Infection Flashcards
Which immune cells are particularly involved with parasitic infections?
Eosinophils
Which immune cells are usually involved for fungal infection?
Monocytes
Neutrophils
T lymphocytes
Which immune cells are usually raised for bacterial infection?
Neutrophils
B lymphocytes
What kind of lymphocytes are usually raised in viral infection?
T lymphocytes
Which antibiotics may be used for sepsis prophylaxis?
Ciprofloxacin
Which anti-fungals may be used as prophylaxis for sepsis?
Fluconazole
Itraconazole
What is an anti-viral used for prophylaxis of sepsis?
Aciclovir
What are some other ways risk of sepsis can be reduced?
Growth factors e.g. G-CSF Stem cell rescue/transplant Protective environment e.g. laminar flow rooms IV immunoglobulin replacement Vaccination
What are the main causes of neutropenia?
Marrow failure
Immune destruction
When would neutropenia be “high risk”?
<0.2x10^9/l
Duration > 7 days
What are some risk factors for infection?
Disrupted skin/mucosal surfaces Altered flora Antibiotic resistance Lymphopenia Monocytopenia
Which conditions may increase risk of infection by inducing monocytopenia?
Hairy cell leukaemia
Chemotherapy
What are some bacteria which often cause febrile neutropenia?
MSSA MRSA Strep viridans Escherichia coli ESBL
What are some possible sight of infections leading to sepsis?
Resp tract GI Dental Mouth ulcers Skin sores Exit site of venous catheter Perianal
How might neutropenic sepsis present?
Fever with no localising signs Rigors Chest infection Skin sepsis UTI Septic shock
What are the Sepsis 6?
High flow oxygen Blood cultures IV antibiotics within 1 hour IV fluid resuscitation Serum lactate Urine output
What are some blood tests you would run for neutropenic fever?
FBC
Renal and LFTs
Coagulation screen
Hickman line/peripheral cultures
What are some non-blood tests you might run for neutropenic fever?
Throat swab
Sputum if productive
CXR
What are some good broad spectrum antibiotics used for neutropenic sepsis?
IV tazocin and gentamicin
Add vancomycin or teicoplanin if organism is gram positive
Which therapies would be considered for empirical fungal infection?
Caspofungin
Anidulafungin
What are some good therapy options for aspergillus infections?
Voriconazole
Isavuconazole
How would we treat mould infections?
Liposomal amphotericin
How is PJP treated?
High dose co-trimoxazole
How is cytomegalovirus (CMV) treated?
Ganciclovir
Foscarnet
How are HSV1 and VZV treated?
Aciclovir
How are influenza A and B treated?
Oseltamivir
Zanamivir
How are adenoviruses treated?
Cidofovir
How is respiratory syncytial virus (RSV) treated?
Ribavirin
