Read e-book online Clinical Approach to Infection in the Compromised Host PDF

By Robert H. Rubin

ISBN-10: 1461566452

ISBN-13: 9781461566458

ISBN-10: 1461566479

ISBN-13: 9781461566472

"Infection within the Compromised Host" has turn into a vintage bankruptcy in textbooks dedicated to infectious ailments and inner medication. The numbers of compromised hosts are expanding within the period of modem drugs due to our extended services to house tricky illnesses, in particular neoplasms. for that reason, microbiologic problems on the topic of the extensive care administered to those sufferers are expanding to boot. less than those circum­ stances, not just does the underlying disorder create stipulations favorable for the advance of surprising infections, yet usually the treatment contributes to the purchase of capability pathogens that become brokers chargeable for serious and regularly deadly affliction. Granulocytopenia and immunosuppression were the 2 key fac tors in predisposing sufferers with melanoma and different critical illnesses to critical bacterial infections. Colonization via hospital-acquired pathogens and breaks within the anatomic barriers-as because of the sickness or clinical intervention-have contributed to the excessive prevalence of infectious ailments in those sufferers. even supposing there's a few overlap among the categories of an infection in granulocytopenic and immunosuppressed hosts, each one ofthese medical entities has certain positive aspects thatjustify contemplating them individually, booking the time period immunocompromised hosts in simple terms whilst refer­ ring to sufferers who're predisposed to opportunistic infections. for approximately 20 years, infections in granulocytopenic sufferers have attracted the atten­ tion of clinicians simply because they characterize a version for the examine of antimicrobial medicinal drugs in hosts disadvantaged of a necessary portion of security opposed to bacterial an infection, that's, an enough variety of more often than not functioning granulocytes.

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Regular ingestion. If ingestion is discontinued during granulocytopenia, the resultant rapid repopulation of the alimentary canal by aerobic gram- negative bacilli can lead to overwhelming infection. 29 However, it is our belief that in the appropriate patient the benefits outweigh these risks, but a program of surveillance culturing is absolutely essentiaI so that the antibiotic regimen can be adjusted should a resistant organism be acquired. The utilization of oral nonabsorbable antibiotics cannot be considered lightly; it must be instituted only within a setting of appropriate facilities, staff education, and enthusiasm.

High bacterial counts will also develop rapidly in outdated milk and milk products. The microorganisms that are present on plants may colonize man not only through the ingestion of fresh foods as described but also by means of flowers, especially African violets and chrysanthemums,32 and their vases or containers. 33 Water from such vases which is changed and discarded into hand basins or toilets with its accompanying splash will heavily contaminate the surrounding area. Microbes generally do not survive in the environment in the absence of moisture or the protection of proteinaceous covering unless they produce spores, possess larger amounts of lipid in their cell walls, or resist the effects of drying by some other means.

Most staphylococcal skin leisions occurring at sites of skin trauma tend to occur in patients who have nasal colonization with this organism. Candida pharyngitis and esophagitis occur more frequently in patients heavily colonized with Candida species in the oral cavity, 16 and some cases of Aspergillus flavus pneumonia have been found to be preceded by upper airway or nasal colonization. , the patient with acute nonlymphocytic leukemia receiving induction chemotherapy. This serial information allows the physician to better select empirical antibiotic therapy should fever develop during granulocytopenia.

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Clinical Approach to Infection in the Compromised Host by Robert H. Rubin

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