February 5, 2016 - Infections

Question 1

When to Suspect Immunosuppression?

Answer 1

1. Prolonged course of infection
2. Unusual organism or infection site
3. Severity is greater than expected

Question 2

Treatment for PJP

Answer 2

Septra

AKA Trimethoprim / Suphamethoxazole

Question 3

Prophylaxis in AIDS

Answer 3

Septra should be given prophylactically daily uintil the CD4 count returns above 200 for at least 6 months.

CD4 counts below 200 pose a risk for serious infections.

Question 4

Splenectomy and Infection

Answer 4

More likely to infected with…

1. Streptococcus pneumoniae

2. Haemophilus infleuzae

3. Neisseria meningitiditis

Vaccinate your patient against these.

Question 5

Aspergillus Infection

Answer 5

Aspergillus is everywhere. In patients who are severely immunocompromised such as bone marrow patients, aspergillus can cause lung infections.

Note the “halo” on the CT scan. This will progress to an air crescent in about a week. Will not show up well on CXR.

Question 6

Treatment of Aspergillus

Answer 6

Voriconazole

Even with treatment, mortality is about 50%.

Question 7

Air Crescent Sign

Answer 7

Aspergillus lung infiltrate after about Day 7.

Treat with voriconazole.