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IM - MISCELLANEOUS INFECTIONS

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tonystep1's version from 2017-08-15 16:42

MISCELLANEOUS INFECTIONS CLINICAL FEATURES

Question Answer
Toxic Shock Syndrome 􀂍TSS)The onset of symptoms is characteristically abrupt // Flu-like symptoms: high fevers, headache, myalgias - Diffuse macular, erythematous rash - Hyperemic mucus membranes, "strawberry tongue" // By definition, there must be involvement of at least three organ systems
Catheter-Related Sepsisclinical evidence of infection at the site of insertion (i.e., erythema, purulence) // Risk factors for catheter-related sepsis are emergent placement, femoral lines, and prolonged indwelling of the line.
Neutropenic Feversepticemia, cellulitis, and pneumonia. // Neutropenia is defined by absolute neutrophil count (ANC) <1,500/mm3
Infectious Mononucleosismode of transmission is through infected saliva // Temperatures may be as high as 40°C (104°F); fever usually resolves within 2 weeks. // Lymphadenopathy-This is found in >90% of patients. Tonsillar or cervical (especially posterior cervical) lymph nodes may be quite enlarged, painful, and tender.
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MISCELLANEOUS INFECTIONS DIAGNOSIS AND TREATMENT

Question Answer
TSSCultures may be taken from the suspected source, but the diagnosis is primarily clinical.// Hemodynamic stabilization // The source of toxin (e.g., tampon) should be removed immediately // Give antistaphylococcal therapy, such as nafcillin, oxacillin, or vancomycin
Catheter Related SepsisIf you suspect catheter-related sepsis, promptly remove the catheter and send the tip for culture. // Antibiotics are usually initiated // narrow once the organisms has been identified
Neutropenic FeverNeutropenia is defined by absolute neutrophil count (ANC) <1,500/mm3 (ANC: combination of bands and mature neutrophils // reverse isolation precautions // Give broad-spectrum antibacterial agents immediately after cultures are drawn // If fever persists beyond 4 to 5 days despite broad-spectrum antibacterial therapy, give antifungal agents, such as IV amphotericin B. Consider G-CSF
EBV mononucleosisMonospot test-for detection of heterophile antibody // Heterophile antibodies are positive within 4 weeks of infection with EBV mononucleosis and are undetectable by 6 months // Generally, no specific treatment is indicated (or available) as most people recover completely within 3 to 4 months.
CMV mononucleosisMonospot test-for detection of heterophile antibody // Heterophile antibodies do not form in CMV mononucleosis // Generally, no specific treatment is indicated (or available) as most people recover completely within 3 to 4 months.
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