Sepsis and endocarditits

Question 1

Infections that commonly present with bacteraemia

Answer 1

• Pyelonephritis
• Sever pneumonia
• bilary/intrabdominal tract infection
• Meningococcal disease

Question 2

Define sepsis

Answer 2

Pathological response to infection

• Meningococcal disease
• Pneumonia
• UTI
• Trauma, surgery, catheters

Question 3

Requirements for sepsis diagnosis

Answer 3

Site of infection plus two of:

• temp over/under 36/38.3
• HR over 90
• Resp rate over 20
• WCC under 4 or over 12 *10^9/L

Consiudered severe if there is also hypoperfusion or organ failure

Question 4

Common causes of Sepsis

Answer 4

• E. coli 30%
• S. aureus 25%
• Enterobacteria 15%

Question 5

Special considerations in lab diagnosis of bacteraemia

Answer 5

• May be intermittent; need two seperate blood cultures(prior to treatment)
• Strict aseptic precautions (skin commensal contamination)

Question 6

Common presentation/causes of infective endocarditis

Answer 6

• Usually by colonization of aggregates of platelets/firbin of valves
  
  • A-haemolyical streptocooci
  • Mouth commensals, patients often had dental treatment (viridans group strep)

Question 7

Organisms that can cause Culture negative endocarditis

Answer 7

Fastidious and non-culturable organisms

• Strep galloyticus
• Coxiella
• Bartonella
• Tropheryma

Question 8

Antimicrobial treatment for infective endocarditis

Answer 8

Combination therapy with MIC monitoring

e.g. penicillin+gentamicin in streptococcal/enterococcal endocarditis