5. Infections (2) Flashcards
What is amoebiasis?
Amoebic dysentry. Infection by Entamoeba histolytica. Mainly found in tropical areas. Painful stomach cramps Bloody diarrhoea/ mucus containing diarrhoea Vomiting High temperature
Treatment of amoebiasis (amoebic dysentry)
Usually self resolves in 3-7 days. Oral rehydration + paracetamol Avoid loperamide Stay home 48h after diarrhoea resolves If severe, may give metronidazole or tinidazole or meparcine hydrochloride (antiprotozoal)
Which antibiotics are more likely to be associated with adverse reactions related to the selection of resistant organisms? (e.g. fungal infections/ antibioric associated oclitis)
Broad spectrum antibacterials e.g. cephalosporins
Example of a class of broad spectrum antibiotics
Cephalosporins
Notifiable diseases
Anthrax Botulism Brucellosis Cholera Diarrhoea (infectious/ bloody) Diptheria Encephalitis, acute Food poisoning Haemolytic uraemic syndrome Haemorrhagic fever (viral) Legionnaires' disease Leprosy Malaria Measles Meningitis Meningococal septicaemia Mumps Paratyphoid fever Plague Poliomyelitis, acute Rabies Rubella SARS Scarler fever Smallpox Streptococcal disease Tetanus Tuberculosis Typhoid fever Typhus Whooping cough Yellow fever
Treatment of patients identified as being at high risk of severe illness of death due to suspected sepsis
Broad spectrum antibacterial at maximum recommended dose within 1 hour
If source identified treat in line with local guidelines
Assess need for IV fluids, inotropes, vasopressors and oxygen assed
Consider lactate, SBP, risk of death
Treatment of patients with suspected sepsis who are not immediately deemed to be at high risk of severe illness/ eath
Re-assess regularly for need for empirical treatment
Take into consideration all risk factors including lactate concentration and evidence of AKI
What is sepsis?
Sepsis is a syndrome defined as life-threatening organ dysfunction due to a dysregulated host response to infection
What is rheumatic fever?
A very rare complication that can develop after bacterial throat infection. Causes painful joints+ heart problems. If you have had it once it makes it more likely that it could come back.
Prevention of recurrence of rheumatic fever
Phenoxymethylpenicillin or sulfadiazine
What is meningococcal meningitis?
Inflammation of the membranes (meninges) around the brain or spinal cord caused by Neisseria meningitidis bacteria.
Prevention of recurrence of meningococcal meningitis
Ciprofloxacin or rifampicin or unlicensed im ceftriaxone
What is haemophilus influenzae type B (Hib)?
A bacterial infection that can cause meningitis, sepsis, pneumonia, pericarditis, epiglottitis, septic arthritis, cellulitis, osteomyeleitis
Even with treatment, 1 in every 20 children with Hib meningitis will die
Prevention of secondary cases of Hib
Rifampicin or unlicensed im/ iv ceftriaxone
What is diptheria?
Highly contagious bacterial infection that can affect the nose and throat and sometimes the skin.
Usually causes a thick grey-white coating at the back of the the throat, swollen glands in the neck, difficulty breathing and swallowing. Can also cause pus filled blisters on legs, feet and hands, large ulcers surrounded by red, sore looking skin.
What is pertussis?
Bacterial infection of the lungs and breathing tubes. Coughing bouts that last for a few minutes and are worse at night.
Prevention of secondary cases of diptheria
Erythromycin or another macrolide e.g. azithromycin/ clarithromyxcin
Prophylaxis of pertussis
Clarithromycin (or azithromycin/ erythromycin)
Within 3 weeks of onset of cough in the index case give antibacterial prophylaxis to all close contacts if criteria for prophylaxis met.
What are pneumococcal infections?
Caused by the bacterium Streptococcus pneumoniae and can lead to pneumonia, septicaemia and meningitis.
Prophylaxis of pneumococcal infections in asplenia or sickle cell
Phenoxymethylepnicillin
If penicillin allergic, erythromycin
What is sickle cell?
Inherited health condition: produce unusually shaped red blood cells that can cause problems because they do not live as long as usual RBCs and can block vessels
What is asplenia?
Splenectomy. Other organs, such as the liver can take over many of the spleen’s functions. But there is still a small risk that a serious infection may develop quickly. Always stay up to date with vaccinations. Take abx for rest of life. Beware of animal and tick bites. Carry medical ID. Travel advice.
What is tuberculosis?
Infection caused by Mycobacterium tuberculosis complex bacterium. May be active/ latent disease. Symptoms of active disease: weight loss, fever, night sweats, anorexia, may have cough, breathlessness, haemoptysis. Check for risk factors e.g. being born in high prevlance areas.
Animal and human bites, antibactieral prophylais
Co-amoxiclav
or doxycycline+metronidazole if pen allergic
Clean wound thoroughly
Give human tetanus immunoglobulin
Consider rabies prophylaxis if in endemic country
If wound <72h
Give for up to 5 days
