E:2.2 Flashcards
(83 cards)
Where are intra-abdominal infections?
Contained to the peritoneum or retroperitoneal space
Where can intra-abdominal infections come from?
Can arise from contamination of these sterile sites by microbiota bacteria via perforation (spillage) of the GI tract
Intra-abdominal infection that is generalized
Peritonitis
Intra-abdominal infection that is localized
Abscess, appendicitis
Bacterial Peritonitis
General (diffuse) inflammation of serous lining of the peritoneum
Primary peritonitis
Inflammation without evident intra-abdominal disease
Also caused spontaneous bacterial peritonitis (SBP) usually only involves one pathogen.
Pathogens: E. coli
Primary peritonitis is most commonly associated with what?
Liver disease (cirrhosis)
Pathophysiology of Primary Peritonitis
Inflammation due to both bacterial toxin and WBC cytokines
*Exudate from blood floods the peritoneum containing the infection → dramatic decrease in circulating blood volume → death due to hypovolemic shock
Secondary peritonitis
Infection due to spillage of bowel content that usually will contain a mixture of microbiota (enteric) bacteria into the peritoneum
Secondary peritonitis pathogens
GI anaerobes (B. fragilis, Clostridium, Peptostreptococcus), Gram (-) bacilli (E. coli), Enterococcus
Tertiary peritonitis
Recurrent infection after therapy; usually occurs in health-care setting after surgery
Intra-abdominal Abscess
A pocket of infected fluid or pus that forms in the abdominal cavity.
Intra-abdominal Abscess common causes
Common causes include ruptured appendix and inflammatory bowel disease.
Intra-abdominal Abscess common pathogens
E. coli (aerobe) and B. fragilis (anaerobe)
Intraperitoneal Abscess
abscess in the abdominal cavity from colon fecal spillage
Intraperitoneal Abscess pathogens
Intestinal flora, infections are usually polymicrobial. GI anaerobes (B. fragilis*, Clostridium, Peptostreptococcus), Gram(-) bacilli (E. coli), Enterococcus
Retroperitoneal Abscess
Near the kidney or spine
Retroperitoneal Abscess pathogens
GI anaerobes (B. fragilis, Clostridium, Peptostreptococcus), Gram (-) bacilli (E. coli), Enterococcus
Visceral abscess
Within abdominal organs
Visceral abscess pathogens
GI anaerobes (B. fragilis, Clostridium, Peptostreptococcus), Gram (-) bacilli (E. coli), Enterococcus
Hepatic abscess
Due to perforation of biliary tract
Cholecystitis, Cholangitis cause
Caused by obstruction of the biliary tree (gallstone)
Septic cholecystitis (gallbladder) results from contamination by GI bacteria
Cholecystitis, Cholangitis pathogens
Infections are usually polymicrobial
GI anaerobes (B. fragilis, Clostridium, Peptostreptococcus), Gram (-) bacilli (E. coli), Enterococcus
Appendicitis
Septic appendicitis results from contamination by GI bacteria
Appendicitis is the most common cause of intra-abdominal sepsis