It seems I can never get around talking about staphylococcus aureus. I believe it was Paul Sax who mentioned that an infectious disease fellowship is essentially a staphylococcus fellowship, since you see all different types of complications. Many institutions have implemented automatic infectious disease consultation for anyone with staphylococcus aureus bacteremia (SAB), as it has
Tag: 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
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
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
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
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
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
Does anyone remember signing out as residents, how there is always a line that goes something along the lines of “if fever, then culture.” As in fever always means there is an infection, or at least a suspicion of it. Of course, fever means inflammation but infection is a type of inflammation so why not
Blood cultures are typically drawn in patients who present with sepsis due to concern for infection. While the trigger response to “fevers and leukocytosis” is to obtain blood cultures, the positive rate that has been quoted ranges from 4-7% (1), depending on the source. Indeed, blood culture contamination is a frequent problem that is encountered
Coagulase negative staphylococcus are generally skin commensals we tend to ignore when they pop up in one set of blood cultures as they tend to represent contamination of the blood culture bottles rather than true bacteremia. The most commonly seen is Staphylococcus epidermidis. The reason they are called “coagulase negative staphylococcus” is these organisms, compared