Approach to Acutely Ill Febrile Patient Flashcards
Fever may be absent
Elderly
Compromised host
Cultures in IE
3 sets
Organisms to detect presence of bacteria by buffy coat exam in asplenic patients
> 10(6) organisms/ml
10(4) in intact spleen
Howell-Jolly bodies
Asplenia
Course of management for meningitis
Blood culture > give antibiotics > imaging
Infections requiring rapid surgical intervention before other diagnostics or therapeutic interventions
Necrotizing fasciitis
Clostridial myonecrosis
Empirical treatment for sepsis without a clear focus
Vanco + Genta + Pip-Taz/Cefepime
Empiric DOC for meningococcemia
Penicillin
or
Ceftriaxone
May be used in fulminant meningococcemia
Protein C replacement
Empiric DOC for Erythroderma:TSSS
Group A Strep, Staph aureus
Vanco + Clinda
Debridement should be done
Empiric DOC for necrotizing fasciitis
Group A Strep, mixed aero/anaero
Penicillin + Clinda + Genta
If MRSA, Vanco over Pen
Empiric DOC for Clostridial myonecrosis
C.perfringes
Penicillin + Clinda
Empiric DOC for bacterial meningitis
S.pneumo, N.meningitidis
Ceftri + Vanco
Treatment for Bacterial meningitis in patients >50 years old or with comorbid disease
Ampicillin for Listeria coverage
Improves meningitis outcomes in patients with
pneumococcal meningitis
cloudy CSF
positive CSF Gram’s stain
CSF leukocytes >1000/mcL
Dexamethasone
Empiric DOC with brain abscess, suppurative intracranial infections
(Strep spp, Staph spp, anaerobes, gram-neg)
Vanco + Metro + Ceftri