Intraabdominal and SSTI Flashcards
Peritonitis
K
Inflammation of the peritoneum (serous membrane lining the abdominal
cavity)
O
Types
L
Primary
L
Secondary
L
Spontaneous or idiopathic, no primary focus of infection
O
Occurs secondary to an abdominal process
O
Causes of Secondary Peritonitis
O
Peptic ulcer perforation
L
Perforation of a GI organ
K
Appendicitis
L
Endometritis secondary to intrauterine
device
K
Bile peritonitis
L
Pancreatitis
P
Operative contamination
P
Diverticulitis
-
Intestinal neoplasms
O
GI normal flora
S
Peritonitis: Microbiology
D
Stomach and proximal small intestine:
O
Aerobic and facultative gram-positive and gram-negative organisms
K
Ileum
O
E. coli, Enterococcus, anaerobes
O
Large intestine:
L
Anaerobes (i.e., Bacteroides, Clostridium perfringens)
K
Aerobic and facultative gram-positive and gram-negative organisms (i.e., E. coli,
Streptococcus, Enterococcus, Klebsiella, Proteus, Enterobacter)
O
Peritonitis: Clinical presentation
L
Abdominal pain aggravated by motion, rebound tenderness
L
Bowel paralysis
L
Pain with breathing
L
Decreased renal perfusion
O
Ascitic fluid
K
Protein
K
WBCs
K
more than 3 g/dL
K
Therapy or prophylaxis should be limited in
K
Bowel injuries caused by trauma that are repaired within 12 hours (treat for less
than 24 hours)
K
Intraoperative contamination by enteric contents (treat for less than 24 hours)
L
Perforations of the stomach, duodenum, and proximal jejunum (unless patient is
on antacid therapy or has malignancy) (prophylactic antibiotics for less than 24
hours)
K
Acute appendicitis without evidence of perforation, abscess, or peritonitis (treat
for less than 24 hours)
,
Mild to moderate community-acquired infection
K
Cefoxitin
M
Cefazolin, cefuroxime, ceftriaxone, or cefotaxime plus metronidazole
L
Ertapenem
K
Moxifloxacin
L
Ciprofloxacin or levofloxacin plus metronidazole
L
Tigecycline
K
High-risk or severe* community-acquired or health
care–acquired infection
L
Piperacillin/tazobactam •
L
Comorbidities and organ dysfunction
Ceftazidime plus metronidazole or cefepime plus
,
Inability to achieve adequate source control
metronidazole
,k
Presence of malignancy
K
