This document provides an overview of blood stream infections, sepsis, and pyrexia of unknown origin. It defines blood stream infection and discusses predisposing factors such as healthcare-associated infections and intravenous devices. Sepsis is defined as a life-threatening condition caused by the body's response to an infection. The document outlines the pathogenesis of blood stream infections and sepsis at the organ, tissue, cellular, and molecular levels. Treatment involves antibiotic therapy based on culture and sensitivity testing, while prevention focuses on sterile techniques and education.
Hospital-acquired bloodstream infections in Intensive Care Units in Hungary, ...Rita Szabó
This document summarizes a study on hospital-acquired bloodstream infections (HABSI) in intensive care units (ICUs) in Hungary between 2005-2013. The study found an overall HABSI incidence rate of 1.0 per 100 patients. The most common pathogens were Staphylococcus aureus, Acinetobacter species, and Klebsiella species. The overall case fatality rate was 24.9%, with coagulase-negative staphylococci and Pseudomonas species most commonly related to death. The conclusion calls for strict application of prevention and control measures to reduce HABSI incidence and mortality.
This document discusses blood stream infections, including bacteremia, septicemia, and the various types of bacteremia. It covers the clinical presentation of intravascular and extravascular infections. Laboratory diagnosis involves blood culture techniques to isolate the causative organism. Identification is done through Gram stain, biochemical tests, and antibiotic sensitivity testing. Serology and other tests can also aid diagnosis.
This document discusses bloodstream infections (bacteremia and sepsis). It defines the different types of bloodstream infections including bacteremia, sepsis, severe sepsis, and septic shock. It describes the typical clinical features and pathophysiology of sepsis. It also outlines the various causes and sources of bacteremias including those related to specific infections, medical devices, intravenous drug use, and hospital-acquired infections. Finally, it discusses the diagnostic approach using blood cultures and treatment approach typically involving antibiotics, organ support, and source control.
Blood stream infections- clinical microbiologySijo A
Blood stream infections (BSI) refers to the presence of organisms in blood which are threat to every organ in the body.
It causes shock, multiple organ failure and DIC (Disseminated Intravascular Coagulation).
The presence of bacteria in blood is called Bacteremia.
The bacteria circulate and actively multiply in the blood stream is called Septicemia.
The presence of virus in blood is called Viremia.
The presence of parasite in blood is called Parasitemia.
The presence of fungi in blood is called Fungemia.
Some patients experience ongoing symptoms after recovering from the initial acute phase of COVID-19 infection, known as post-COVID syndrome. Symptoms can include fatigue, respiratory issues, and neurological or psychological problems like PTSD. There is risk of long-term lung damage from fibrosis for severe cases, especially those requiring intensive care or ventilation. Extended thromboprophylaxis should be considered after discharge for high risk patients. Regular follow up is important to monitor patients for post-COVID complications.
19. presenting problems in infectious diseasesAhmad Hamadi
This document discusses the evaluation and management of fever. It notes that the differential diagnosis for fever is broad and initial screening investigations should include blood tests, imaging, and cultures of potential sites of infection depending on symptoms. For patients where the cause is not obvious, further targeted investigations are needed. The document also discusses considerations for evaluating fever in people who inject drugs, including risks related to injection practices and common infections in this population.
Γρηγόριος Γεροτζιάφας, Health Innovation Conference 2021Starttech Ventures
Ομιλία – Παρουσίαση:“Artificial intelligence and personalised medicine for patients at high risk of severe COVID-19”
Γρηγόριος Γεροτζιάφας, Καθηγητής Αιματολογίας, Ιατρική σχολή της Σορβόνης, Υπεύθυνος, Τμήμα Θρόμβωσης, Νοσοκομείο Tenon, Παρίσι & Διευθυντής, Ερευνητική Ομάδα Καρκίνος και Θρόμβωση INSERM U938
Hospital-acquired bloodstream infections in Intensive Care Units in Hungary, ...Rita Szabó
This document summarizes a study on hospital-acquired bloodstream infections (HABSI) in intensive care units (ICUs) in Hungary between 2005-2013. The study found an overall HABSI incidence rate of 1.0 per 100 patients. The most common pathogens were Staphylococcus aureus, Acinetobacter species, and Klebsiella species. The overall case fatality rate was 24.9%, with coagulase-negative staphylococci and Pseudomonas species most commonly related to death. The conclusion calls for strict application of prevention and control measures to reduce HABSI incidence and mortality.
This document discusses blood stream infections, including bacteremia, septicemia, and the various types of bacteremia. It covers the clinical presentation of intravascular and extravascular infections. Laboratory diagnosis involves blood culture techniques to isolate the causative organism. Identification is done through Gram stain, biochemical tests, and antibiotic sensitivity testing. Serology and other tests can also aid diagnosis.
This document discusses bloodstream infections (bacteremia and sepsis). It defines the different types of bloodstream infections including bacteremia, sepsis, severe sepsis, and septic shock. It describes the typical clinical features and pathophysiology of sepsis. It also outlines the various causes and sources of bacteremias including those related to specific infections, medical devices, intravenous drug use, and hospital-acquired infections. Finally, it discusses the diagnostic approach using blood cultures and treatment approach typically involving antibiotics, organ support, and source control.
Blood stream infections- clinical microbiologySijo A
Blood stream infections (BSI) refers to the presence of organisms in blood which are threat to every organ in the body.
It causes shock, multiple organ failure and DIC (Disseminated Intravascular Coagulation).
The presence of bacteria in blood is called Bacteremia.
The bacteria circulate and actively multiply in the blood stream is called Septicemia.
The presence of virus in blood is called Viremia.
The presence of parasite in blood is called Parasitemia.
The presence of fungi in blood is called Fungemia.
Some patients experience ongoing symptoms after recovering from the initial acute phase of COVID-19 infection, known as post-COVID syndrome. Symptoms can include fatigue, respiratory issues, and neurological or psychological problems like PTSD. There is risk of long-term lung damage from fibrosis for severe cases, especially those requiring intensive care or ventilation. Extended thromboprophylaxis should be considered after discharge for high risk patients. Regular follow up is important to monitor patients for post-COVID complications.
