Sandbox/table
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The following table contains the main risk factors for CDI:[1][2][3][2][2]
Alterations in the coagulation system |
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Consumption of clotting factors |
Increased concentrations of fibrin degradation products |
Disseminated intravascular coagulation |
table
Disease | Agent | Typical Season | Typical Age | Prodrome | Fever | Duration of the rash (days) | Rash | Other Signs & Symptoms |
---|---|---|---|---|---|---|---|---|
Measles | Paramyxovirus Measles virus |
Winter - Spring | 1 to 20 years | 2-4 days of cough, conjuctivitis, and coryza | High | 5 - 6 | Erythematous, irregular size, maculopapular; starts on temples & behind ears; progresses down from face; fades to brownish | Koplik’s spots: C blue-white papules (salt grains) on bright red mucosa opposite premolar teeth |
Kawasaki disease | Unknown | Winter - Spring | < 5 years | 3 days of abrupt fever | High; fever of 5 days is a diagnostic criteria | 5 - 7 | Erythematous, morbilliform, maculopapular or scarlatiniform, central distribution; erythematous, indurated palms and soles | Acute: dry, fissured and injected lips, strawberry tongue; irritability; cervical lymphadenopathy; conjunctival injection; peripheral edema Subacute: finger-tip desquamation; Complications: arthritis, carditis |
Roseola Infantum (exanthem subitum) | Human herpes virus type 6 | Any season | 6 months to 2 years | None | High | 1-2; it follows defervescence | Discrete erythematous macules, rarely involves face, begins as fever ends | Lymphadenopathy, irritability |
Rubella | Togavirus | Spring | 7 months to 29 years | 0 - 4 days; mild malaise, fever; absent in children | Low grade | 1 - 3 | Discrete, rose-pink, diffuse, maculopapular; progresses downward from face, may change quickly | Arthralgia (usually in adults), tender posterior cervical and suboccipital lymphadenopathy, malaise, petechiae on soft palate |
Scarlet Fever | ß-hemolytic streptococci | Winter | > 2 years | 0 - 6 day, marked | Low to high | 2 - 7 | Scarlet "sunburn" with punctate papules "sandpaper", circumoral pallor, increased intensity in skin folds, blanches stars face/head, upper trunk and progresses downward | Sore throat, exudative tonsillitis, vomiting, abdominal pain, lmphadenopathy, white then red strawberry tongue |
Erythema Infectiosum 9Fifth Disease) | Human parvovirus type B19 | Spring | 5 - 10 years | None, usually in children, may occur in adults | None to low-grade | 2 - 4 | Starts as “slapped cheek”, maculopapular; progresses to reticular (lacy) pattern; can recur with environmental changes such as sunlight exposure | Arthralgia/arthritis in adults, adenopathy |
Enterovirus | Echovirus Coxsackie virus |
Summer - Fall | Mainly childhood | 0 - 1 day fever and myalias | Low to high | 1 - 5 | Fine, pink, always affects face; variant is Boston exanthem (large ~ 1 cm, discrete maculopapules) | Sore throat, headache, malaise, no lymphadenopathy, gastroenteritis |
Dengue Fever | Flavivirus Dengue virus types 1 - 4 |
None | High | 1 - 5 | Generalized maculopapular rash after defervescence; spares palms and soles | Headache, myalgia, abdominal pain, pharyngitis, vomiting | ||
Drug induced rash | Many | Any | Any | Possible due to underlying illness | Possible | Varies | Typically diffuse but may be concentrated in diaper area, typically no progression, erythema multiform rash can progress over a few days | Possibly due to underlying illness or complications |
Infectious Mononucleosis | Epstein-Barr Virus | None | 10 - 30 years | 2 - 5 days of malaise and fatigue | Low to high | 2 - 7 | Trunk and proximal extremities. Rash common if Ampicillin given | Pharyngitis, lymphadenopathy, splenomegaly, malaise |
Pharyngoconjunctival Fever | Adenovirus types 2, 3, 4, 7, 7a | Winter - Spring | < 5 years | Low to high | 3 - 5 | Starts on face and spreads down to trunk and extremities | Sore throat, conjunctivitis, headache, anorexia |
table
Diagnostic test | North America | South America | Middle East | Far East |
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ELISA (serology) detects:
|
† There is a reported prevalence of 15% in the Northeast of the US.
