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PPT On Infections

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Published in: Medicine
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I comprehensively cover infections in immunocompromised individuals. The presentation describes: Immunocompromised state Febrile neutropenia Management of febrile neutropenia Diseases of HIV positive adults Timeline of infections post-solid organ transplantation

Noor U / Dubai

6 years of teaching experience

Qualification: Bachelor of Medicine, Bachelor of Surgery (MBBS) IGCSE and A level Cambridge Intl School Dubai

Teaches: Science, Medicine, Biology, Chemistry, SAT, USMLE, Pharmacology, Physics

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  1. Infection in immunocompromised host
  2. Objectives Describe immunocompromised state Describe febrile neutropenia Describe management of febrile neutropenia Common diseases of HIV positive adults Other opportunistic infections List causative organisms of infections post solid organ transplantation Describe the timeline of infections post-solid organ transplantation
  3. What does it mean to be immunocompromised? Immunocom romisation, also known as immunodeficienc , is a state in which the immune s stem's abilit to fi ht infectious diseases and cancer is com romised or entirel absent. Most cases are ac uired "seconda ") due to extrinsic factors that affect the atient's immune s stem.
  4. There are 2 t es of immunodeficiencies: Primary immunodeficiencies. Primar immunodeficienc disorders FIDD area rou of over 400 inborn errors of immunitv PIDD ran e in severit from life-threatenin disorders resentin in infanc to less severe isorders dia nosed in adulthood. Exam les: Wiscott-Aldrich s ndramc. Severe combined immunodeficiency disease (SCIDI DiGoorgo syndrom2 Secondary immunodeficiencies. secondar immune deficienc disease occurs when the immune s stem is com romised ue to an environmental factor. Exam les of these outside forces include HIV. chemotherap•yq severe burns or malnutrition (50% population in poor countries)
  5. Common diseases of HIV positive adults:
  6. Continued
  7. HIV RNA Copies per ml Plasma
  8. Opportunistic Fungal Infections in Immunocompromised
  9. Continued
  10. What is febrile neutropenia? Neutro enic fever is defined as a sin le oral tem erature reater than or e ual to 101 F, or a tem erature e ual to 100.4 F for at least an hou with an absolute neutro hil count ANC of less than 1500 cells/microlite in severe neutro enia, the absolute neutro hil count ANC is less than 500 or ANC is ex ected to decrease below 500 cells/microL in the next 2 hours reater than or er microliter,
  11. N/A
  12. History and Physical A detailed histor of patients resentin illness chemothera treatment medication use revious histor of infections es eciall with bacterial resistant or anisms, and the resence of aller ies, should be noted to uide our thera Si nificant risk factors for the develo ment of febrile neutro enia include older a e, comorbidities, the s ecifict e of cancer, and thet e and number of m elosu ressive chemothera a ents in use. Evaluation CBC Blood, urine analysis, throat cultures. Chest X ray The Multinational Association for Supportive Care in Cancer (MASCC) and The Clinical Index of the Stable Febrile Neutropenia (CISNE) can be part of the patient interview. These tools can help to risk-stratify patients into a high-risk and low-risk neutropenic fever.
  13. Management Low-risk patients- oral empiric therapy with a fluoroquinolone plus amoxicillin/clavulanate in out atient. Clindam cin- enicillin aller ies. If the atient remains febrile for 48 to 72 hours, the atient will re uire admission. For hi h-risk atients resentin with neutro enic fever, an intravenous antibiotic thera should be iven within 1 hour after tria e and be monitored more than 4 hours before dischar e. Vancom cin- not recommended for initial thera but should be considered if sus ectin catheter- related infection, skin or soft tissue infections, neumonia, or hemod namic instabilit . If atients do not respond to treatments, coverage should be expanded to include resistant species.
  14. Describe the timeline of infections post-solid organ transplantation First month-
  15. Continued Second to 6 months posttransplantation 6 months posttransplantation onward
  16. N/A

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