Transcript 1133693644_460433

CHAPTER 8
Microbiological Diseases:
Non-Respiratory Infectious Diseases
8-2
Introduction
• This chapter includes a discussion of
infectious diseases of systems of the body
(except respiratory system)
• Includes
•
•
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•
Diseases
Symptoms
Diagnostic procedures
Treatments
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Infectious Diseases of Head and Neck
• Meningitis
– Inflammation of meninges (viral or bacterial)
– Signs/Symptoms (S/S): fever, nuchal rigidity,
fatigue, headache, decline in mental status
– Diagnostics: blood culture, lumbar puncture,
gram stain, CSF culture
– Transmission: respiratory droplets
– Treatment: antibiotics (if bacterial)
(Continues)
8-4
Infectious Diseases of Head and Neck
• Encephalitis
– Inflammation of brain tissue
– S/S: fatigue, headache, abnormal brain
function, seizures, paralysis, abnormal
movements
– Diagnostic: lumbar puncture
– Treatment: acyclovir
– Prognosis: death (if untreated)
(Continues)
8-5
Infectious Diseases of Head and Neck
• Otitis media
– Inflammation of middle ear
– S/S: irritability, ear tugging, decreased energy
and appetite, fever, vomiting
– Treatment
• Antibiotics/topical steroids/analgesics/NSAIDs
• Myringotomy
• No ASA due to possibility of Reye syndrome
(Continues)
8-6
Infectious Diseases of Head and Neck
• Parotitis
─Infection of parotid gland
─S/S: localized redness, swelling, firmness,
and pain; difficulty swallowing; high fever;
chills
─Treatment
• Antibiotics
8-7
Infections of the Eye
• Conjunctivitis
– Inflammation of sclera
– Acute: noninfectious (allergies)
– Bacterial: usually contagious
– Viral: contagious, often preceded by URI
– Treatment
• Bacterial: topical antibiotics
• Viral: antihistamines/decongestants
(Continues)
8-8
Infections of the Eye
• Keratitis
– Inflammation of cornea
– Due to: viruses, bacteria, parasites, fungi
– Can cause blindness; refer to ophthalmologist
immediately
– Diagnostic: culture
– Treatment: antibiotics if bacterial (medication
is compounded by pharmacist, since not
commercially available), antivirals if due to
Herpes simplex
8-9
Cardiovascular Infections
• Endocarditis
– Infection in one or more heart valves
– S/S: dyspnea; fever; edema of legs/feet;
petechiae/lesions of skin, hair, nails
– Diagnostic: echocardiogram
– Treatment
• Valve replacement
• IV antimicrobials
– Prognosis: death if not properly treated
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Catheter-Related Bloodstream
Infections (CRBIs)
• Types of catheters (based on infusion site)
– Central (subclavian, internal jugular, femoral)
• S/S: localized redness and purulent drainage,
fever, hypotension, change in mentation
• Diagnostic: culture from catheter and from a
peripheral vein
• Treatment: antimicrobials, removal of catheter
– Peripheral (arms/hands), rarely infected
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Infectious Diseases of Skin and Soft
Tissues
• Cellulitis
– Infection of lower dermis/fat tissue
– S/S: flat, red area on skin; difficult to
distinguish border; possible drainage
– Slow development
– Risk factors: non-intact skin; chronic edema of
extremities
– Treatment
• Antibiotics
(Continues)
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Infectious Diseases of Skin and Soft
Tissues
• Erysipelas
– Infection of upper dermis and lymphatics of
skin
– S/S: redness with swelling of tissue above
level of skin, fever, chills
– Abrupt onset
– Treatment
• Antibiotics
(Continues)
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Infectious Diseases of Skin and Soft
Tissues
• Necrotizing skin and soft tissue infections
(including necrotizing fasciitis)
– Serious, rapid destruction of skin/fascia
– Anaerobic or aerobic
– S/S: edematous, fluid-filled blisters at site;
fever; tachycardia; hypotension; confusion;
decreased urine output
– Treatment
• Debridement, antibiotics
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Intra-Abdominal Infections
• Appendicitis
– S/S: abdominal pain, radiating from navel to
right lower abdomen; nausea; vomiting; loss
of appetite
– Treatment
• Surgery
• Antibiotics, if required
(Continues)
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Intra-Abdominal Infections
