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Yr 3 - December lectures 2018 > Bacteraemic infections > Flashcards

Flashcards in Bacteraemic infections Deck (13)
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1

Why is septicemia/bacteraemia not a diagnosis?

bacteria in the blood have to come from a source (e.g. infected heart valve, urinary tract, abscess, gut)

2

What are some examples of precipitating agents?

endotoxin
toxic shock syndrome toxin (s aureus)
erythrogenic toxin (group a streptococcus)
cell wall of game +ve bacteria

3

Where do endocarditic vegetations localise from high velocity regurgitant blood flow?

ventricular surface of valve
chordae tendinae of anterior mitral leaflet
atrial wall
atrial surface of mitral valve

4

What are the common organisms recovered from bacteraemia in the oral cavity?

streptococci, diphtheroids, s. epidermis

5

What are the common organisms recovered from bacteraemia in the airway?

streptococci, haemophilus, diphtheroids, streptococci, s. epidermidis, aerobic gram -ve rods

6

What are the common organisms recovered from bacteraemia in the GIT?

streptococci, s epidermidis, diphtheroids, neisseria, aerobic gram -ve rods, bateroides,

7

What are the common organisms recovered from bacteraemia in the urinary tract?

aerobic gram -ve rods, diphtheroids, streptococci

8

What are the common organisms recovered from bacteraemia in the genital tract?

aerobic gram -ve rods, streptococci

9

What is diagnostic of infective endocarditis in terms of blood culture?

increasing vol of blood cultured between 2 and 20ml - increasing relative yield of positive blood cultures

10

Which bacteria are more likely to cause hospital acquired bacteraemia compared to community acquired?

staph aureus, klensiella, pseudomonas aeruginosa, coagulase negative staphylococci

11

What are the symptoms of infective endocarditis?

fever, weakness, sweats, anorexia, weight loss, malaise, myalgia-arthralgia, back pain, confusion

12

What are the signs of infective endocarditis?

pyrexia, murmur, embolic event, peripheral manifestations (osier's nodes, petechiae, laneway lesions), retinal lesion, stroke, splenomegaly, septic complications

13

How is clinically significant bacteraemia managed?

supportive therapy
- fluids = IV colloids, saline
- inotropes = dobutamine
- organ support = ventilation, haemofiltration
removal of infected focus
- surgery to drain abscess
- removal of infected intravascular catheter
- wound debridement
antibiotics
- IV at least initially
- broad spectrum - if etiology unknown
- narrow spectrum when etiology known
immunotherapy
- ?corticosteroids - no current evidence base
- ? monoclonal antibodies