Approach to a fever Flashcards
Define a hospital acquired infection
This is an infection that starts 48 hours after a hospital admission or a patient that has been hospitalised in the last 3 months
What are the risk factor for a HAI
- Extremes of age
- Immunocompromised
- Prolonged hospital stays
- Invasive prosdures
- If broad spectrum antibiotics are used
- Staff shortages
- Overcrowding
- Lack of standard operating procedures
How can health care associated infections be prevented
- Hand hygiene
- PPE
- Standard precautions
- Environmental cleaning
- Decontamination of equipment
- Transmission based protocol
What are the most likely cause of hospital aquired infections
ESKAPE infections
Enterococcus faecieum
Straphylococcus aureus
Klebsiella pneumoniae
Acinetobacter baumanii
Pseudomonas aeruginosa
Enterobacter species
Define sepsis
Dysregulated host response secondary to a confirmed or suspected infection
WHat is the qSOFA score which above 2 tells you that the patient is likely to have an infection
- Resp rate above 22
- Altered mental state
- Systolic blood pressure of less than 100mmHg
Definition of septic shock
Persistent hypotension and a lactate above 2 mmol/L
What are the infectious differencial for a fever of unknown origin
- TB
- Pyogenic abscess
- Infective endocarditis
What are the neoplastic causes of a fever of unknown origin
- Lymphoma
- Leukaemia
- Renal cell cancer
- Hepatocellular carcinoma
What are the connective tissue disorders that can cause a fever of unknown origin
- Adult stills disease
- SLE
- Rheumatoid athritis
- Giant cell athritis
- Wegners [systemic vasculitis]
What are the infectious causes of a fever of unknown origin in a patient with HIV
- Subclinical TB
- Cryptococcosis
- Histoplasmosis
- CMV
What are the immune mediated causes of a fever of unknown origin in patient with HIV
IRIS
What are the malignancies that are often present in fever of unknown origin in a patient with HIV
- Lymphoma
- Karposi sarcoma
- Multicentric castlemans disease
- Cervical cancer