19. presenting problems in infectious diseasesAhmad Hamadi
This document discusses the evaluation and management of fever. It notes that the differential diagnosis for fever is broad and initial screening investigations should include blood tests, imaging, and cultures of potential sites of infection depending on symptoms. For patients where the cause is not obvious, further targeted investigations are needed. The document also discusses considerations for evaluating fever in people who inject drugs, including risks related to injection practices and common infections in this population.
Γρηγόριος Γεροτζιάφας, Health Innovation Conference 2021Starttech Ventures
Ομιλία – Παρουσίαση:“Artificial intelligence and personalised medicine for patients at high risk of severe COVID-19”
Γρηγόριος Γεροτζιάφας, Καθηγητής Αιματολογίας, Ιατρική σχολή της Σορβόνης, Υπεύθυνος, Τμήμα Θρόμβωσης, Νοσοκομείο Tenon, Παρίσι & Διευθυντής, Ερευνητική Ομάδα Καρκίνος και Θρόμβωση INSERM U938
This document discusses cytokine storm syndrome in patients with COVID-19. It defines cytokine storm as an uncontrolled release of inflammatory cytokines that can lead to organ damage. COVID-19 is proposed to progress through four stages, with stage II involving an excessive immune response and cytokine release. Cytokine storm is associated with acute respiratory distress syndrome and multi-organ failure in COVID-19 patients. The document outlines treatments for cytokine storm including immunomodulators, anticoagulants, antivirals, and extracorporeal therapies.
Cardiovascular Disease Associated with SARS-CoV-2 and HIV InfectionsInsideScientific
1) The document discusses a study presenting a new mouse model for severe COVID-19 disease.
2) The model shows lung infection and damage, as well as multi-organ impacts including thrombosis.
3) The study finds evidence that SARS-CoV-2 can directly infect and dysregulate endothelial cells in the lungs and other organs in this mouse model as well as nonhuman primates and humans.
1) Diabetes is identified as a risk factor for worse outcomes from COVID-19 based on studies from China. Mortality was 10% in COVID-19 patients with diabetes versus 2.5% for non-diabetic patients.
2) People with diabetes have an increased risk of severe COVID-19 infection due to defects in innate immunity from hyperglycemia and an increased inflammatory response.
3) The interaction between the SARS-CoV-2 virus and the renin-angiotensin-aldosterone system, which regulates blood pressure and fluid balance, may help explain the link between diabetes, hypertension, and increased COVID-19 severity. The virus relies on binding to ACE2 receptors to infect
Coronavirus by ahmed alghamdi and abdulrahman alghamdiAhmdAlghamdi1
The document summarizes key information about coronaviruses including SARS-CoV-2, which causes COVID-19. It discusses the history of major plagues over the last century and describes past coronavirus outbreaks like SARS, MERS, and known human coronaviruses. It also examines the virology of coronaviruses, epidemiology of SARS and MERS, transmission mechanisms, and treatment approaches. Additionally, it explores the origins and evolution of SARS-CoV-2, the link between COVID-19 and pangolins, clinical presentation of COVID-19, and molecular testing recommendations.
The document discusses bloodstream infections, including the etiological agents, types, clinical manifestations, laboratory diagnosis, and fever of unknown origin. It defines various types of bloodstream infections such as bacteremia, septicemia, and fungemia. The document also outlines the diagnostic process for bloodstream infections including specimen collection, culture methods, identification, and antimicrobial susceptibility testing.
This document defines sepsis and related terms like infection, bacteremia, septic shock, and severe sepsis. It describes the SIRS criteria and its pitfalls for diagnosing sepsis. It also discusses the SOFA and qSOFA scoring systems used to stage sepsis severity. Risk factors, pathogenesis, clinical manifestations, common etiologies, sites of infection, and management approaches like the Surviving Sepsis Campaign guidelines are summarized. Lactate levels are addressed as a marker of tissue hypoperfusion in sepsis.
WHO CME ANTIBIOTC STEWARDSHIP ITALY
• Describe appropriate blood culture specimen collection techniques to reduce opportunities for contamination, which can lead to inappropriate antimicrobial use
• Review framework for appropriate antimicrobial prescribing for
patients with suspected blood stream infections (BSI).
• Demonstrate opportunities for collaboration between clinicians and microbiologist to achieve the dual goals of antimicrobial and
diagnostic stewardship
Immunodeficiency disorders are associated with defects or impairments in immune function that can be congenital or acquired. Primary immunodeficiency diseases involve genetic defects affecting B cell, T cell, or phagocytic cell development. Common symptoms include recurrent infections, failure to thrive, and increased susceptibility to opportunistic infections. HIV/AIDS is an acquired immunodeficiency disorder that progressively weakens the immune system by attacking CD4 cells, leaving the body vulnerable to opportunistic infections.
Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis, is a rare systemic necrotizing vasculitis characterized by granulomatous inflammation involving the respiratory tract and necrotizing glomerulonephritis. It is associated with the presence of antineutrophil cytoplasmic antibodies (ANCA). Treatment involves inducing remission with high-dose corticosteroids combined with cyclophosphamide or rituximab to prevent organ damage and relapses. With effective treatment, remission rates are high but relapses remain common, requiring long-term management and monitoring.
This document discusses opportunistic infections that can occur in patients with AIDS/HIV. It begins by providing background on the HIV epidemic in India. It then describes the structure and life cycle of HIV. The document outlines the typical stages of HIV disease progression from acute infection to chronic infection to AIDS. It discusses how HIV evades the immune system and establishes a chronic infection. Finally, it provides details on common opportunistic infections caused by fungi, bacteria, viruses and protozoa that patients with advanced HIV/AIDS face, such as Pneumocystis pneumonia, toxoplasmosis and cryptosporidiosis.
