Flashcards in Infection Deck (188)
Why are cf patients more at risk of infection?
Lack of mucous clearence
Lung damage (bronchiectasis)
Why should cf cf contact be reduced?
Environmental psuedomonas tx is amenable to ABX but given time in a cf pt it develops ability to produce biofilm becoming much harder to treat - this can be spread to other cf patients
What pathogens are associated with copd exacerbations?
Haemophilus influenzae, pseudomonas aeruginosa, respiratory syncytial virus, parainfluenza virus, influenza A
Why are poorly controlled diabetics more at risk of infection?
Impaired humoural, neutrophil and lymphocyte function
Microvascular damage = poor tissue perfusion = damage
Neuronal damage = not noticing stimuli = damage
Sugar in urine = food for uti
What specific infections are associated with diabetes?
Malignant otitis externa
What are risk factors for uti in diabetics?
Increases glucose in urine
Neurogenic bladder that doesn't empty fully
What pathogens are prone to infecting diabetic foot ulcers?
Streptococcus pyrogenes (beta haemolytic)
What is malignant otitis externa?
Otitis externa with psuedomonas aerugenosa that can spread to neighbouring soft tissue and bone
What is rhinocerebral mucormycosis?
Mold fungi like aspergillus effecting paranasal sinuses invading blood vessels
Does downs syndrome effect risk of infection?
Yes - higher risk of urtis and lrtis due to altered structure of mouth and airways
What is an immunodeficiency?
A state in which the immune system is unable to respond appropriately and effectively to infectious microorganisms
What immune system deficites (generally) can cause immunodeficiencey
What about an infection should make a clinician consider immunodeficiency?
S - severe
P - persistent
U - unusual
R - recurrent
Other than infection what are other issues with immunodeficiency?
Linked to autoimmune disease and malignancy
What are the categories of primary immunodeficiency? What are each group vulnerable too?
B cell - bacterial infection
T cell - viral (and fungal) infection
Complement - bacterial infection
Phagocyte - bacterial and fungal infection
What are the main B cell deficiencies?
Common variable immune deficiency
IgG subclass deficiency
What is CVID?
Common variable immunodeficiency
Inability of B cells to mature into plasma cells
What is brutons disease?
X linked agammagloblinaemia
Impaired b cell development with low igg and iga
Hw do b cell deficiencies present?
Recurrent bacterial urti and lrti
Lyphatic and gastric cancers
How do you treat b cell deficiencies
Avoidance of unnecessary radiation due to cancer risk
Give two t cell deficiencies
De georges syndrome
Severe combined immunodeficiency (SCID)
What are the problems in de georges syndrome
C - cardiac abnormalities
A - abnormal facies
T - thymic hypoplasia
C - cleft palate
H - hypocalcaemia
Tx of de georges syndrome
Bone marrow transplant
How do SCID diseases present?
Failure to thrive
Viral and fungal infections (PCP, CMV, VZV, EBV)
Skin and organ abcesses
Low t lymphocytes and decreased b activation so low ig
How do you treat SCID?
Reverse barrier nursing
Bone marrow transplant
How do complement deficiencies present?
Hereditory angioedema (C1 inhibitor deficiency)
Recurrent bacterial infections (C3 deficiency)
Neiserria infection (C5-7 deficiency)
What are the phagocyte deficiencies?
Leukocyte adhesion deficiency
Chronic granulomatous disease
Failure of phagosome formation
What is chronic granulomatous disease?
Lack of respiratory burst
How do phagocyte deficiencies present?
Bacterial and fungal infections of the skin, mucous membranes and lungs