Approach to the Infected Patient Flashcards
What are the signs of a patient with infection?
- Fever
- Tachycardia
- Rash
- Pus
- Enlarged lymph nodes
What are the symptoms of a patient with infection?
- Headache
- Pain, sore throat, runny nose
- Pale face
- Sweating
- Shivers
What are the risk factors of infection?
- Being immunocompromised
- Having abnormal leukocyte function
- Open wounds
- Age
- Surgery
- Catheters
- Metabolic abnormalities
What are the first line investigations in a patient with infection?
=> Bloods - FBC, ESR, CRP, U&Es, LFTSs, Lactate, Procalcitonin
- FBC should indicated neutropenia
- ESR and CRP should be raised
- Procalcitonin is raised proportional to the severity of the infection
- Lactate levels are high
What are the clinic and labratrory findings in a patient with severe infection?
- Confusion and lightheadedness
- Spread to blood
- High procalcitonin and lactate levels
What microbial investigations can be carried out to identify the causative organism of infection?
- Microscopy
- Blood culture
- Antigen detection
- Nucleic Acid detection
- Antibody detection
How does ELISA work?
- Antigen added to a well and coats the surface
- Solution containing antibodies is then added to the well
- Antibodies specific to the antigens present bind, and the free floating non- specific antibodies are washed away
- Another solution is added that contains an enzyme bound to antibodies specific to the immune complexes present in the wells
- Solution is again washed
- Substrate is added
- If the correct immune complexes had formed based on specific antigen antibody interaction, a colour change indicates a positive result
What is NEWS?
New Early Warning Score
What is bacteremia?
Bacteria has entered the blood circulation
What is septicemia?
Inflammatory response to bacteria in the blood circulation
What is severe sepsis?
Cases of sepsis involving end organ damage due to low perfusion
What is Meningitis?
Acute inflammation of the protective layers of the brain
What is the clinical presentation of Meningitis?
- Acute onset
- Fever and headache
- Non blanching spots on lower legs
- Neck stiffness + photophobia
- Tachycardia
What are the most common causative organisms of Meningitis?
- Streptococcus Pneumoniae
- Haemophilius Influenzae
- Neisseria Meningitidis
What are the investigations in suspected Meningitis?
- Blood and CSF cultures
- CT to check for raised intracranial pressure
=> Lumbar puncture is contraindicated if raised intracranial pressure is suspected