HIV/AIDS remains a major global epidemic, infecting over 59 million people worldwide since the 1980s and causing over 20 million deaths. Developing countries account for most new HIV infections, with sub-Saharan Africa the hardest hit region. While there is no cure for HIV, treatment using antiretroviral drugs can control the virus and prevent transmission. Developing an effective HIV vaccine remains challenging due to the virus's ability to mutate and evade the immune system.
The document discusses COVID-19 and how it progresses in the body. It begins by explaining how the virus enters through the nose or throat and makes its way to the lungs, where it attacks the alveoli. This can cause the alveoli to become stuffed with fluid and cells, reducing oxygen intake. The virus or immune response can also damage other organs like the brain, heart, kidneys, and intestines. The document then outlines recommendations from the WHO on treatment and prevention, as well as answering common questions. It concludes by discussing home care and stress management for those recovering from COVID-19.
The document summarizes key information about HIV/AIDS, including:
1. HIV has infected 59 million people worldwide, with 20 million deaths. Developing countries account for 64% of cases and 2/3 of new infections.
2. Common early symptoms of HIV infection include fever, fatigue, rash, headache, lymphadenopathy, and gastrointestinal issues.
3. HIV is transmitted through unprotected sex, blood transfusions, needle sharing, and from mother to child during pregnancy, birth, or breastfeeding.
4. While there is no cure for HIV, treatment with antiretroviral drugs can control the virus and prevent transmission.
HIV attacks and weakens the immune system by destroying CD4+ T cells. This leaves the body vulnerable to opportunistic infections and diseases. AIDS is the final stage of HIV infection where the CD4+ cell count drops below 200, resulting in life-threatening illnesses. There are two types of HIV - HIV-1 is the predominant global type while HIV-2 is less common and concentrated in West Africa. Both can be transmitted sexually, through blood exposure, and from mother to child, ultimately causing AIDS if left untreated.
This document provides information on COVID-19, including:
1) It describes the clinical presentation of COVID-19 including dry cough, fever, and shortness of breath.
2) It explains that COVID-19 was first reported in Wuhan, China in December 2019 and was declared a pandemic by the WHO on March 11, 2020.
3) It discusses the virus taxonomy, noting it is an enveloped, positive sense single stranded RNA betacoronavirus that primarily infects the respiratory system via the ACE2 receptor.
This document discusses AIDS and opportunistic infections. It defines AIDS as the final phase of HIV infection where the CD4+ T cell count drops below 200/uL, making patients highly susceptible to opportunistic infections. Some common opportunistic infections seen in AIDS patients include Pneumocystis jiroveci pneumonia, toxoplasmosis, cryptococcosis, histoplasmosis, candidiasis, mycobacterial infections, and infections caused by viruses like cytomegalovirus and herpes simplex virus. The progression from HIV to AIDS can take from 2-10 years depending on factors like viral load, immune status, and genetic factors.
This document provides information on HIV/AIDS, including:
1. HIV was discovered in 1983-1984 and is the cause of AIDS. It is a retrovirus that infects CD4 cells and progressively destroys the immune system.
2. HIV has three main genes - Gag, Env, and Pol - which code for structural proteins. The virus attaches to and enters CD4 cells via the Env protein, then uses the Pol protein to integrate its genetic material into the host cell DNA.
3. As the virus destroys CD4 cells over many years, it leaves the infected person vulnerable to opportunistic infections. AIDS is diagnosed when the CD4 count drops below 200. Common infections include PCP
This document provides information on the care of patients with sepsis presented by Mesfin Shifara to nursing students. It defines sepsis, explains the pathophysiology and signs. It describes diagnostic procedures, medical management including antibiotics and fluid resuscitation, complications that can arise if untreated, and ways to prevent sepsis. Physiotherapy aims to clear secretions and begin early mobilization once the patient is stable.
Infection Control In Health Care SettingsSagar Desai
The goal of this report was to assess the current and potential future role of diagnostics in hospital-acquired infection (HAI) control programs. We examined current issues resulting from HAIs and determined which infections needed foremost attention. Then, with input from Prof. Neimz, we selected diagnostics available on the market we could use. The final chapter of the review contains a market analysis with info about costs prevented upon implementation of diagnostic recommendations.
This document discusses cytokine storm syndrome in patients with COVID-19. It defines cytokine storm as an uncontrolled release of inflammatory cytokines that can lead to organ damage. COVID-19 is proposed to progress through four stages, with stage II involving an excessive immune response and cytokine release. Cytokine storm is associated with acute respiratory distress syndrome and multi-organ failure in COVID-19 patients. The document outlines treatments for cytokine storm including immunomodulators, anticoagulants, antivirals, and extracorporeal therapies.
Cardiovascular Disease Associated with SARS-CoV-2 and HIV InfectionsInsideScientific
1) The document discusses a study presenting a new mouse model for severe COVID-19 disease.
2) The model shows lung infection and damage, as well as multi-organ impacts including thrombosis.
3) The study finds evidence that SARS-CoV-2 can directly infect and dysregulate endothelial cells in the lungs and other organs in this mouse model as well as nonhuman primates and humans.
1) Diabetes is identified as a risk factor for worse outcomes from COVID-19 based on studies from China. Mortality was 10% in COVID-19 patients with diabetes versus 2.5% for non-diabetic patients.
2) People with diabetes have an increased risk of severe COVID-19 infection due to defects in innate immunity from hyperglycemia and an increased inflammatory response.
3) The interaction between the SARS-CoV-2 virus and the renin-angiotensin-aldosterone system, which regulates blood pressure and fluid balance, may help explain the link between diabetes, hypertension, and increased COVID-19 severity. The virus relies on binding to ACE2 receptors to infect
Coronavirus by ahmed alghamdi and abdulrahman alghamdiAhmdAlghamdi1
The document summarizes key information about coronaviruses including SARS-CoV-2, which causes COVID-19. It discusses the history of major plagues over the last century and describes past coronavirus outbreaks like SARS, MERS, and known human coronaviruses. It also examines the virology of coronaviruses, epidemiology of SARS and MERS, transmission mechanisms, and treatment approaches. Additionally, it explores the origins and evolution of SARS-CoV-2, the link between COVID-19 and pangolins, clinical presentation of COVID-19, and molecular testing recommendations.
