Infectious diseases Flashcards
sources of bacteraemia
skin - cellulitis, wound, ulcer bone - osteomyelitis prosthesis IE Septic arthritis discitis septic emboli pneumonia indwelling lines UTI IVDU
what is the sepsis 6 protocol
O2 fluids antibiotics cultures - blood, urine, prosthesis, wound, bone urine output lactate
what imaging should be done for bacteraemia
TTE followed by TOE if abnormal
antibiotic regimen for bacteraemia
2 weeks IV flucloxacillin/vancomycin
antibiotic regimen duration for osteomyelitis
4 weeks
antibiotic regimen for IE
4 weeks
RF for IE
abnormal heart valves - calcification, prosthetic, CHD, post rheumatic fever
IVDU
indwelling lines
dental treatment
organisms causing native valve IE
staph aureus
viridans strep
enterococcus
staph epi
what is the name of the criteria used for IE
Dukes criteria
work up of investigations for IE
blood cultures
TTE
TOE
Gm + cocci in clusters
staph
Gm + cocci in chains
strep
staph epi is a skin contaminant
yes
but can also infect prosthetic material
other skin contaminant
corynebacterium
presenting symptoms of acute IE
sepsis and heart failure
presenting features of subacute IE
weight loss night sweats malaise tiredness SOB
signs of subacute IE
fever new murmur finger clubbing splinter haemorrhages splenomegaly Roth spots - eyes Janeway lesions - hands Oslers nodes - 'ouch' hands microscopic haematuria
where are IVDU more likely to get IE
tricuspid valve (RHS)
colonisation
presence of microbe with no inflammation
infection
inflammation due to microbe
bacteraemia
presence of viable bacteria in the bloodstream
sepsis
dysregulated host response to infection
life threatening organ dysfunction
criteria for septic shock
sepsis AND
persistent hypotension
lactate >2
failure with fluid resuscitation
pathogen
any bug that has the potential to cause disease
Gm + have thick/thin peptidoglycan wall
thick
