37: Infectious Disease - Smith Flashcards
clinical s/s of infection
- Fever, Chills, Night Sweats
- Lump
- Red streaks
- Duration of symptoms
- Prior therapy
- Medical history
- Allergies
- Social history
- Pets
PE infection
- Overall patient appearance (appear sick, lethargic, diaphoretic, disheveled)
- Temperature
- Cellulitis
- Lymphadenopathy
- Lymphangitis
- Open lesions
- Drainage/ Fluctuance/ Crepitus
define cellulitis and its most common pathogen
Inflammation of the skin and connective tissues - Streptococcus (usually a gram + organism)
five cardinal signs of celsus ***
Rubor (Redness) Tumor (Edema) Dolor (Pain) Calor (Heat) Functio Lasea (Loss of function)
“red, hot, painful, swollen “
Red streaking caused by inflammation of the lymphatic channels draining the of infection
lymphangitis
what do you have to record about open lesions? ***
depth
size
shape
tissue or debris within lesion
how do you describe drainage?
How much
Type
Color
Odor
Fluid beneath surface of skin which may be an abscess or hematoma
fluctuance (like palpating a water balloon)
yellow/gold drainage
staphAUREUS
white drainage
staphEPI
brown dishwater drainage
anaerobic bacteria life-threatening severe
crepitus w/ signs and symptoms of infection =
surgical emergency
- feeling of crepitus is created by subcutaneous air or gas
what is a normal WBC
under 11,000
left shift WBC
fighting off infection and putting immature into circulation
do platelets increase or decrease with infection
increase
describe ESR erythrocyte sedimentation rate
- Measures the distance (mm) that a column of erythrocytes falls in one hour
- Erythrocytes fall in a rouleaux formation in the presence of acute phase reactants
- INCREASED in infection, malignancy or inflammation
- Used to monitor therapy
- normal sed rate is 15 or less male, 20 or less female
more sensitive but not specific in comparison to sed rate
CRP c-reative prtn
- acute phase reactant
infection does what to blood glucose
increase
where should a wound culture be taken from first?
- Wound culture taken from the deepest part of the wound (anaerobic culture first)
- Culture should be taken prior to antibiotic therapy
3 types of blood cultures
Transient Bacteremia - Happens on daily basis
Intermittent
Bacteremia - Septic foci seeding the blood
Continuous Bacteremia - Bacterial endocarditis
*** hospitalization guidelines
- High fever > 101º F
- High WBC > 13,000
- Systemic infection or sepsis
- Failure to respond to outpatient therapy
- Organism only susceptible to parenteral agent
- Debridement requiring general anesthesia
- Systemic disease
infected ingrown nail
paronychia
- nail spicule must come out
- five cardinal signs of infection along nail with purulent drainage
interdigital maceration and pruritus, with possible cellulitis
gram negative interspace infection
wood’s lamp (UV) reveals…
green fluorescence = gram neg pseudomonas
coral red = gram pos = Erythrasma (Corynebacterium)