The document discusses bloodstream infections, including the etiological agents, types, clinical manifestations, laboratory diagnosis, and fever of unknown origin. It defines various types of bloodstream infections such as bacteremia, septicemia, and fungemia. The document also outlines the diagnostic process for bloodstream infections including specimen collection, culture methods, identification, and antimicrobial susceptibility testing.
This document defines sepsis and related terms like infection, bacteremia, septic shock, and severe sepsis. It describes the SIRS criteria and its pitfalls for diagnosing sepsis. It also discusses the SOFA and qSOFA scoring systems used to stage sepsis severity. Risk factors, pathogenesis, clinical manifestations, common etiologies, sites of infection, and management approaches like the Surviving Sepsis Campaign guidelines are summarized. Lactate levels are addressed as a marker of tissue hypoperfusion in sepsis.
WHO CME ANTIBIOTC STEWARDSHIP ITALY
• Describe appropriate blood culture specimen collection techniques to reduce opportunities for contamination, which can lead to inappropriate antimicrobial use
• Review framework for appropriate antimicrobial prescribing for
patients with suspected blood stream infections (BSI).
• Demonstrate opportunities for collaboration between clinicians and microbiologist to achieve the dual goals of antimicrobial and
diagnostic stewardship
Immunodeficiency disorders are associated with defects or impairments in immune function that can be congenital or acquired. Primary immunodeficiency diseases involve genetic defects affecting B cell, T cell, or phagocytic cell development. Common symptoms include recurrent infections, failure to thrive, and increased susceptibility to opportunistic infections. HIV/AIDS is an acquired immunodeficiency disorder that progressively weakens the immune system by attacking CD4 cells, leaving the body vulnerable to opportunistic infections.
Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis, is a rare systemic necrotizing vasculitis characterized by granulomatous inflammation involving the respiratory tract and necrotizing glomerulonephritis. It is associated with the presence of antineutrophil cytoplasmic antibodies (ANCA). Treatment involves inducing remission with high-dose corticosteroids combined with cyclophosphamide or rituximab to prevent organ damage and relapses. With effective treatment, remission rates are high but relapses remain common, requiring long-term management and monitoring.
This document discusses opportunistic infections that can occur in patients with AIDS/HIV. It begins by providing background on the HIV epidemic in India. It then describes the structure and life cycle of HIV. The document outlines the typical stages of HIV disease progression from acute infection to chronic infection to AIDS. It discusses how HIV evades the immune system and establishes a chronic infection. Finally, it provides details on common opportunistic infections caused by fungi, bacteria, viruses and protozoa that patients with advanced HIV/AIDS face, such as Pneumocystis pneumonia, toxoplasmosis and cryptosporidiosis.
HIV/AIDS remains a major global epidemic, infecting over 59 million people worldwide since the 1980s and causing over 20 million deaths. Developing countries account for most new HIV infections, with sub-Saharan Africa the hardest hit region. While there is no cure for HIV, treatment using antiretroviral drugs can control the virus and prevent transmission. Developing an effective HIV vaccine remains challenging due to the virus's ability to mutate and evade the immune system.
The document discusses COVID-19 and how it progresses in the body. It begins by explaining how the virus enters through the nose or throat and makes its way to the lungs, where it attacks the alveoli. This can cause the alveoli to become stuffed with fluid and cells, reducing oxygen intake. The virus or immune response can also damage other organs like the brain, heart, kidneys, and intestines. The document then outlines recommendations from the WHO on treatment and prevention, as well as answering common questions. It concludes by discussing home care and stress management for those recovering from COVID-19.
The document summarizes key information about HIV/AIDS, including:
1. HIV has infected 59 million people worldwide, with 20 million deaths. Developing countries account for 64% of cases and 2/3 of new infections.
2. Common early symptoms of HIV infection include fever, fatigue, rash, headache, lymphadenopathy, and gastrointestinal issues.
3. HIV is transmitted through unprotected sex, blood transfusions, needle sharing, and from mother to child during pregnancy, birth, or breastfeeding.
4. While there is no cure for HIV, treatment with antiretroviral drugs can control the virus and prevent transmission.
HIV attacks and weakens the immune system by destroying CD4+ T cells. This leaves the body vulnerable to opportunistic infections and diseases. AIDS is the final stage of HIV infection where the CD4+ cell count drops below 200, resulting in life-threatening illnesses. There are two types of HIV - HIV-1 is the predominant global type while HIV-2 is less common and concentrated in West Africa. Both can be transmitted sexually, through blood exposure, and from mother to child, ultimately causing AIDS if left untreated.
This document provides information on COVID-19, including:
1) It describes the clinical presentation of COVID-19 including dry cough, fever, and shortness of breath.
2) It explains that COVID-19 was first reported in Wuhan, China in December 2019 and was declared a pandemic by the WHO on March 11, 2020.
3) It discusses the virus taxonomy, noting it is an enveloped, positive sense single stranded RNA betacoronavirus that primarily infects the respiratory system via the ACE2 receptor.
This document discusses AIDS and opportunistic infections. It defines AIDS as the final phase of HIV infection where the CD4+ T cell count drops below 200/uL, making patients highly susceptible to opportunistic infections. Some common opportunistic infections seen in AIDS patients include Pneumocystis jiroveci pneumonia, toxoplasmosis, cryptococcosis, histoplasmosis, candidiasis, mycobacterial infections, and infections caused by viruses like cytomegalovirus and herpes simplex virus. The progression from HIV to AIDS can take from 2-10 years depending on factors like viral load, immune status, and genetic factors.