• Acute cholecystitis
– Presence of stone blocking bile flow
– S/S: fever, right upper abdominal pain
radiating to back or right shoulder, nausea;
vomiting; lack of appetite, onset of pain one
hour after eating fatty meal
– Diagnostic: gallbladder ultrasound
– Treatment: surgery, antibiotics, if required
(Continues)
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Intra-Abdominal Infections
• Diverticulitis
– Inflammation of diverticula
– Rupture can cause localized abscess, diffuse
peritonitis (or death if not treated)
– S/S: pain in left lower abdomen, nausea,
vomiting, constipation or diarrhea
– Treatment
• Antibiotics
(Continues)
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Intra-Abdominal Infections
• Clostridium difficile colitis
– Mild to severe and/or life-threatening
– Usual history of antibiotic therapy
10 weeks prior to onset of symptoms
– S/S: diarrhea, abdominal pain with cramping,
low-grade fever, leukocytosis
– Diagnostic: symptoms, history of antibiotics
– Treatment: contact isolation, combination
therapy
(Continues)
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Intra-Abdominal Infections
• Infectious diarrhea
– Associated with consumption of contaminated
food, travel, or exposure to pets
– S/S: abdominal cramps, diarrhea that might
be bloody
– Treatment: self-limiting, replacement fluids
– Source: usually food, not water
– Prevention: handwashing, cautious food and
beverage consumption
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Genitourinary Tract Infections
• Sexually transmitted diseases
• Preventable with safe sex practices
– Chlamydia
• Incubation period 7–21 days
• Males: asymptomatic (or) painful urination, mucoid
discharge from penis
• Females: cervicitis, urethritis, salpingitis,
endometritis, PID
• Treatment: doxycycline or azithromycin
(Continues)
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Genitourinary Tract Infections
• Sexually transmitted diseases
– Gonorrhea
• Asymptomatic (or) urogenital, pharyngeal and
rectal infections (males and females)
• Conjunctivitis (young children and adults)
• Coinfection with chlamydia is common
• Treatment: ceftriaxone, cefixime, azithromycin
(Continues)
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Genitourinary Tract Infections
• Herpes simplex 1 or 2
– Type 2 usually causes genital herpes
– S/S: asymptomatic (or) blisters around
rectum/genitals
– Outbreaks may recur since viruses cannot be
eliminated from the body
– Treatment
• Antivirals
(Continues)
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Genitourinary Tract Infections
• Human immunodeficiency virus (HIV)
– If untreated, progresses to AIDS
– Risk factors: STD, injection drug use,
receiving blood products, needle stick of
health care workers
– S/S: similar to common cold
– Treatment
• Antiretrovirals
• Lack of treatment leads to opportunistic infections
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Bone and Joint Infections
• Osteomyelitis
– Infection in one or more bones of the body
– S/S: localized pain, redness, warmth and
edema at site; fever; chills
– Treatment
• Debridement
• Antibiotics
• Surgery to remove necrotic bone
(Continues)
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Bone and Joint Infections
• Septic arthritis
– Infection in one or more joints of the body
– Risk factors: diabetes, steroid use, surgery or
trauma to joint, rheumatoid arthritis,
IV drug use, advanced age
– S/S: painful, swollen joint; warmth at site;
fever with chills; pain with movement of joint
– Treatment
• Antibiotics
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Summary
• Clinical presentation, diagnosis, treatment
of common non-respiratory infections
– Infectious diseases of the head and neck
– Infections of the eye
– Cardiovascular infections
– Infectious diseases of the skin and soft tissues
– Intra-abdominal infections
– Genitourinary tract infections
– Bone and joint infections
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Summary
• Treatment
– Empiric therapy if required
– Appropriate anti-infective when microbe is
targeted
• Refer to text/tables for expanded
information related to diseases, treatments
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