Infectios Disease Emergencies

Question 1

3 infectious disease emergencies

Answer 1

Severe community acquired pneumonia
Severe malaria
Bacterial meningitis

Question 2

What is Sepsis

Answer 2

Clinical evidence of infection together with 2 or more of the following quick Sequential [Sepsis-related] Organ Failure Assessment score (qSOFA):
-Altered mental state (GC Scale <15)
-Resp rate >22/min
-Systolic BP< 100mmHg

Question 3

What is septic shock

Answer 3

Sepsis with hypotension (systolic <90 or >40 fall in systolic BP) persisting despite fluid challenge.

Question 4

End organ damage in Sepsis

Answer 4

CNS:
Confusion, altered consciousness, derilium and cognitive loss

Lungs:
Oedema, diffuse alveolar damage, acute lung injury, ARDS (acute Resp distress syndrome)

Kidney
Oedema, acute tubular injury

Liver

CVS

Pancreases

Adrenals

Question 5

Management of Sepsis

Answer 5

-Start appropriate resuscitation & general support measures urgently; e.g., oxygen, fluid balance with isotonic crystalloids
-Inotropic agents (typically adrenaline/epinephrine infusions) for shock.
-Select empiric antimicrobials that are appropriate for the likely infecting organism/s (always give intravenously & give a loading dose)
-Give the empiric antimicrobials as soon as possible