ID consult
Infectious disease
Empiric abx to FUO. First-hour choices, MDRO logic, CAP/HAP, CNS, C. diff, fungi, and fever workups.
01
Empiric antimicrobials
Meningitis: vanc + CTX 2 g q12; add ampicillin if ≥50 or immunocompromised; acyclovir if HSV possible. Steroids if pneumococcus.
Amanda Ward5 min6 Qs02
Multidrug-resistant organisms
AmpC (HECK-Yes: Hafnia, E. cloacae complex, C. freundii, K. aerogenes, Yersinia): can derepress. Serious infections: cefepime (MIC ≤2) or carbapenem. Avoid CTX even if ‘S’.
Dan Rubin5 min6 Qs03
Community-acquired pneumonia
Infiltrate + compatible syndrome. CURB-65 0–1 outpatient; PSI more accurate. Severe CAP: 1 major (shock/vent) or 3 minor ATS criteria.
Alberto M. Sobrero5 min6 Qs04
HAP, VAP & aspiration pneumonia
HAP ≥48 h after admission; VAP ≥48 h after intubation. Cover PsA; add MRSA if risk (prior MRSA, IV abx 90 d, high local rates).
Alberto M. Sobrero5 min6 Qs05
Urinary tract infections
Cystitis vs pyelo vs CAUTI vs asymptomatic bacteriuria. Symptoms define infection, not the UA alone.
Nick Peterson5 min6 Qs06
Meningitis & encephalitis
95% of bacterial meningitis have ≥2 of fever, nuchal rigidity, AMS, headache. Do not delay abx for CT/LP if delay is expected.
Amanda Ward5 min6 Qs07
C. difficile infection
CDI = new ≥3 watery stools/day + positive toxin/NAAT interpreted in context (colonization vs disease).
Jenna Zhang5 min6 Qs08
Invasive fungal infections
Risk: neutropenia, transplant, high-dose steroids, biologics, HIV with low CD4, liver failure, TPN, broad abx, central lines.
Nick Peterson5 min6 Qs09
Fever of unknown origin
Classic FUO: T >38.3°C, ≥3 weeks, no diagnosis after reasonable investigation (≥3 hospital days or ≥3 outpatient visits).
Eashwar Somasundaram5 min6 Qs