Bacterial sepsis following pregnancy GTG Flashcards
What factors increases risk of maternal sepsis?
DM
Obesity
Immunosuprresed
Anaemia
Vaginal discharge
Hx pelvic infection
Invasive procedures
Cervical cerclage
PROM
RPOC
Vaginal trauma/CS/haematoma
GAS in close contact
Black or minority ethic background
What antibiotic covers both typical and atypical pneumonia
Beta-lactam and macrolide (clinda)
Haemoptysis is a feature of which pneumonia>
Pneumococcal
What could severe haemopysis and low WCC indicate?
PVL-associated staphylococcal necrotising pneumonia
Mortality rate 70% in young people
What criteria should be used to assess pharyngitis to assess for GAS?
Centor criteria (fever, tonsillar exudate, no cough, tender anterior cervical lymphadenopathy) 3/4 - give Abx
If GAS suspected what is the best Abx?
Clindamycin
What analgesia should be avoided in sepsis
NSAIDS
If agonising pain out of proportion to clinical signs, what must be considered?
Deep infection and necrotising fasciits/myositits
What contacts should you enquire about when considered GAS?
Contact with streptococcal infections (pharyngitis, impetigo, cellulitis)
If GI symptoms such as diarrhoea or vomiting, what to consider?
C.Diff
Early toxic shock
All cases of PP sepsis should be discussed with whom?
Microbiology or ID physician
When sending stool culture what to consider?
Routine stool culture - salmonella/campylobacter
Need to send specific C.Diff, if recent Abx/particullar offensive
If consider listeria (recent soft cheese/cured meats)
Hx travel (parasites, typhoid, cholera)
If high platatelts, high CRP, swinging pyrexia - what does this suggest
Collection of pus - ?infected haematoma
What is the mortality of untreated C.Diff in mothers?
30%
Whilst results pending can consider PO metronidazole, oral vancomycin
What infections are at risk of infecting the baby?
GAS and PVL producing S aureus
Which infections requires prophylaxis for family/staff
Neisseria Meningitidis
GAS
If superficial skin infection but higher risk of MRSA (such as IV Drug user), what abs?
Oral vancomycin
Severe sepsis without clear source?
IV meropenem, clindamycin and stat gentamicin
What % of women with chlamydua trachomas at time of delivery develop a puerperal infection?
30%
What % of neonates who mothers have active chlamydia trachoma’s at birth develop
i) Ophthalmia neonatroum
ii) Chlamyda pneumonitis
i) 50%
ii) 15%
What disease are tested for in newborn blood spot screening>
Phenylketonuria
Congenital hypothyroidism
Sickle cell disease
Cystic fibrosis
Medium chain acyl CoA dehydrogenase deficiency
