intraabdominal infections Flashcards
typhlitis
neutropenic enterocolitis
primary peritonitis vs secondary
Primary: aka spontaneous bacterial peritonitis. Occurs in setting of ascites. Cirrhosis results in complement deficiency
Secondary: spillage of gi or gu endogenous microbes into peritoneal cavity.
diagnosis of primary peritonitis
paracentesis showing >250 PMNs/mm3 in ascitic fluid. Monomicrobial infection (secondary averages 4.5 microbes).
what antibiotics would you use in primary peritonitis? secondary?
target aerobic gram negative bacilli.
target Anaerobic bacteria (broad-spectrum)
diagnosis of secondary peritonitis
elevated WBC. free air on CXR. ileus abdominal x ray
CAPD peritonitis
contamination of dialysis catheter by staph epidermidis and staph aureus. Pain and cloudy dialysate (give antibiotics via dialysate)
most common pathogen in intraperitoneal abcess
bacteroides fragilis, although they are usually polymicrobial
tenderness in secondary peritonitis vs intraperitoneal abcess
diffuse vs localized
visceral abscesses: when do they occur? etiology?
complicate underlying organ injury (pancreatitis, splenic infarct, etc). Monomicrobial via hematogenous, polymicrobial via communication with bowel lumen
diagnosis of acute apendicitis
CT
McBurney’s pt
1/3 distance from ASIS to umbilicus.
true vs false diverticulum
true: all 3 gut wall layers (eg. Meckel’s).
False: only mucosa and submucosa
diverticulosis: causes
low fiber diet, age
diverticulitis: presentation
LLQ pain “left-sided appendicits”, fever, leukocytosis, hematochezia.
