Infections Flashcards
neutrophils - infections
bacterial and fungal
monocytes - infections
fungal
eosinophils - infections
parasitic
T lymphocytes - infections
fungal and viral
B lymphocytes - infections
bacterial
reducing risk of infection in haematological malignancy
prophylaxis eg antibiotics, anti-virals, antifungals
growth factors
protective environment eg laminar flow rooms
IV Ig replacement
vaccines
Neutropenic risk - 3 parts
cause of neutropenia
degree of neutropenia
duration of neutropenia
Additional risk factors for infection
disrupted skin/mucosa eg hickman line/venflon
altered flora
lymphopenia eg lymphoma
monocytopenia
Causes of febrile neutropenia - bacteria
60-70% gram positive
30-40% gram negative bacilli
gram +ve bacteria
staph - MRSA, coagulase negative
step - viridans
gram -ve bacteria
E.coli
pseudomonas
klebsiella
Possible sites for infection
respiratory tract GI tracts mouth ulcers skin sores exit site of central venous catheters
Fungal infections in immunocompromised
candida, aspergillus
lung, liver, brain
monocytopenia
Presentation of neutropenic sepsis
fever rigors chest infection cellulitis septic shock UTI
sepsis 6
IV antibiotics, IV fluids and high flow oxygen
urine output, serum lactate and blood cultures
investigating neutropenic fever
history and exam blood cultures - hickmans CXR throat swab, sputum etc FBC, coagulation screen, renal and liver function
managing neutropenic sepsis
resuscitation - ABC broad spectrum IV antibiotics gram +ve add vancomycin no response: IV anti-fungal CT chest/abdo/pelvis
Infection in severely lymphopenic patients causes
allograft stem cell transplant
total body irradiation
lymphoid malignancy
types of infection in lymphopenic patients
atypical pneumonia - PJP CMV shingles, EBC, adenovirus, mouth ulcers fungal atypical mycobacteria
