14 topics with concise breakdowns: definitions, key facts, and class questions.
This section brings together severe and highly relevant infectious pathologies, ranging from localized skin lesions to generalized life-threatening conditions. Here, we thoroughly analyze the mechanisms of development, symptoms, and modern approaches to the management of patients with erysipelas, rabies, and sepsis.
The material is divided into logical blocks. You will study the clinical forms and treatment of erysipelas, as well as strict algorithms for providing anti-rabies care. The largest block is dedicated to sepsis: from current classification and pathogenesis to criteria for early diagnosis, selection of antibiotics, and management of septic shock.
In practical classes and exams, questions most frequently cover indications for anti-rabies vaccination, differential diagnosis of forms of erysipelas, and modern sepsis assessment scales (SOFA). Pay special attention to the mechanisms of septic shock development and the rules of empirical antibiotic therapy—these are classic "trap" questions.
Which microorganisms are most commonly associated with the development of toxic shock?
Gram-positive bacteria play the primary role, such as staphylococci (especially Staphylococcus aureus) and streptococci, which secrete specific exotoxins.
Why does erysipelas frequently recur?
Relapses are associated with the fact that Streptococcus transitions into L-forms and persists intracellularly within macrophages for a long time. When immunity weakens, the microbes regain pathogenicity.
Does a red spot always appear on the first day of the disease?
No, in more than half of the cases (especially with lower limb involvement), acute intoxication syndrome with high fever and chills precedes local manifestations by several hours or even 1–2 days.
Is it possible to discharge a patient if they still have leg edema after erysipelas?
Yes, you can. Common residual phenomena, such as moderate edema or persistent lymphostasis, are not a contraindication to discharge, provided that the acute phase and intoxication have been resolved.
Is it necessary to prescribe antibiotics for viral tonsillitis?
No, in a viral process, antibacterial therapy is not indicated, as the disease resolves spontaneously within one to two weeks.
Why do profuse salivation and aquaphobia occur in rabies?
The virus descends centrifugally from the brain into the salivary glands. Aquaphobia (the inability to swallow due to painful spasm) and sialorrhea ensure the accumulation of a huge amount of infected saliva in the mouth, which is evolutionarily advantageous for the virus to transmit via a bite.
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