Mycobacterium lightning lecture

• TB
  • 1/3 of world infected with TB
  • 2^nd leading cause of death
  • Symptoms
    • Cough
    • Hemoptysis
    • Night sweats
  • Management
    • Respiratory isolation
    • Contact health department
    • Isoniazid/rifampin/pyrazinamide/ethambutol
• Tuberculous Lymphadentis (scrofula)
  • Enlarging painless neck mass in child
  • Treated similarly as TB
• M. Leprae
  • Dry hypopigmented macules
  • Hair loss
• MAC
  • CD4 < 75
  • Fever/dyspnea/night sweats/cough
  • Azithromycin/erythromycin/ethambutol
• M. Marinum
  • Ascending lymphangitis in aquarium workers
  • Azithromycin or clarithromycin with ethambultol.
  • Treat for 25 weeks.

Rabies lightning lecture

• Acute progressive encephalitis
• Bats are #1 vector in the US.
• Management
  • Treatment is palliative in symptomatic patients
  • Postexposure prophylaxis is recommended if bite cannot be ruled out
    • Watch animal for 10 days if available
    • High risk animals – raccoons, skunks, foxes, bats
    • One dose of HRIG and 4 doses of rabies vaccine over a 14 day period. 5 of 28 days if immunocompromised
• Tetanus
  • Neuro illness from toxin created by clostridium tetani
  • Generalized – diffuse muscle spasms and rigidity
  • Cephalic – cranial nerve palseys
  • Neonatal- passed from unvaccinated mothers

Public Health Updates

• Restaurant inspections, STD tracking, vaccination tracking, septic systems
• Important to find niche outside of EM in your career, Public health could be a good option
• Covid
  • Significantly decreased level of acuity since onset.
  • Downtrending cases and deaths
• Yearly patterns
  • Upticks in November/December and right at start of school year
• Myocarditis
  • Can get from vaccine, but also from covid at an even higher rate