This document provides information on HIV/AIDS, including:
1. HIV was discovered in 1983-1984 and is the cause of AIDS. It is a retrovirus that infects CD4 cells and progressively destroys the immune system.
2. HIV has three main genes - Gag, Env, and Pol - which code for structural proteins. The virus attaches to and enters CD4 cells via the Env protein, then uses the Pol protein to integrate its genetic material into the host cell DNA.
3. As the virus destroys CD4 cells over many years, it leaves the infected person vulnerable to opportunistic infections. AIDS is diagnosed when the CD4 count drops below 200. Common infections include PCP
This document provides information on the care of patients with sepsis presented by Mesfin Shifara to nursing students. It defines sepsis, explains the pathophysiology and signs. It describes diagnostic procedures, medical management including antibiotics and fluid resuscitation, complications that can arise if untreated, and ways to prevent sepsis. Physiotherapy aims to clear secretions and begin early mobilization once the patient is stable.
Infection Control In Health Care SettingsSagar Desai
The goal of this report was to assess the current and potential future role of diagnostics in hospital-acquired infection (HAI) control programs. We examined current issues resulting from HAIs and determined which infections needed foremost attention. Then, with input from Prof. Neimz, we selected diagnostics available on the market we could use. The final chapter of the review contains a market analysis with info about costs prevented upon implementation of diagnostic recommendations.
In the throes of the current COVID-19 pandemic, intense interest has burgeoned in cardiovascular involvement by the novel coronavirus. While fulminant myocarditis can occur via direct viral infection, many patients experience secondary cardiac involvement. Remote infections like COVID-19 pneumonia can activate the immune system, exacerbating pre-existing coronary atherosclerosis and increasing thrombotic risk. Cytokines may also impair the microvasculature. Additionally, fever and hypoxemia increase oxygen demands while hypotension decreases supply, predisposing to ischemia even without obstructive disease. Multiple mechanisms likely contribute to cardiac complications, and troponin elevations require careful interpretation.
This document provides an overview of infective endocarditis (IE), a rare but life-threatening disease caused by bacterial infection of the heart valves or endocardium. It discusses the epidemiology, risk factors, causative pathogens, pathophysiology, and challenges in diagnosis and treatment of IE. Key points include: IE incidence ranges from 1.5 to 11.6 cases per 100,000 people globally, with mortality around 25% even with treatment; risk factors include underlying heart conditions like rheumatic heart disease as well as healthcare exposures; staphylococci and streptococci cause most cases but proportions vary globally; the vegetation develops through bacterial adhesion to damaged heart valves and formation of a protective matrix.
Septicemia is a life-threatening blood infection caused by bacteria entering the bloodstream from a site of infection. Common symptoms include fever, rapid breathing/heartbeat, low blood pressure, and mental confusion. Bacteria such as E. coli, streptococcus pneumoniae, and salmonella are often involved. The document details types, causes, diagnosis, and treatment of septicemia, including antibiotics and supportive care. It concludes by emphasizing the importance of preventing and promptly treating infections to avoid septicemia.
Hospital acquired infections and their survival rateHafsaQasim1
This document discusses various types of hospital acquired infections, including their causes, symptoms, treatments and survival trends. It covers bloodstream infections, ventilator-associated pneumonia, surgical site infections, and catheter-associated urinary tract infections. The document indicates that hospital acquired infections are a major public health issue, though incidence and mortality rates have decreased in recent years due to improved treatment and prevention efforts.
Splenic Abscess: Etiology, clinical spectrum and Therapyiosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Basic description of Infective Endocarditis from a Clinical and Microbiological point of view with description on Pathogenesis, Clinical Manifestations, Clinical and Laboratory diagnosis.
Infective endocarditis is an infection of the inner lining of the heart chambers and heart valves. It has varying presentations from subacute to acute. Diagnosis involves blood cultures, echocardiography, and clinical criteria. Common causes are bacteria like streptococci and staphylococci. Complications include heart failure, embolic events, and kidney or brain infections. Treatment involves prolonged antibiotics and sometimes surgery.
Principles of Management of Odontogenic Infections.pptxHadi Munib
This document outlines principles for the management of odontogenic infections. It discusses determining the severity based on anatomic location, rate of progression, and risk of airway compromise. Early surgical drainage is important to prevent spread. Cultures should be obtained. Supportive care includes hydration, nutrition, and fever control. Antibiotics are chosen based on culture results and administered properly along with frequent reevaluation of the patient.
This document provides an overview of infective endocarditis, including its definition, pathogenesis, epidemiology, clinical presentation, diagnosis, and treatment. It defines infective endocarditis as a microbial infection of the heart valves or endocardium. It discusses the typical pathogens involved and describes the formation of vegetations on heart valves. It also outlines the diagnostic criteria, including blood cultures and echocardiography. Treatment involves prolonged antibiotic therapy tailored to the causative organism, and may require surgery in cases of heart failure or uncontrolled infection.
The document provides information on sepsis definitions, pathophysiology, and assessment tools. It discusses:
1) The 1992 and 2001 consensus definitions of sepsis, severe sepsis, and septic shock based on SIRS criteria and organ dysfunction.
2) The key pathophysiological processes in sepsis including dysregulated inflammation, coagulation, fibrinolysis and endothelial dysfunction which can lead to organ failure.
3) Limitations of the SIRS criteria and introduction of newer assessment tools like qSOFA and SOFA score which include clinical variables and lab markers to better predict patient outcomes.
The document discusses challenges and future directions in organ transplantation. It outlines how kidney transplantation is an effective treatment for end-stage renal disease but requires lifelong immunosuppression which carries risks. Prevention of organ disease and alternative treatments such as regenerative medicine could reduce transplantation need. Trends show more transplant recipients are older with older donors, increasing risks. Managing immunosuppression side effects and inducing tolerance without drugs could improve outcomes. Coordinated education and research efforts are needed.
