Post on 17-Jan-2016
CHAPTER 8 Microbiological Diseases:
Non-Respiratory Infectious Diseases
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Introduction
• This chapter includes a discussion of infectious diseases of systems of the body (except respiratory system)
• Includes• Diseases• Symptoms• Diagnostic procedures• Treatments
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• 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)
Infectious Diseases of Head and Neck
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• 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)
Infectious Diseases of Head and Neck
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• 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)
Infectious Diseases of Head and Neck
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• Parotitis─Infection of parotid gland─S/S: localized redness, swelling, firmness,
and pain; difficulty swallowing; high fever; chills
─Treatment• Antibiotics
Infectious Diseases of Head and Neck
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• Conjunctivitis– Inflammation of sclera– Acute: noninfectious (allergies)– Bacterial: usually contagious– Viral: contagious, often preceded by URI– Treatment
• Bacterial: topical antibiotics• Viral: antihistamines/decongestants
(Continues)
Infections of the Eye
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• 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
Infections of the Eye
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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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• 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)
Infectious Diseases of Skin and Soft Tissues
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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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