Infectious Disease and Substance abuse Flashcards
Pseudomonas Definition and etiology
bacterium that is commonly found. Can become (And is 1 of the most aggressive stains for human bacterial infections) aggressive and abundant due to its ability to adapt and become antibiotic resistant.
Etiology: harmless to healthy Pts, extremely harmful to an individual that is immunosuppressed. Commonly found in hospital and nursing home settings. Transmitted through contact. thrives on moist surfaces therefore, swimming pools, sinks, medical equipment, and certain body parts.
Pseudomonas Risk Factors and Gender and Age Preference
Risk fxs: Individuals with burns, urinary catheterization, cystic fibrosis, chronic lung diseases, chemotherapy associated neutropenia, and diabetes, mechanical ventilation. Prior hospitalization and being on antibiotics prior to current hospitalization
Men> women
Premature infants and aging adults (can lead to sepsis)
Pseudomonas Clinical Presentation: Signs/symptoms
depend on the site of the infection.
Small arteries and veins
Thrombus and hemorrhagic necrosis of vessel tissues (lungs and skin)
**Respiratory tract **
(Pneumonia) dyspnea, fever, productive cough, low oxygenation, high WBC count, delirium
CNS (meninges)Fever, headache, stiff neck, nausea, and confusion
Skin and mucus membranes
Wound that is hemorrhagic and necrotic
Burn wound may appear blue or green
Bones and joints
Pain and swelling with recent puncture of skin
Spine.
Local tenderness and decrease ROM of spineMild neurologic effects
Ear(swimmers’ ear) pain and pressure.Diagnostic
Pseudomonas Diagnostic tests
Dx based on lab analysis of: wound exudate, sputum from a productive cough, urine blood spinal fluid
Pseudomonas Medical Manament
antibiotic therapy- affected areas may be rinsed, if lungs are affected inhalation could be mode of delivery , Debridement and draining, excision of infected areas
Strep Definition and etiology
Throat infection (strep throat) which comes from streptococcus pyogenes which may also cause scarlet fever, impetigo, strep gangrene, pneumonia and others.
group A-beta hemolytic streptococcal infectionsTransmitted through person-to-person contact from respiratory droplets and through water or food. The incubation period is anywhere from two to four days
Strep Risk Factors and Gender and Age Preference
5-12 are more at risk
Adults with infected children, or who work at school/ daycare.
No gender preference, not as common in summer months
Strep Clinical Presentation: Signs/symptoms
100.4°F (38°C), tonsillar exudate,”10 absence of cough, mild or severe swallowing pain with a sore throat or dysphagia, a red colored pharynx, lymphadenopathy, fatigue, weakness, chills, headache, and abdominal pain
Strep Diagnostic tests
throat culture -gold standard
rapid antigen detection testing (RADT) -considers S/S and age to have score
Strep Medical Manament
Antibiotics: penicillin, amoxicillin, and erythromycin.
a tonsillectomy is executed for patients with recurrent streptococcal pharyngitis
Strep Physical Therapy Tests and Measures and Implications for Strep
Functional strength, 5x STS - for weakness
6MWT- fatigue
Fatigue severity scale questionnaire
Strep Best Pt practice
Keep up hygiene procedures, clean surfaces with (0.1%) chlorine
- exercise during an ongoing viral or bacterial infection worsens symptoms and enhances the risk for complications
- Improve VC endurance with step, or gait training to return to baseline
Physical Therapy Tests and Measures and Implications for Pseudomonas
Test/Measures- Wound healing outcome measures All components of wound exam Vascular screen with ABI-ROM assessment MMT assessments
Lungs: O2 saturation Chest wall expansion/mobility Cough function (productiveness) Balance (BERG, BEST, DGI)-Strength (5xSTS) Mobility (TUG) Endurance (6MWT, 2MWT) Lung auscultation
Pseudomonas Best Pt practice
Wound Intervention/Treatment
Irrigation and debridement
Antiseptics
Negative pressure wound therapy- to decrease bacteria #
Moist wound healing (NPWT is more effective to removing drainage which is essential for preserving underlying tissue)
Silver dressings + antimicrobial + non occlusive
Light aerobic exercise
Lung Intervention/Treatment
Oscillating positive pressure device
Airway clearance exercises (Active cycle breathing with Huff cough)
Aerobic Exercise
Pnemonia
aerobic exercise inhibits colonization and decreases inflammation in the lungs in order to increase O2 perfusion and decrease dyspnea. Introduce resistance training bc most ADLs are a form of RT and improving strength and efficiency of mus of peripheral mus will help decreases lung demand. Also include airway clearance techniques
Prevention: dirty nails and equipment harbor bacteria, keep area clean
Staph Definition and etiology
S.aureus, is a gram positive bacteria is part of the normal flora found on skin and mucus membranes, harmless bc the bacteria does not have a way to penetrate the barrier, until the surface is interrupted.