This document reviews recent developments in the pathophysiology, diagnosis, and treatment of disseminated intravascular coagulation (DIC). DIC is characterized by widespread activation of coagulation leading to microthrombi formation and bleeding due to consumption of platelets and coagulation factors. The pathophysiology involves increased thrombin generation, impaired anticoagulant pathways, impaired fibrinolysis, and inflammation. Diagnosis is based on clinical presentation and laboratory tests showing coagulation abnormalities. Treatment focuses on replacing consumed platelets and clotting factors, anticoagulation, and modulating the underlying disease process.
This document provides information on approaching and evaluating patients with potential infectious diseases. It discusses taking an exposure and social history, performing a physical exam focusing on vital signs, lymph nodes, skin, and foreign bodies. Diagnostic testing options are outlined including lab tests, imaging, and pathogen-specific tests. Empirical antibiotic therapy is recommended for common infections like pneumonia based on presentation. Community-acquired pneumonia causes are discussed. Hospital-acquired pneumonia treatment typically involves antibiotics until culture results are available. Infective endocarditis typically involves bacterial vegetation on heart valves.
Sepsis is a clinical syndrome with a spectrum of severity ranging from infection to septic shock and multiple organ dysfunction syndrome. Early identification of sepsis is important to help prevent progression using tools like qSOFA and NEWS scores. Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock is a type of circulatory failure distinguished by underlying abnormalities and greater risk of mortality than sepsis alone. Multiple organ dysfunction syndrome refers to progressive failure of multiple organs that cannot be maintained without intervention and increases risk of death.
This document provides an overview of sepsis, including its definitions, epidemiology, pathophysiology, clinical manifestations, complications, diagnosis, and management. It notes that sepsis is a systemic inflammatory response to infection that can lead to life-threatening organ dysfunction. An estimated 750,000 cases of severe sepsis and septic shock occur annually in the US, with over 200,000 deaths. The pathophysiology involves a complex interplay between the host's immune response and invading pathogens. Diagnosis is challenging as there is no single diagnostic test, but suspected cases should be promptly investigated and treated.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
10 Benefits an EPCR Software should Bring to EMS Organizations Traumasoft LLC
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
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Clinical micro biology
1. BAHIR DAR UNIVERSITY
COLLEGE OF MEDICINE
AND HEALTH SCIENCES
8/17/2020 1
Topic:- Blood stream infections
- Sepsis and endocarditis
- Pyrexia of unknown origin
By;- Addisu Tesfaye JULY, 2020
BDU, Ethiopia
2. Outline
Introduction
Definition and Predisposing factors
Epidemiology and Causative agents
Pathogenesis and Laboratory diagnosis
Treatment and prevention
8/17/2020 2
3. Introduction
Blood stream infection (BSI) is one of the most devastating
preventable complications in Critical Care Units.
It has far-reaching consequences resulting in prolonged length of
hospital-stay
Sepsis is a life threatening condition that develops from
Blood poisoning or
Host immune response
Sepsis is a global healthcare issue
The leading cause of death from infection
8/17/2020 3
4. Intro Cont……
Early recognition and diagnosis of sepsis is required to prevent
the transition into septic shock
Endocarditis caused by intravenous foreign bodies from
prosthetic valves pacemaker leads and conduits
Pyrexia of unknown origin (PUO) also known as fever of
unknown origin (FUO) is a grouping of many unrelated medical
conditions that share the feature of persistent unexplained fever
despite basic investigation
8/17/2020 4
5. 1. Blood Stream Infections
Definition
Bloodstream infection is an infection causes by
microorganism in the bloodstream that are alive and
capable of reproducing
Predisposing factors
Blood stream infection from
Health care-associated
Community acquired
Maternally acquired
8/17/2020 5
6. Table 1. Predisposing factors of BSI
Preconditions factors
Health care-associated IV and urinary catheter
Surgical site associated
Cardiac, orthopedic devices
Patients in ICU
Community acquired When the episode is not health care associated
Manifest with in 48 hrs admission
Maternally acquired Infection of neonate
Acquired from mother during delivery
Infection appears with less than 48 hrs of birth
8/17/2020 6
7. Epidemiology
Exact rates of BSI differ markedly worldwide
BSI most frequent in intensive care units
There are 2 major sources of IVDR BSI:
A. Catheter-related infection, are responsible for most endemic
BSIs
B. Contamination of the fluid administered through the device is
the cause of most epidemic BSIs
8/17/2020 7
8. Causative agents
A blood stream infection must meet following conditions
1. Recognized pathogens
Isolation of one or more recognized bacterial or
fungal pathogen from one/more blood culture like
8/17/2020 8
S. aureus,
S. pneumoniae,
E.coli,
Proteus
Corynebacterium,
Klebsiella,
Salmonella
Candida
9. Cont… … Caus
Corynebacterium
CONS
Bacillus
α-hemolytic Strept
Non-pathogenic Neisseria
Environmental G-ve bacteria eg: Pseudomonas
8/17/2020 9
2. potential contaminants
The patient has at least one of the following a positive culture
being collected
10. Pathogenesis
BSI causes by dissemination pathogens from other site of infection
Organisms are carried from hospital environment
A. Central Line Associated Blood Stream Infection (CLABSI)
B. Catheter Related Blood Stream Infection (CRBSI)
Examples :- Catheter-related infection
First gain organisms access to surface of the device
They can adhere and become incorporated into a biofilm
Sustained infection and hematogenous dissemination
