Case 5 - Necrotizing Fasciitis

Question 1

Formula to calculate Mean arterial pressure (MAP)

Answer 1

Mean arterial pressure (MAP) = [(2 × Diastolic blood pressure) +
(1 × Systolic blood pressure)]/3

Question 2

What is the goal to keep mean arterial pressure (MAP) ?

Answer 2

At least 65 mm Hg to perfuse the vital organs.

Question 3

What is the goal to keep urine output ?

Answer 3

at least 25 to 30 mL/h (also depending on the degree of renal insufficiency).

Question 4

What is SIRS (systemic inflammatory response syndrome?)
What is Sepsis?
What is septic shock?

Answer 4

SIRS:
T: > 38 c
RR > 22
HR > 90
WBC > 12000
PCO2 < 32 mmHg

Sepsis = SIRs + infection

Septic shock = Sepsis + Hypotension (SBP < 90) + Lactate >4 mmol

Question 5

What is Streptococcal toxic shock syndrome?
indicate the originism.

Answer 5

STSS is a rare but serious bacterial infection. STSS can develop very quickly into low blood pressure, multiple organ failure, and even death. Septic shock sually only takes 24-48 hours after symptoms developed.
Group A β-hemolytic streptococcus

Question 6

Other Streptococcus species

Answer 6

Group B streptococcus (Streptococcus agalactiae)
Streptooccus pneumoniae

Question 7

Diseased caused by Group A strep
» 8 diseases

Answer 7

Strep Throat
Scarlet fever
Cellulitis
Streptococcal Toxic Shock Syndrome
Impetigo
Rheumatic Fever
Necrotizing Fasciitis
Post-Streptococcal Glomerulonephritis