Intra-Abdominal Infections Flashcards
what is diverticulitis
inflammation of diverticula - outpouches of intestinal mucosa
presentation of diverticulitis
left iliac fossa pain fever change in bowel habit - constipation (50%) diarrhoea (25%) PR bleeding nausea / vomiting
investigations for diverticulitis
FBC: WBC raised, CRP raised
CT scan
antibiotics for diverticulitis
cefotaxime + metronidazole
- will require surgery (Hartmanns procedure) if doesn’t settle / if there is perforation or obstruction
what is cholecystitis
impaction of gall stone in cystic duct / neck of gall bladder
- can occur with secondary infection
presentation of cholecystitis
RUQ pain (can radiate to scapula)
fever, N+V
Murphy’s sign +ve (pain worse on inspiration)
investigations for cholecystitis
FBC: WBC raised, CRP raised
USS
management of cholecystitis
IV fluids + Antibiotics (amoxicillin, metronidazole, gentamicin)
may require laparoscopic cholecystectomy
what is ascending cholangitis
gallstone impacted in common bile duct resulting in infection of biliary tree
most common causative organisms in ascending cholangitis
E.Coli / Enterococcus
Charcots triad of symptoms in ascending cholangitis
fever, jaundice, RUQ pain
- jaundice is a cholestatic picture – dark urine, pale stools
blood results ascending cholangitis
increased WBC, increase bilirubin, increased alkaline phosphatase
definitive investigation ascending cholangitis
ERCP
management of ascending cholangitis
IV fluids + amox, met, gent
ERCP allows stone removal
most common causative organism in a pyogenic liver abscess in
- children
- adults
children - staph aureus
adults- E.Coli
management of a pyogenic liver abscess (in adults)
percutaneous drainage + antibiotics
- amoxicillin, ciprofloxacin + metronidazole
what patients typically get spontaneous bacterial peritonitis
patients with liver failure
most common organism in spontaneous bacterial peritonitis
E.Coli
antibiotics given for spontaneous bacterial peritonitis
IV piperacillin/tazobactam
what antibiotic is added if the ascitic fluid neutrophil count >250 in spontaneous bacterial peritonitis
Cefotaxime
