Signs and Sx of infection Flashcards
infection that doesn’t have any Sx
inapparent
silent
subclinical
occulut
infection that is inactive or dormant
latent infection
examinations carried out for diagnosis of infection and to determine severity
HR
RR
temp
blood tests - FBC (WBCs), CRP
others based on Sx:
- urine dipstick
- CXR
What is CRP?
non-specific marker of infection/inflammation
normal temp
37 degC
normal white cell count
4-11 x 10^9 /L
normal CRP
<5 mg/L
What would you be looking for in urine dipstick?
leukocytes
blood
proteins
advantages of using CRP
levels are high during bacterial infection (40-200mg/L)
but lower during viral infection (10-40mg/L)
-> can distinguish between bacterial or viral cause
disadvantages of using CRP
- not reliable to differentiate between viral and bacterial infection because some CRP ranges overlap
- eg. viral infection vs early stage bacterial infection (lower bacterial nos = lower CRP)
- CRP rises in response to inflammation, but there might not be an infection
What is empirical Tx?
Tx chosen based on most likely organism/spectrum of ABX
How to ID the causative organism?
microscopy
PCR test - tests for genetic material from specific organism
Sx of sepsis to look out for
sweaty skin
disorientation
shivering
high HR
extreme pain
SOB
patients at high risk of sepsis/more concerned about
- infants, esp U 3mths
- communication difficulties
- immunocompromised, LT steroids
- indwelling catheters/lines (source of infection)
- recent surgery/injury
SEPSIS 6
- oxygen
- cultures
- IV ABX
- fluids
- blood tets including lactate
- fluid balance monitoring & urine output
What does high lactate levels mean?
patient is very ill
require urgent and effective management
info on severity of infection
monitoring of disease progression
What is lactate?
metabolite of glucose produced by tissues in the body under conditions of insufficient oxygen supply
normally cleared by kidneys/liver
normal = 1-1.5 mmol/L
very ill > 2 mmol/L (shock, hypoperfusion)
> 4 mmol/L = ICU admission
general RF for infection
- age
- comorbidities
- current Tx (immunosuppression)
- nutritional status
- mechanical barriers -> catheters
- lifestyle -> travel, occupational risk
environment
- invasice procedures
- hosiptal/care settings
immunocompromised patients
- congenital
- asplenia (spleen removed, on prophylactic ABX lifelong)
- HIV
- transplantation
- chemotherapy
- steroids
ways to avoid infection
- healthy lifestyle (rest, exercise, diet)
- hand hygiene
- avoiding large crowds/people with infections
- mouthcare
- not sharing towels
- shoes to portect feet (esp diabetics)
- avoid cleaning waste products (animal, baby)
- vaccines
start smart
- don’t start ABX unless evidence of infection
- take drug & allergy Hx
- start effective ABX Tx within 1hr of diagnosis or asap in patients with sepsis/severe infections
- avoid inappropriate use of broad spec ABX
- comply with local guidelines
- document indication/drug/dose/route on drug chart/clinical notes
- include review/stop date
- get cultures before starting ABX (but son’t delay therapy)
FOCUS
review clinical diagnosis and the need for ABX at 48-72hrs and document plan of action
