essential Evidence Topics, 13-Sep-2019
Overall Bottom Line: Consider Legionnaires' disease (LD) in patients with community-acquired pneumonia (CAP); urine antigen assay is the recommended diagnostic test. Fluoroquinolones are the drug of choice; macrolides and tetracyclines are alternative
- Pneumonia (ventilator-associated or hospital-acquired)
Essential Evidence Topics, 27-Feb-2020
Overall Bottom Line: Clinical criteria for ventilator-associated pneumonia (VAP) include new lung infiltrate in a ventilated patient and at least two of the following: temperature >38°C, leukopenia or leukocytosis, and purulent secretions. Semi-quant
- Poliomyelitis
Essential Evidence Topics, 18-Dec-2019
Overall Bottom Line: The Centers for Disease Control and Prevention (CDC) recommends that all children should receive inactivated polio vaccine (IPV) at the ages of 2, 4, 6 to 18 months, and 4 to 6 years. Suspect post-polio syndrome in patients with pri
- Primary antibody deficiency
Essential Evidence Topics, 8-Jun-2020
Overall Bottom Line: Consider primary antibody deficiency (PAD) in patients with recurrent, severe, unusual, or persistent infections, especially upper and lower respiratory infections. The diagnostic approach involves measurement of serum IgG, IgA, IgM
- Q fever
Essential Evidence Topics, 29-Apr-2019
Overall Bottom Line: Suspect Q fever in patients with appropriate livestock or unpasteurized milk exposure, fever, and elevated transaminases. Obtain CBC, metabolic profile, polymerase chain reaction (PCR) testing, and acute and convalescent Coxiella bu
- Rabies
Essential Evidence Topics, 19-Jun-2020
Overall Bottom Line: Rabies infects only mammals and is most commonly transmitted by raccoons, skunks, bats, and foxes in the United States. Clinical diagnosis can be made in patients with encephalitis and a history of a bite from a known rabid animal. Su
- Rheumatic fever
Essential Evidence Topics, 3-May-2019
Overall Bottom Line: Treatment of preceding group A streptococcus (GAS) pharyngitis with antibiotics helps prevent 70% to 80% of cases of acute rheumatic fever (ARF). An echocardiography with Doppler should be performed in all patients with confirmed
- Rocky Mountain spotted fever
Essential Evidence Topics, 29-Mar-2017
Overall Bottom Line: Typical symptoms of Rocky Mountain spotted fever (RMSF) include fatigue, myalgias, spiking fever, headache, GI symptoms, and a characteristic rash at 3 to 5 days into the illness. There is a tick bite history in only about 50% of ca