etiology: Once the bacteria is introduced into the body via a broken skin/membrane barrier, host deffenses will try to fight off membrane destroying enzymes that bacteria produces. The bacteria may evade host response and enter the blood stream, joints, other membranes ect
Staph Risk Factors and Gender and Age Preference
all people who live in close quarters; military personnel, jail inmates, athletes, children at daycare. Pts admitted in hospitals; indwelling cathertars, surgical, burn ect HIV, injection drug users, hemodialysis patients, homosexual men, and healthcare workers
Staph Clinical Presentation: Signs/symptoms
Soft tissue skin rxns- abscess formation, Pneumonia, may present with mild fever, pain, and slightlyelevated leukocytosis with a subtle course of illness, may present as food poisoning. Staph associated skin infections include cellulitis, furuncles and carbuncles, and small macules that sometimes develop into pus-filled abscesses
Staph Diagnostic tests
Gram stain and culture of the organism from the blood, infected site, or other fluid is the main diagnostic test
An antibiotic sensitivity test determines which AB will fight the best
PCR-based assays or 2 hours blood assays allow for test tx, that is within hours not days
Staph Med Mgmt
minor soft tissue and skin infections: oral medications such as trimethoprim-sulfamethozole and tetracyclines
<5cm draining and removal of abscess is enough
intravenous antibiotic treatment(typically vancomycin) for more severe infections
Staph Physical Therapy Tests and Measures and Implications
Proper hand hygiene - use antimicrobial soap
Staph Best PT practices
Monitor for looking for red streaks, poorly defined borders, increase in temperature, disproportionate edema, increased pain, disproportionate, thick, purulent drainage or symptoms of the patient feeling sick.
Educate on hand hygiene, patient and caregivers about the ability of the bacteria to spread to others, dont D/C or got to PT if inpatient setting till WBC is managed
Herpes Definition and etiology
Infects through mucocutaneous exasperation, organ damage, and neurological deficits, with 8 different forms that are all morphologically the same with distinct epidemiologic features - each are active for a lifetime and have “flarups”
Type 1- HSV 1 Oral herpes
Type 2- HSV 2Genital herpes - can have herpes shedding
Type 3 - Varicella-zoster virus (VZV) Causes varicella/ chickenpox, reactivation causes shingles Epstein-Barr Infectious mononucleosis virus (EBV)
Type 4- Mononucleosis also known as kissing disease
Type 5- (CMV) Cytomegalovirus Commonly transmitted to embryo
6 HHV- Roseola Type Normally occurs in infants followed by high fever and rash
Type 7- Serologically associated with roseola Normally occurs in infants followed by high fever and rash
Type 8 sarcoma- Kaposi sarcoma Form of cancer typically affecting the immunosuppressed ex.HIV
Etiology: initial contraction of HSV- virus multiplies locally at mucocutaneous junction manifesting in blood and peripheral sensory neurons, then, translating through axons residing latent at the CNS ganglia.
Herpes Risk Factors and Gender and Age Preference
Unprotected sex -Kissing multiple people -sex with multiple partners -Sharing drinks or oral objects -a partner who has HHV -Immunosuppressed people -Homosexual male intercourse -Women are more likely to contract the virus Females> males for HSV 1 & 2 Risk increases as age increases;
Herpes Clinical Presentation: Signs/symptoms
HSV-1
Most common sign = cold sore/blister around the lips, May have lesions in or around the mouth followed by sore throat. most commonly contracted by children leading to gingivostomatitis which causes painful sores around the mouth, fever, and swelling.
HSV-2
Grouped blisters, burning, itching, and tingling around the genitals, and malaise. may experience headaches, nausea, seizures associated with meningitis or encephalitis.
