138.2 📚 國考版

138.2.0.1 必背 — 不可給 antibiotic 的 diarrhea

• EHEC O157:H7 (HUS 風險 ↑)
• Salmonella non-typhoidal (延長 carriage; 除非 severe + immunocompromised)
• Viral diarrhea

138.2.0.2 必背 — 經典關聯

食物	經典病原
再加熱炒飯	B. cereus (emetic)
奶油蛋糕、沙拉、火腿	S. aureus (preformed toxin)
未煮熟牛肉	EHEC O157:H7
未殺菌牛奶	Campylobacter, Listeria, E. coli, Salmonella
未煮熟雞肉/雞蛋	Salmonella, Campylobacter
生牡蠣 / 海鮮	Vibrio (parahaemolyticus, vulnificus), norovirus
熟食店 reheated meat	C. perfringens
山泉水, daycare	Giardia, Cryptosporidium
進口越南春捲	Salmonella

138.2.0.3 必背 — Empirical Tx Drugs

• Travelers (mild): bismuth subsalicylate
• Travelers (mod-severe): Azithromycin 1g single dose
• Shigella: azithro or cipro
• Campylobacter: azithro (cipro resistance high)
• C. diff: vanco PO or fidaxomicin
• Giardia: metronidazole / tinidazole / nitazoxanide

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