Microorganisms gain access by different mechanism
8/17/2020 10
11. Sources of intravascular catheter infection
8/17/2020 11
Intraluminal
from tubes and hubs
Extra luminal
from skin
Haematogen
from distant sites
12. Laboratory diagnosis
1. Blood culture
2.MALDI-TOF (Matrix-assisted laser desorption/ ionization time-of-
flight mass spectrometry) analyte molecules
Can provide genus and species level identification
Significant time saving over conventional methods
3.Modified PCR/ESI-MS (electrospray ionization mass spectrometry)
provide
Genotyping, virulence marker and resistance mechanism
8/17/2020 12
13. Cont … …Lab
4 . Diagnostic tools for early detection of candidemia
Clinical and radiological signs are non specific
Traditional culture-based tools suffer from low sensitivity
Generated interest include combined detection
Mannan antigen
Anti-mannan antibodies,
𝛽-1, 3, D-glucan
Molecular techniques
8/17/2020 13
14. Treatment and prevention
Multidrug resistant bacteria in hospitals cause therapeutic
challenges therefore
Develop strategies to prevent BSI infections
Education and training of health-care workers,
Use of maximum sterile barrier precautions
Appropriate skin antisepsis during central venous catheter
insertions
Rx: Based on AST of isolate
8/17/2020 14
15. 2. Sepsis
Definition
Sepsis is a life threatening condition from blood poisoning
Can be systemic inflammatory response syndrome
Can be bacterial, viral, fungal, and parasitic infection
8/17/2020 15
16. Table 2. Three stages of sepsis
stages of sepsis Symptoms and severity
Sepsis Sepsis syndrome
High fever, rapid breathing and high pulse
Sever sepsis sepsis syndrome
complication of organ dysfunction,
hypotension,
oliguria, hypoxia, confusion, slurred speech and dizziness
Septic shock sepsis syndrome
organ dysfunction
Hypotension
unresponsive to adequate fluid replacement
8/17/2020 16
17. Predisposing factors
Organisms vary with several factors such as
Low immunity due to
HIV/AIDS,
Cirrhosis,
Autoimmune disease
Solid organ transplantation
8/17/2020 17
Pregnant women
Newborns
Elderly
Low immunity
Diabetes
Life support devices
Surgery
Chronic kidney disease
Neutropenia
Cancer
Inflammatory disorder
18. Epidemiology
Over the past 40 years the incidence of severe sepsis has
substantially increased,
Common (More than 200,000 cases per year in US)
Women have a lower incidence of severe sepsis
Older patients are far more likely to develop sepsis
Only AIDS, neutropenia and cancer
Were idependent risk factors for 28 day
mortality
Genetic variants like polymorphisms in Toll-like receptor (TLR4)
and TLR1 have been associated with increased susceptibility to
sepsis
8/17/2020 18
19. Table 3. Genetic variants and sepsis
TLR4 polymorphism Mechanism
Asp299Gly variants and Protection against cerebral malaria
Related to ethnic deferences in incidence and
severity of sepsis
SVEP1 allele frequency Which encodes a cell adhesion molecule
Capable of interacting with complement,
growth factors, integrins, and cytokines
FER gene (Fps/FES related tyrosine kinase,
Cytosolic protein
Involved in leukocyte recruitment
Associated with increased survival from sepsis
patients with pneumonia
NOD2 were additive in increasing the risk of
bacteremia
and hospital mortality
8/17/2020 19
20. Causative agents
A. Non-infectious
Patients who develop a clinical picture of sepsis without an
identifiable infection
Several sterile inflammatory conditions can also progress to shock
and multiorgan failure these include
8/17/2020 20
Pancreatitis
Tissue ischemia
Trauma
Surgical tissue injury
Thromboembolism
Vasculitis
Drug reactions
Burns
21. Cont… …Cau
2. Infectious
The infectious causes of sepsis
Gram-positive bacteria-cocci
Gram-negative bacteria-bacilli
fungi (Candida),parasites and viruses
The site of infection mainly
8/17/2020 21
Lungs
An infected insect bite
Abdominal infection
Wound infection
Genitourinary tract
Central line infection
22. Pathogenesis
Sepsis
8/17/2020 22
Pathogenic
products and
components
Activation of
coagulation and
complement system
Tissue factor release
fibrinolytic activity
Macrophage
and other
immune cell
TNF –a
IL-1
IL-6
Neutrophil
activation
aggregation and
Degranulation
Release ROS and
protease
Platelet
activation and
degranulation
Endothelial damage
Tissue injury
Organ dysfunction
T-cell release
IL-1 and INF-ý
23. Cont … … path
Among bacteria inflammatory and coagulation pathways may
be complex interactions
Malfunction of the regulatory mechanisms during sepsis
Loss of control inflammation due to the excessive activation
of the inflammatory response
Widespread tissue factor expression, fibrin deposition, and
impaired anticoagulant mechanisms
Can produce and disseminated intravascular coagulation (DIC)
Widespread immunothrombosis can result in DIC
8/17/2020 23
24. Cont… … path
Impaired microvascular function and organ injury
Asyndrome associated with increased organ dysfunction
Bleeding and mortality
pathogenesis in different level
A. Organ and tissue level
A sepsis progresses from a localized infection to mild systemic
inflammation and on to septic shock, disseminated to different
organ
The endothelial changes in severe sepsis are associated with altered
barrier function in other organs
8/17/2020 24
25. Tabel 4. sepsis in different Organ
Organ pathogenesis in sepsis
Lung Permeable lung capillaries and accumulation of protein-rich edema fluid
Alveolar epithelial barrier dysfunction and edema fluid floods into alveoli
Mismatch arterial hypoxemia and reduced lung compliance
Breakdown endothelial and epithelial barriers lethal organ dysfunction
Gastro intestinal Gut epithelium permeable in hypercytokinemia
Gut injury by pancreatic enzymes (autodigestion)
Bacterial translocation
Worsening systemic inflammation and multiple organ dysfunction
Liver Impairs hepatocyte and loss crucial hepatic functions
Loss clearance of bilirubin
Loss transport and processing of enteric pathogen lipids
Acute kidney
injury (AKI)
Is common in severe sepsis and increases the risk of death
Cytokine and immune mediated microvascular tubular dysfunction
