Post-Op Infections

Question 1

Furuncle/ carbuncle- Eti

Answer 1

• Primary cutaneous abscess originating from glands and hair follicles
• Furuncles most common surgical infection
• Immunodeficient pts
• Staph and anaerobes

Question 2

Furuncle/ carbuncle- Sx

Answer 2

• Red to white to necrosis
• Boils
• Itch
• Regional lymphadenopathy
• Funruncles to carbuncles
• Carbuncles- Deep seated mass of fistulous tracts

Question 3

Furuncle/ carbuncle- Tx

Answer 3

• Furncle- Drainage

- Carbuncle- Excision and abx

Question 4

Cellulitis- Eti

Answer 4

Connective tissue infection

• PMNs
• Strept or staph

Question 5

Cellulitis- Sx

Answer 5

• Brawny reddish brown skin
• Edematous
• Surgical wound site as portal of entry
• High fever
• Lymphangitis

Question 6

Cellulitis- Tx

Answer 6

• Rest, elevation
• Abx
• Warm packs

Question 7

Pyomyositis- Eti

Answer 7

• Skeletal muscle infection

- S. aureus and GAS

Question 8

Gas gangrene- Eti

Answer 8

• Clostridium species

Question 9

Wound infection- Eti

Answer 9

• Staph or strept infection during procedure

- 3rd most common infection

Question 10

Wound infection- Timeline

Answer 10

5-10 days post op

Question 11

Wound infection- Sx

Answer 11

• Fever

- Erythema, pain, warmth at surgical site

Question 12

Wound infection- Tx

Answer 12

• Open wound and drain

- Abx if invasive

Question 13

Pyomyositis- Sx

Answer 13

• Severe muscle edema
• Compartment syndrome
• Necrosis
• Skin change

Question 14

Pyomyositis- Dx

Answer 14

CT

Question 15

Pyomyositis- Tx

Answer 15

• Drainage

- Abx

Question 16

Gas gangrene- Sx

Answer 16

• Red-brown skin sloughing off
• Rapid progression
• Foul smell
• Discharge and gas bubbles

Question 17

Gas gangrene- Timeline

Answer 17

6 hrs - 4 days

Question 18

Gas gangrene- Tx

Answer 18

• Urgent surgical debridement
• Amputation
• Hyperbaric o2

Question 19

Necrotizing fasciitis- Eti

Answer 19

• Spreads along fascial plane
• Rapid progression
• Clostridium perfringens most common

Question 20

Necrotizing fasciitis- Sx

Answer 20

• Systemic toxicity
• Fever
• Pain out of proportion
• Crepitus and bullae
• Hemorrhagic bullae

Question 21

Necrotizing fasciitis- Tx

Answer 21

• Surgical removal of dead skin and fascia

- Abx

Question 22

Abscess- Eti

Answer 22

• Fibrin trapped collection of pus

Question 23

Abscess- Sx

Answer 23

• Fluctuation
• Fever, pain at surgical site
• Edema of surrounding skin

Question 24

Abscess- Dx

Answer 24

Culture for abx

Question 25

Abscess- Tx

Answer 25

• Open and drain
• Remove necrotic tissue
• Abx

Question 26

Fistulas/ sinus tracts- Eti

Answer 26

• Progression of abscess

Question 27

Fistulas/ sinus tracts- Timeline

Answer 27

5-10 days post op

Question 28

Fistulas/ sinus tracts- Sx

Answer 28

• Prolonged ileus
• Fever
• Abd tenderness
• Wound infection

Question 29

Fistulas/ sinus tracts- Dx

Answer 29

CT with contrast

- Fistulogram

Question 30

Fistulas/ sinus tracts- Tx

Answer 30

• Drain
• Abx
• TPN

Question 31

Bacteremia/ Septicemia- Eti

Answer 31

• Bacteria in blood
• Infected GI or Uro tract
• Speticemia = inflammatory response to infection

Question 32

Bacteremia/ Septicemia- Sx

Answer 32

• Delerium
• Hypoxia
• Shock and edema
• Multiple organ system dysfunction
• Warmth, erythema and tenderness at site of incision

Question 33

Bacteremia/ Septicemia- Dx

Answer 33

• Cutures

Question 34

Bacteremia/ Septicemia- Tx

Answer 34

• Abx

Question 35

Pneumonia- Eti

Answer 35

• Aspiration d/t oropharyngeal secretions

- Psuedomonas aeruginosa or gram negative

Question 36

Pneumonia- Sx

Answer 36

• Tachypnea
• Lung consolidation
• Purulent sputum
• • CXR

Question 37

Pneumonia- Tx

Answer 37

Empiric abx

Question 38

UTI- Eti

Answer 38

• E coli
• Immunocompromised
• Catheterization

Question 39

UTI- Timeline

Answer 39

48-72 hrs

Question 40

UTI- Sx

Answer 40

Fever, dysuria

• Frequency, urgency
• Flank pain
• Confusion in elderly

Question 41

UTI- Tx

Answer 41

• Sulfa abx