common infections and sepsis Flashcards
symptoms of pneumonia or LRTI
fever, sweating, chills
cough, often severe, phlegm
shortness of breath
difficulty breathing
symptoms of intrabdominal infections/peritonitis (10)
abdominal pain
bloating
fever
nausea/vomiting
loss of appetite
diarrhoea
low urine output
thirst
inability to pass stool or gas
fatigue
viral hepatitis
inflammation and damage to liver
can be virus, bacteria (Leptospira spp.) and other microorganisms
congenital infections
intrauterine infection may result in death of fetus or congenital malformations
after primary infection during pregnancy, microorganisms enter blood, establish infection in foetus and invades foetus
CNS infections
usually blood-borne or infectious agents invading via peripheral nerves
brain and spinal cord protected by enclosure in skull and vertebrae
symptoms of meningitis (5)
fever
irritability
neck stiffness
photophobia
often a haemorrhagic skin rash with petechiae
investigations of meningitis
preliminary microscopy results with WCC and gram staining for bacteria available within hour of CSF sample in lab
CSF/Serum ratio useful as bacteria break down glucose so low CSF sugar compared with serum indicates bacterial infection
tetanus
Cl. tetani toxin is carried to CNA in peripheral nerve axons
spore enters wound, and necrotic tissue or presence of foreign body allows anaerobic growth of bacteria where tetanospasmin is produced
3 predictors of sepsis
low systolic blood pressure <100mmhg
increased respiratory rate >22 b/m
altered mental state
any 2 in presence of life-threatening infection are sufficient to diagnose
risk groups for sepsis (5)
under 1 and over 75
impaired immune systems
have had surgery or an invasive procedure in past 6 weeks
breach of skin integrity
indwelling lines or catheters
desired antimicrobial properties of new antimicrobial agents
selectivity for microbial rather than mammalian targets
cidal activity
slow emergence of resistance
narrow spectrum of activity
desired pharmacological activities of new antimicrobial agents
non toxic to host
long plasma half life
good tissue distribution including CSF
low plasma-protein binding
oral and parental dosing forms
no interference with other drugs
5 main signs of inflammation
pain
redness
swelling
heat
loss of function
10 viruses that cause a saw throat and their symtpoms
- rhinoviruses and coronaviruses - mild symptoms in common cold
- adenoviruses (types 3, 4, 7, 14, 21) - pharyngoconjuctival fever
- parainfluenza viruses - more severe than common cold
- influenza viruses, CMV, EBV - symptoms not always present
- Coxsackie A and other enteroviruses - small vesicles (herpangina)
- EBV - occurs in 70%-90% of glandular fever patients
- herpes simplex virus type 1 - can be severe with palatal vesicles or ulcers
5 bacteria that cause saw throat and their symptoms
- streptococcus pyogenes - causes 10-20% cases of acute pharyngitis; sudden onset; mostly in 5-10 yo children
- neisseria gonorrhoeae - often asymptomatic; usually via orogenital contact
3.corynebacterium diphtheriae - pharyngitis often mild but toxic illness can be severe - haemophilus influenzae - epiglottitis
- borrelia vincentii plus fusiform bacilli - vincents angina commonest in adolscents and adults
what are some complications of throat infections
quinsy
scarlet fever
rarely; rheumatic fever, rheumatic heart disease, glomerulonephritis
explain acute otitis media
acute signs of illness or signs of symptoms of middle ear infection
moderate to severe bulging of tympanic membrane
new onset of otorrhea
bacterial pathogens; S. pneumoniae, H, influenzae, and Moraxella catarrhalis
what are the symptoms of pneumonia
productive cough
fever
SoB
difficulty breathing
nausea and vomiting
tachycardia
chest pain
what is the Curb 65 score
used for assessing the severity of pneumonia
score out of 5; confusion, urea>7mmol/rL, RR>30, SBP<90mm Hg or DBP<60mm Hg, age>65
0-1 low risk home treatment
2 admission as close outpatient management
3-5 admission manage as severe
what is bronchitis
infection of main airways
more common in teens and adults
what is bronchiolitis
infection of smaller airways
more common in<2s
how should an MSU sample be taken
into sterile wide mouthed container after careful cleansing of labia or glans with soap (not antiseptic) and water
allow first part of urine stream to be voided as this helps to wash out contaminants in the lower urethra
when is a bacteriuria considered significant
when a properly collected MSU specimen is shown to contain over 105 organisms/mL
infected urine usually contains a single predominant bacterial species
contaminated urine usually has <104 organisms/mL and often contains more than one bacterial species
what is the most commonly diagnosed bacterial cause of hospital acquired infectious diarrhoea and worldwide
clostridium difficile
noroviruses - nearly 20% of all diarrhoea episodes
