Presentation
Advances made in the past decade are presented in this article. [ncbi.nlm.nih.gov]
Cardiovascular
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Refractory Shock
Critical illness relative corticosteroid insufficiency (CIRCI) should be considered in any patient with refractory shock after adequate restoration of circulatory volume has been achieved. [cancertherapyadvisor.com]
Liver, Gall & Pancreas
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Gallbladder Enlargement
If the patient is undergoing cholecystectomy for acute cholecystitis, antimicrobial therapy should be discontinued within 24 hours unless there is evidence of infection outside the wall of the gallbladder. Enlarge Print Table 3. [aafp.org]
Skin
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Hemorrhagic Bullae
She developed periumbilical hemorrhagic bullae and finally had a fatal outcome with medical therapy. Severe intra-abdominal infection such as pneumatosis intestinalis should be suspected when periumbilical bullae increase in size. [ncbi.nlm.nih.gov]
Neurologic
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Peripheral Neuropathy
The perceived severity of adverse effects reported were: Acute neuromuscular blockade (8.0), severe allergic reaction (7.5), ototoxicity (7.4), nephrotoxicity (7.1), antibiotic-associated colitis (7.0), peripheral neuropathy (5.3), general neurological [ncbi.nlm.nih.gov]
Workup
[…] complete blood count, urine pregnancy test followed with quantitative blood beta-hCG Imaging: transvaginal ultrasound If patient is unstable: IV fluid resuscitation, urgent obstetrics and gynecology consultation If patient is stable: continue diagnostic workup [en.wikipedia.org]
Others are more often subacute in nature (viral hepatitis) and workup can proceed along at a less critical pace. [antimicrobe.org]
The role of microbiologic workup of infected fluid has been debated in the last years. Since the causative pathogens can easily be predicted in community acquired infections, bacteriological diagnosis is not necessary. [wjes.biomedcentral.com]
Treatment
The frequencies of treatment-related adverse events were similar (16 with piperacillin/tazobactam and 19 with imipenem/cilastatin). [ncbi.nlm.nih.gov]
Prognosis
The postoperative intra-abdominal infection group exhibited a worse prognosis than the non-intra-abdominal infection group (P 0.001). [ncbi.nlm.nih.gov]
"Prognosis in intra-abdominal infection: Multivariate analysis of 604 patients". [clinicaladvisor.com]
“Prognosis in intra-abdominal infection: Multivariate analysis of 604 patients”. [cancertherapyadvisor.com]
Etiology
BACKGROUND: Age has been shown to play a significant role in the etiology of complicated intra-abdominal infections (cIAIs), but the correlation between age and outcomes after therapy was not investigated in the Study to Optimize Peritoneal Infection [ncbi.nlm.nih.gov]
The etiology of these infections varies by age, with necrotizing enterocolitis being the most common cause in neonates, and appendicitis the most common cause in children. [content.iospress.com]
Organism resistance is of concern; thus, it is imperative that pharmacists have the necessary education on etiology and treatment of intra-abdominal infection. [uspharmacist.com]
They are difficult to detect clinically, often presenting with fever of unclear etiology. Localized tenderness may be present in as few as 33% of cases, with an abdominal mass in only 10% [Surg Clin North Am 74: 693, 1994]. [openanesthesia.org]
Epidemiology
(Part of this research was presented as poster 251 at IDWeek, the annual meeting of the Infectious Diseases Society of America [IDSA], the Society for Healthcare Epidemiology of America [SHEA], the HIV Medicine Association [HIVMA], and the Pediatric Infectious [aac.asm.org]
The acute (surgical) abdomen — epidemiology, diagnosis and general principles of management. Z Gastroenterol. 2010; 48(6): 696–706. Roland SPH, Brunkhorst MF. Sepsis biomarkers and pathogen detection methods-state of the art. [sanamed.rs]
Important to recognize and track epidemiologically, to prevent more people from being infected. E. coli, Salmonella, Campylobacter and Staphylococcus are among the most common pathogens causing food-borne outbreaks. [biomerieux-diagnostics.com]
The character and duration of the diarrhea, the associated symptoms and signs, and the epidemiologic features usually determine whether further investigation is warranted. [microbiologybook.org]
Impact of evolving epidemiology on treatments for complicated skin and skin structure infections: the surgical perspective. J Am Coll Surg. 2015;220(1):105–106. 3. Horan TC, Andrus M, Dudeck MA. [dovepress.com]
Pathophysiology
"Pathophysiology and management of abdominal compartment syndrome". Am J Crit Care. vol. 12. 2003. pp. 367-71. (Very practical review of pathophysiology, diagnosis and treatment of elevated abdominal pressure.) Montravers, P, Gauzit, R, Muller, C. [clinicaladvisor.com]
“Pathophysiology and management of abdominal compartment syndrome”. Am J Crit Care. vol. 12. 2003. pp. 367-71. (Very practical review of pathophysiology, diagnosis and treatment of elevated abdominal pressure.) Montravers, P, Gauzit, R, Muller, C. [cancertherapyadvisor.com]
Peritonitis: pathophysiology and local defense mechanisms. Hepatogastroenterology. 1997; 44 (16):927–936. [ PubMed ] Hall JC, Heel KA, Papadimitriou JM, Platell C. The pathobiology of peritonitis. [ncbi.nlm.nih.gov]
We will review clinical definitions, pathophysiology, and treatment strategies for IAI in an effort to provide guidelines for clinical management. Definitions Intra-abdominal infection (IAI) describes a diverse set of diseases. [wjes.biomedcentral.com]
Infected necrosis refers to bacterial contamination of necrotic pancreatic tissue in the absence of abscess formation. 11 Pathophysiology PA forms through various mechanisms, including fibrous wall formation around fluid collections, penetrating peptic [anaerobicinfections.blogspot.com]
Prevention
More effective thrombocytopenia prevention strategies are necessary in intra-abdominal infection patients. [ncbi.nlm.nih.gov]
Role of antiseptics in the prevention of surgical site infections. Dermatol Surg. 2015;41(6):667–676. 124. Bratzler DW, Houck PM; Surgical Infection Prevention Guideline Writers Workgroup. [dovepress.com]