Infectious Disorders

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Infectious Disorders
2013-12-02 00:23:49
infectious disorders

infectious disorders
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  1. Fever in a Neonate (FIN) is defined as
    a neonate, aged birth-28 days, with a fever derived as a rectal temp of ≥ 38
  2. Why are neonates at higher risk of developing a serious bacterial infection (SBI)
    • immune function (or lack thereof)
    • during the 3rd trimester, the fetus receives some of the maternal IgG, but these wane over time.
  3. How are neonate's immune system impaired?
    • the function of the B & T cells is impaired
    • natural killer cells cyctotoxic activity is decreased
  4. FIN - 2 most common bacterial infections
    • urinary tract infection
    • occult bacteremia -25% develop meningitis
  5. Most common cause of fever in a neonate (FIN)
    viral infections
  6. Fever of unknown origin (FUO)
    illness of more than 3 weeks duration with a fever of 38.3 or more on most days and without diagnosis after a week of intense investigation
  7. Neutropenia is defined as
    • an ANC of less than 500 neutrophils/mm3
    • less than 1,000 neutrophils/mm3 and an anticipated decline to less than 500 neutrophils/mm3
  8. health care-associate infections (HAI)
    • are infections that occur within the health care facility
    • these pts are often already impaired immunologically
  9. Health care associated infections will often present
    • with a new-onset fever
    • EXCEPT THE INFANT/PREEMIE - who would present w/ temperature instability or hypothermia; poor feeding/increased irritability
  10. Fungal infections - what are the 3 types that cause clinical illness in immunocompetent hosts
    • histoplasmosis
    • coccidiodomycosis
    • blastomycosis
  11. Histoplasmosis occurs when
    mold spores are inhaled and migrate to the distal bronchioles and pulmonary alveoli, where they are phagocytized by alveolar macrophages
  12. Histoplasmosis - once inside the macrophage, what happens to the mold
    it converts to yeast
  13. within 1-3 weeks, what happens to the respiratory tract?
    • it becomes inflamed 
    • histopathologic changes occur
    • subsequent lesions become encapculated, fibrotic, granulomatous and sometimes calcified
  14. Coccidioidomycosis is caused by
    dimorphic fugi that are spore forming molds in soil.
  15. After inhalation of coccidioidomycosis,
    the spores germinate in the lungs w/ subsequent cleavage and spread of endospores - these serve to exponentially increase the number of fungal elements in the host
  16. What kind of inflammatory response stems from the granulomatous inflammation from coccidioidomycosis?
    • neutrophilic
    • and it's dependent upon T cell mediated immunity to clear the organism from the host.
  17. Where doesn't the coccidioidomycosis infection usually present?
    it rarely causes extrapulonary infection
  18. Coccidioidomycosis species are endemic in
    hot, arid regions of the southwestern US: southern CA, AZ, western & southern TX, NM, southern NV and UT, but also Mexico, central & south america
  19. Coccidioidomycosis is also known as
    San Joaquin Valley fever

    Valley fever?
  20. Blastomycosis is a
    dimorphic fungus that produces conidia from the hyphae of the mycelial for at room temperature & in soil
  21. Blastomycosis. Infection occurs by
    inhalation of the conidia into the lungs
  22. Blastomycosis. Once the conidia reach body temperature in the infected tissue,
    it is transformed into the yeast form
  23. Blastomycosis. Once the fungus reaches yeast form, it ...
    germinates and are phagocytized by pulmonary macrophages, beginning suppurtive inflammation
  24. Blastomycosis thrives in
    • warm, moist, acidic environments, like the eastern North America
    • in the MI, OH and lower St. Lawrence River Valleys
    • in the Lake Michigan basin
    • in several eastern US states
    • in northern Ontario
    • in bordering eastern Manitoba