164.2 📚 國考版

164.2.0.1 必背 — HACEK

• H, A, C, E, K — culture-negative IE 鑑別
• Slow growing, oral flora
• Ceftriaxone 4 wk (native) / 6 wk (prosthetic)

164.2.0.2 必背 — Cat Bite

• Pasteurella multocida — rapid cellulitis < 24 hr
• Amox-clav (覆 Pasteurella, anaerobe, staph, strep)
• 1st-gen ceph / dicloxacillin 沒有 Pasteurella cover

164.2.0.3 必背 — Human Bite

• Eikenella corrodens + oral anaerobes + staph/strep
• Amox-clav (覆 Eikenella + anaerobe)
• 1st-gen 不 cover Eikenella

164.2.0.4 必背 — Dog Bite + 無脾

• Capnocytophaga canimorsus — fulminant sepsis + DIC
• Asplenic / EtOH 高致死 ≤ 30%
• Educate, prophylactic abx if bitten

164.2.0.5 必背 — Cat Scratch

• B. henselae + regional LAP
• Self-limit; azithromycin if severe / atypical
• Atypical: hepatosplenic, neuroretinitis, IE (culture-neg)

164.2.0.6 必背 — Tularemia + Plague (Cat A bioterror)

• Tularemia: rabbit, tick — streptomycin/gent
• Plague: flea/rodent — streptomycin/gent; pneumonic 隔離

164.2.0.7 必背 — Brucellosis

• Unpasteurized dairy, livestock
• Doxy 6 wk + rifampin 6 wk

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