GI sepsis Flashcards
What is the presentation of ascending cholangitis?
Fever
RUQ pain
Jaundince
An infection in the CBD usually resulting from a stone
How is enterococcus treated?
Amoxicillin
Vancomycin if penicillin allergic
What is sepsis?
A life-threatning organ dysfunction caused by a dysregulated host response to infection
What is septic shock?
A subset of sepsis with circulatory and cellular/ metabolic dysfunction associated with a higher risk of mortality
What score of NEWS indicates sepsis?
NEWS more than 5
How is an infection diagnosed?
History
Examination
Investiagations: microbiology - blood, stool, urine, wound, tissue cultures
What can cause an unusual host response to an infection?
Age Immunosuppression Co-morbitidity Drugs Genetics
What can cause an unusual microbe response?
Virulence expression latency - intracellular predilection for certain sites
Where are hard sites of infection to treat?
Deep seated or vague symptoms (CV, bone joint, liver) occult
What is sepsis 6?
Blood cultures + septic screen, U&Es Urine output Fluid rescucitation Antibiotics IV Lactate measurement Oxygen
What infections are likely to present in the RUQ?
Cholecystitis Pylonephritis Ureteric colic Hepatitis Pneumonia
What infections are likely to present in the LUQ?
Gastric ulcer
Pyelonephritis
Uteric colic
Pneumonia
What infections are likely to present in the RLQ?
Appenditicitis Uteric colic Inguinal hernia IBD UTI Gynaecological Testicular torsion
What infections are likely to present in the LLQ?
Divericulitis Uteric colic Inguinal hernia IBD UTI Gynaecological Testicular torsion
Why can abscesses not be treated with antibiotics?
They have no blood supply and therefore antibiotics will not penetrate them, need to be drained by a surgeon