table
Disease | Agent | Typical Season | Typical Age | Prodrome | Fever | Duration of the rash (days) | Rash | Other Signs & Symptoms |
---|---|---|---|---|---|---|---|---|
Measles | Paramyxovirus Measles virus |
Winter - Spring | 1 to 20 years | 2-4 days of cough, conjuctivitis, and coryza | High | 5 - 6 | Erythematous, irregular size, maculopapular; starts on temples & behind ears; progresses down from face; fades to brownish | Koplik’s spots: C blue-white papules (salt grains) on bright red mucosa opposite premolar teeth |
Kawasaki disease | Unknown | Winter - Spring | < 5 years | 3 days of abrupt fever | High; fever of 5 days is a diagnostic criteria | 5 - 7 | Erythematous, morbilliform, maculopapular or scarlatiniform, central distribution; erythematous, indurated palms and soles | Acute: dry, fissured and injected lips, strawberry tongue; irritability; cervical lymphadenopathy; conjunctival injection; peripheral edema Subacute: finger-tip desquamation; Complications: arthritis, carditis |
Roseola Infantum (exanthem subitum) | Human herpes virus type 6 | Any season | 6 months to 2 years | None | High | 1-2; it follows defervescence | Discrete erythematous macules, rarely involves face, begins as fever ends | Lymphadenopathy, irritability |
Rubella | Togavirus | Spring | 7 months to 29 years | 0 - 4 days; mild malaise, fever; absent in children | Low grade | 1 - 3 | Discrete, rose-pink, diffuse, maculopapular; progresses downward from face, may change quickly | Arthralgia (usually in adults), tender posterior cervical and suboccipital lymphadenopathy, malaise, petechiae on soft palate |
Scarlet Fever | ß-hemolytic streptococci | Winter | > 2 years | 0 - 6 day, marked | Low to high | 2 - 7 | Scarlet "sunburn" with punctate papules "sandpaper", circumoral pallor, increased intensity in skin folds, blanches stars face/head, upper trunk and progresses downward | Sore throat, exudative tonsillitis, vomiting, abdominal pain, lmphadenopathy, white then red strawberry tongue |
Erythema Infectiosum 9Fifth Disease) | Human parvovirus type B19 | Spring | 5 - 10 years | None, usually in children, may occur in adults | None to low-grade | 2 - 4 | Starts as “slapped cheek”, maculopapular; progresses to reticular (lacy) pattern; can recur with environmental changes such as sunlight exposure | Arthralgia/arthritis in adults, adenopathy |
Enterovirus | Echovirus Coxsackie virus |
Summer - Fall | Mainly childhood | 0 - 1 day fever and myalias | Low to high | 1 - 5 | Fine, pink, always affects face; variant is Boston exanthem (large ~ 1 cm, discrete maculopapules) | Sore throat, headache, malaise, no lymphadenopathy, gastroenteritis |
Dengue Fever | Flavivirus Dengue virus types 1 - 4 |
None | High | 1 - 5 | Generalized maculopapular rash after defervescence; spares palms and soles | Headache, myalgia, abdominal pain, pharyngitis, vomiting | ||
Drug induced rash | Many | Any | Any | Possible due to underlying illness | Possible | Varies | Typically diffuse but may be concentrated in diaper area, typically no progression, erythema multiform rash can progress over a few days | Possibly due to underlying illness or complications |
Infectious Mononucleosis | Epstein-Barr Virus | None | 10 - 30 years | 2 - 5 days of malaise and fatigue | Low to high | 2 - 7 | Trunk and proximal extremities. Rash common if Ampicillin given | Pharyngitis, lymphadenopathy, splenomegaly, malaise |
Pharyngoconjunctival Fever | Adenovirus types 2, 3, 4, 7, 7a | Winter - Spring | < 5 years | Low to high | 3 - 5 | Starts on face and spreads down to trunk and extremities | Sore throat, conjunctivitis, headache, anorexia |
- ↑ Hensgens MP, Goorhuis A, Dekkers OM, Kuijper EJ (2012). "Time interval of increased risk for Clostridium difficile infection after exposure to antibiotics". J Antimicrob Chemother. 67 (3): 742–8. doi:10.1093/jac/dkr508. PMID 22146873.
- ↑ 2.0 2.1 2.2 Knight, Christopher L.; Surawicz, Christina M. (2013). "Clostridium difficile Infection". Medical Clinics of North America. 97 (4): 523–536. doi:10.1016/j.mcna.2013.02.003. ISSN 0025-7125.
- ↑ Planche, Tim (2013). "Clostridium difficile". Medicine. 41 (11): 654–657. doi:10.1016/j.mpmed.2013.08.003. ISSN 1357-3039.