Common Infections Flashcards
Infections that can result in a sepsis response?
UTI
respiratory tract infections
Lemièrre’s syndrome - URTI
pneumonia - LRTI
Symptoms of UTI?
Symptoms may be specific.
(painful micturation (dysuria), urinary frequency, urinary urgency, haematuria,
lower abdominal/loin pain).
or may be vague systemic symptoms.
(confusion, diarrhoea, vomiting).
- Often in older pt
Signs of urosepsis?
- Signs - fever, abdominal tenderness, cloudy urine.
- Simple uncomplicated.
- Complicated (i.e. pyelonephritis or prostatitis).
How do you diagnose UTI?
- Dipstick showing nitrites or leucocytes.
- Diagnosis supported by examination of urine.
- Pus cells help differentiate between asymptomatic bacteriuria and infection.
- Bacterial growth: usually Gram negative e.g. Escherichia coli, Klebsiella,
Proteus; less commonly Enterococcus spp.
Bacteria associated with a UTI?
usually Gram negative
e.g. Escherichia coli, Klebsiella,
Proteus;
less commonly Enterococcus spp.
Upper respiratory tract infections include what anatomical features?
nasal cavity
pharynx
larynx
Lower respiratory tract infections include what anatomical features?
trachea
primary bronchi
lungs
aetiology of URTI?
VIRAL - most common
(rhinovirus, enterovirus, adenovirus)
- EBV or bacterial - Streptococci (Group A, C, G) - not as common
typical causes of URTI?
Common cold
laryngitis
pharyngitis
tonsillitis
oral manifestation of URTI?
pus in oral cavity
tonsillar swelling - airway obstruction
peritonsillar abscess
usually polymicrobial eitology
who usually gets Lemièrre’s syndrome?
fit healthy young pts
symtpms of Lemièrre’s syndrome?
sore throat/tonsillitis leading to sepsis
what bacteria causes Lemièrre’s syndrome?
fusobacterium necrophorum
pathophysiology of Lemièrre’s syndrome?
peritonsillar abscess formation, bacteraemia & thrombus
formation in neck veins (internal jugular) –> septic emboli to lungs/joints.
what is fusobacterium necrophorum associated with?
associated with periodontal disease
oral anaerobic bacteria
what can occur with fusobacterium necrophorum?
bacteraemia (spread to blood stream)
thrombus formation in the neck
send off septic emboli to lungs and joints
an example of a metastatic infection
can Lemièrre’s syndrome be fatal?
YES, can be fatal, so requires a high degree of suspicion and urgent imaging.
* Rx penicillin plus clindamycin/metronidazole.
tx of Lemièrre’s syndrome?
Rx penicillin plus clindamycin/metronidazole.
examples of LRTI?
Pneumonia
what is pneumonia?
- Infection of the parenchyma of the lung.
- Can affect patients of all ages
who is predisposed to pneumonia?
alcoholics, post influenza.
symptoms of pneumonia?
productive cough (green purulent sputum), pleuritic chest pain,
shortness of breath.
bacteria casing pneumonia?
s. pneumonia, gram positive
skin and soft tissue infections causing sepsis?
Are complicated SSTI common?
no, rare but serious
example of complicated SSTI?
necrotising fasciitis
necrotising fasciitis symptoms?
– life-threatening, hypotension, pain ++++, may be
minimal cellulitis.
- Myositis/deep abscess – swinging fevers, pain.
usually septic
call consultant asap
tx for necrotising fasciitis?
broad spectrum abx
- clindamycin, penicillin, benzylpenicillin.
surgical debridement
most common pathogens for SSTI?
Most common pathogens:
o Staphylococcus aureus (consider MRSA in patients previously colonised/ lots of hospital
exposure) - wound infections
o Beta-haemolytic streptococci (esp. Group A) - nec
remember group A strep for nec
usually not polymicrobial
Biggest bacterial culprit for wound infections?
Staph. aureus
what to consider if pot has staphylococcus aureus infection (SSTI)?
consider MRSA in patients previously colonised/ lots of hospital exposure
