Category: bacteremia

The Semi-Procalcitonin in Bacteremia

Trying to figure out if a febrile patient showing up to the ED is having a bacterial infection is a conundrum. The main concern is bacteremia, since it confers higher mortality depending on the type of bacteremia a patient has. Inflammatory markers such as CRP and the neutrophil-to-lymphocyte ratio are relatively useful surrogates that may

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Lines on lines on lines: CLABSI, CRBSI, and Line Infections

Central lines are cool, for the most part. Except for when they’re infected. The pathophysiology behind these is explained in this diagram (1): Microorganisms gain access to the extraluminal or intraluminal surface of the device. Both skin and hub may be the important entry point of organisms, with the development of biofilm contributing to their

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Ahorita-que? The New Gram Positive Antibiotic, Oritavancin

Vancomycin is the work-horse antibiotic every person reaches for. It is a glycopeptide that covers a wide range of gram positive bacteria, with its niche being in its coverage of methicillin-resistant staphylococcus aureus and Enterococcus spp. It is bacteriostatic, with dosing issues and highly nephrotoxic, however it is ubiquitous throughout any hospital in the United

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One PET, Two PET – Endocarditis and Positron Emission Tomography

PETs. We all love them. I have two of those, if the pictures in my “about me” page are any indication as well as the main pic of this post. This post will not cover our beloved (and sometimes only) friends. No, we will be talking about positron emission tomography, an imaging modality we usually

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Neutropenic Fever – I Need The Vancz

Neutropenic fever, defined as a single temperature 38.3C (101F) OR 38.0C (100.4F) for one hour in patients whose granulocyte count are <500 cells OR <1000 cells with an expected decline to <500 over the next 48 hours. This is actually a fairly frequent occurrence in those who undergo intensive chemotherapy, especially in hematological malignancies, which

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ESBL Infections: A Conundrum Yet to be Figured Out

Extended spectrum-beta lactamase producing organisms are those gram negatives that make beta-lactamases that inhibit third and fourth generation cephalosporins. As such, things such as piperacillin-tazobactam tends to show up as susceptible in antibiograms, however there has been a push lately towards the use of carbapenems as therapy for infections with these organisms. It seems kind

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One or Two Antibiotics for Pseudomonas? A Look at the Data.

So, you are thinking about starting antibiotics to cover for pseudomonas? That is great. Piperacillin-tazobactam or cefepime are great choices. Perhaps ceftazidime is another one if you are feeling a bit wild. Piperacillin-tazobactam covers anaerobes while the other 2 do not, however metronidazole is a nice addition to the latter 2. Either way, these all

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Echo? Who, what, when, how? Role of echo modality in Staph aureus bacteremia.

I absolutely love this song. I tried to learn how to play it on guitar, but I think you may need 7 strings for it, at least when I checked back in the day. This week we are adding to last week’s topic and talking about when and what type of echo to get. There

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Infective Endocarditis: A Journey Through Definitions

At any rate, at approximately one-quarter to twelve that night, I remember distinctly getting up from my chair and from the table, where my books lay, and taking off my suit coat. No sooner had I removed the left arm of my coat, than there was on the ventral aspect of my left wrist a

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Dogs, dirty mouths, cancer, and booze: What you need to know about Capnocytophaga

There are multiple associations in medicine where the mere mention of a location, occupation, or risk factor elicits a response with regards to the disease. In infectious disease, there are multiple such as “spelunking” being associated with histoplasmosis, IV drug abuser associated with MRSA endocarditis, or cows placentas being associated with Q fever. When it

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