ID Consults Roster #7

In this month, I saw about 60 new consults. SIXTY! I’m rivaling my first month of ID wards.

1. BIODEFENSE
   • none
2. BONE/JOINT
   • Prosthetic knee infection, not otherwise specified
   • Presumed methicillin resistant Staphylococcus aureus prosthetic hip infection
   • Methicillin resistant Staphylococcus aureus prosthetic knee infection
   • Vancomycin resistant Enterococcus prosthetic knee infection
   • Methicillin sensitive Staphylococcus aureus C4 – C6 osteomyelitis
   • Methicillin sensitive Staphylococcus aureus hip septic arthritis in HIV patient
   • C4 – C6 osteomyelitis of unclear etiology in normal host
   • Coagulase negative Staphylococcus prosthetic hip infection
3. CARDIAC
   • Diptheroids as contaminant in pericardial fluid
   • Presumed methicillin sensitive Staphylococcus aureus endocarditis in HIV patient
   • Methicillin resistant Staphylococcus uureus tricuspid valve endocarditis and pacer infection
4. DERMATOLOGIC
   • Cellulitis, not otherwise specified
   • Methicillin sensitive Staphylococcus aureus soft tissue infection associated with epidural catheter
   • Escherichia coli and methicillin resistant Staphylococcus aureus diabetic foot ulcer
   • Diabetic heel ulcer, not otherwise specified
   • Varicella zoster in immunocompetent patient
   • Frostbite/Gangrene of lower extremities, multiple pathogens
5. EYES/ORBITS
   • none
6. FEVER
   • Fever of unknown etiology in transitional cell bladder cancer patient
   • Neutropenic fevers of unclear etiology
7. GASTROINTESTINAL
   • Peritoneal catheter associated peritonitis in ESRD patient, not otherwise specified
   • Clostridium difficile colitis (2)
   • Pancreatitis
8. GENERALIZED INFECTION
   • Drug induced rash and headache
   • Persistent leukocytosis (years) of unexplained etiology
9. GENITOURINARY
   • BK polyomavirus associated hemorrhagic cystitis in bone marrow transplant recipient
   • Catheter associated urinary tract infection, not otherwise specified
   • Citrobacter freundii urinary tract infection
   • Escherichia coli urinary tract infection
   • Enterococcus spp. urinary tract infection
10. GYNECOLOGIC
    • Tubo-ovarian abscess, not otherwise specified
11. HEENT
    • none
12. HIV/AIDS
    • Streptococcus pneumoniae community acquired pneumonia
    • Methicillin sensitive Staphylococcus aureus bacteremia/septic arthritis/presumed endocarditis
13. NEUROLOGIC
    • Presumed viral meningitis
    • Presumed bacterial meningtitis, altered anatomy
    • Viral meningitis
    • Varicella zoster meningitis
14. RESPIRATORY
    • Presumed cavitatory pneumonia not otherwise specified (vs. lung cancer)
    • Presumed ventilator associated pneumonia, no pathogens isolated
    • Hospital acquired pneumonia, not otherwise specified
    • Serratia marcesens ventilator associated pneumonia
    • Methicillin sensitive Staphylococcus aureus pneumonia, presumed post-influenza
    • Streptococcus pneumoniae community acquired pneumonia with parapneumonic effusion in newly diagnosed HIV patient
    • Streptococcus pneumoniae, Haemophilus influenzae & Aspergillus spp (not niger/flavus/fumigatus) in BAL fluid in patient with prior non-small cell lung cancer with new nodule
    • Aspiration pneumonia, not otherwise specified, in advanced parkinsonism
15. SEPSIS SYNDROMES
    • High grade methicillin resistant Staphylococcus aureus bacteremia with increasing vancomycin MIC > 2.o
    • Methicillin sensitive Staphylococcus aureus bacteremia (3); typically line associated
    • Streptococcus pneumoniae sepsis
    • Candida albicans fungemia with Eikenella corrodens & coagulase negative Staphylococcus bacteremia
    • Methicillin resistant Staphylococcus aureus bacteremia (2); typically line associated
    • High grade coagulase negative Staphylococcus bacteremia after recent AV graft placement
    • Candida albicans fungemia associated with tunnelled line for dialysis
16. SEXUALLY TRANSMITTED INFECTIONS
    • none
17. SURGICAL INFECTIONS
    • Escherichia coli anstomotic leak after hiatal hernia repair
    • Methicillin sensitive Staphylococcus aureus vascular graft infection
    • Coagulase negative Staphylococcus & Enterobacter cloacae mediastinitis after esophagectomy for esophageal cancer
    • Micrococcus and Candida albicans mediastinitis after esophageal repair after spontaneous rupture
    • Extended spectrum beta-lactamase producing Escherichia coli and Bacteroides fragilis pelvic abscess after ureteral stent repair
    • Coagulase negative Staphylococcus superficial surgical wound infection after placement of AV graft
    • Wound infection soon after vascular graft placement (days – weeks) (2)
18. TRAVEL/TROPICAL
    • none
19. VACCINE ADVERSE REACTIONS
    • none