Acute Infections Flashcards
SIRS criteria
core temp >38.5 C or 101.2 F
or < 36C
tachycardia or bradycardia if less than 1 yo
mean RR >2 SDs above normal
leukocytosis, leukopenia or >10% immature Neutros
sepsis
systemic manifestations of infection: SIRs with infection
severe sepsis vs sepsis
severe sepsis has hypotension causing organ dysfunction
septic shock vs severe sepsis
arterial hypotension causing septic shock organ dysfunction DESPITE fluid resuscitation
what causes bacterial meningitis
strep p neumo
H flu
N meningitidis
Salmonella
Initial Tx for bacterial meningitis
cefotaxime or ceftriaxone 50 mg/kg and dexamethasone for H fl ue and S pneumo at 0.15 mg/kg/dose
Tx for HSV meningitis
Acyclovir 15mg/kg/dose
dangerous organism causing encephalopathy in kids
plasmodium falciparum
metabolic derrangements that can cause twitching, dec BP, inc HR, inc RR
hypoglycemia
hyponatremia
hypocalcemia
bacterial meningitis cause in infants
GBS
E coli
enteric gram neg organismts
listeria and enterococcus
ddx for appendicitis
DKA
bowel perforation
organisms likely causing peritonitis
gram neg E coli and klebsiella
gram + pneumococcus, staph, alpha hemolytic strep, enterococcus
anaerobes like bacteroides
what is treatment for gram + peritonitis
clinda at 10mg/kg/dose with amp 50mg/kg/dse or amp and gent
ascaris stronglyloides can cause peritonitis how
perforation
what is VAP
ventilator associated pneumonia
3 types pneumonia
community acquired
aspiration
healthcare associated
Tx community acquired pneumonia in immunocompetent
3rd gen cephalo with macrolid or fluoroquinolone
community acquired pneumonia in immunocompromised treatment
TMP SMX and antifungal
to cover pneumocystis jirveci
treatment of hospital acquired or ventilator associated pneumonia
3rd or 4h generation cephalosporin with a betalactamase or carbopenem
OR
fluorowuinolone with glycoside
Tx gram + pneumonia
linezolid vanco or daptomycin
Tx pseudomonas
carbapenems don't use cipro as single agent. fluoros best for upper airway or pip taz ticarcillin with clavunate
Tx for aspiration pneumonia
clinda
Treatment choices for immunocompromised empiric therapy for high risk febrile eneutropenia
cefepime or ceftazidime 50 mg/kg/dose OR meropenem 20mg/kg/dose OR pip tazo 80-100 mg/kg/dose
may add vanco for gram + and either metro or clinda for anaerobes
if fever persisting in high risk febrile neutropenia after 24 -48 hours of fever persisting
anti fungal and anti virals
most common cause of bacterial skin infections
staph and strep because of exotoxins
what causes type 2 NECrotizing fasciitis
beta hemolytic strep
treatment for staph and strep exotoxins
beta lactam/vanco/dapto
linezolid if resistance
HAART
highly active antiretroviral treatment
what is immune reconstitution inflammatory syndrome
when the immune system returns (most likely during HAART therapy) and the immune system attacks all the pathogens that have been adding up causing a inflammatory surge
how to manage immune reconstitution syndrome
supportive and controlling causative infection
may need to withdraw HAART
anti inflammatory agents