Nervous system Endothelial dysfunction compromises the blood-brain barrier
Cytokines and cells to enter the brain causing encephalopathy
8/17/2020 25
26. Cont… …path
B. Cellular and molecular level
Asingle inflammatory macrophage derived cytokine can produce a
clinical picture of septic shock
Proteins such as complement and fibrinogen cause neutrophils to
release extracellular traps (NETs),
Inflammatory cytokine production response is rapid control
localized infections but response exceeds systemic injury occurs
8/17/2020
26
27. Table 5. Cellular and molecular level
Pathophysiologic
processes
Mechanism
Inflammatory
signaling
Inet immune cell to detect PAMPs, DAMPs and receptors in the cytosol
Transcription type I interferons , TNF-a IL-1 and IL-6
NOD assemble in to inflammasomes
Maturation and secretion IL-18 and IL-1ß,
Can trigger highly inflammatory and programmed cell death by caspase
Early damage
pathways
Inflammatory cytokine production
Reactive oxygen species (ROS) production
Damage cellular proteins lipids, and DNA
Impair mitochondrial function
Metabolic dysfunction ATP levels drop at the cellular level
Catabolism
Rapid breakdown of muscle tissue
Proliferation of innate immune cells
Resolution pathways Anti-inflammatory cytokine pathways are activated
Produced IL-10 suppresses production of IL-6 and interferon ý
Production receptors anti TNF-a and IL-1 signaling to neutralize
Subcellular level autophagy provides to eliminate DAMPs and PAMPs
Lysosomal degradation of pathogens, damaged organelles and proteins
Reducing inflammasome activation8/17/2020 27
31. Diagnosis
It’s difficult to self- diagnose blood poisoning because its
symptoms mimic those of other conditions
First perform a physical exam
Lab dx
Imaging scan :- Detect infection in body’s organs
8/17/2020 31
Blood culture and PCR
Blood oxgen levels
Blood count
Clotting factor
Urine tests including urine culture
Electrolyte and kidney function tests
X-ray
CT scan
Mri Scan
Ultrasound
32. Treatment and Prevention
Treatment of blood poisning is essential because the
infection can quickly spread to tissues or heart valves
Showing symptoms of shock admitted to the ICU
Sepsis is usually treated with
Mechanically ventilated
Dialysis
Vasopressor resuscitation
Prevention
• Source control should be considered
8/17/2020 32
Hydration
Use of blood products
Intravenous antibiotic therapy
34. 3. Endocarditis
Definition:
Is an infection of the endocardium, which is the inner lining of
heart chambers especially heart valves
Risk factors
Intravenous foreign bodies from
prosthetic valves pacemaker leads and conduits and also
Bacteremia
Hematogenous infection
Intravenous drug abusers
8/17/2020 34
Urinary catheterization
Small injuries to skin
Mucosal surfaces injuries
35. Epidemiology
Infective endocarditis is uncommon but not rare infection
Affecting 10,000 to 20,000 persons annually in the United States
Accounts for approximately1 in every 1,000 hospital admissions
Causative agent
Generally occurs when bacteria, fungi or other germs from another
part of the body spread through bloodstream and attach to damaged
areas
8/17/2020 35
36. Pathogenesis
Infective endocarditis begins when germs enter the bloodstream
and then travel to the heart
The path physiology of infective endocarditis comprises at least
three critical elements:
Preparation of the cardiac valve for bacterial adherence
Adhesion of circulating bacteria to the prepared valvular
surface
Survival of the adherent bacteria on the surface
8/17/2020 36
38. Clinical feature
Non specific symptoms, low grade fever , headache, fatigue…
CHF
8/17/2020 38
39. Diagnosis
Blood culture and PCR,
Serological tests and BFA
Electrocardiogram (ECG) for myocardial status
Treatment:
Antibiotics IV for 2-8 weeks and Surgery to replace valves
Prophylaxis in high risk pts. like tonsillectomy, infections of
the GI or GU and urinary tract manipulation
8/17/2020 39
40. 4. Pyrexia of Unknown Origin
Definition:
Pyrexia of unknown origin refers to a condition in which the
patient has an elevated temperature but despite investigations by
a physician no explanation has been found
Risk factors
Infection
Noninfectious inflammatory diseases
Neoplasm
Thermoregulatory disorders
8/17/2020 40
42. Clinical features
Death is rare but can occur due to
Respiratory obstruction
Haemorrhage (splenic rupture or thrombocytopenia
Encephalitis
8/17/2020 42
43. Table 6. Classification of Fever of Unknown Origin (FUO)
Category of
FUO
Definition Common etiologies
Classic Temperature >38.3°C (100.9°F) Infection,
Malignancy,
COllagen vascular disease
Duration of >3 weeks
Evaluation of at least 3 outpatient
visits or 3 days in hospital
Nosocomial Temperature >38.3°C Clostridium difficile enterocolitis,
Drug-induced,
Pulmonary embolism,
Septic thrombophlebitis,
Sinusitis
Patient hospitalized ≥24 hours but
no fever or incubating on admission
Evaluation of at least 3 days
Immune
deficient
(neutropenic)
Temperature >38.3°C Opportunistic bacterial infections,
Aspergillosis,
Candidiasis,
Herpes virus
Neutrophil count ≤ 500 per mm3
Evaluation of at least 3 days
HIV-
associated
Temperature >38.3°C Cytomegalovirus,
Mycobacterium avium-intracellulare
complex,
Pneumocystis carinii pneumonia,
Drug-induced,
Kaposi's sarcoma,
Lymphoma
Duration of >4 weeks for
outpatients, >3 days for inpatients
8/17/2020 43
44. Lab Diagnosis
General Lab indicators: CBC, ESR, CRP, BF and BFA
Blood, Urine culture
Serology
Treatment
Generally avoid empirical treatment
Since it can mask / delay diagnosis
8/17/2020 44
45. Summary
Improving the methodologies for detection, prevention, and
management of blood stream infections so that we can reach a
stage of “zero” morbidity and mortality from this infection
Sepsis is a severe blood infection, introduces a large number of
bacteria into the bloodstream and affected organ.
The number of bacteria in the bloodstream is large enough
endocarditis can develop, even in people who have normal heart
valves
Endocarditis occur mitral valve or the aortic valve is infected.8/17/2020 45