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infection (infectious disease)

The presence of bacteria or other microorganisms in sufficient quantity to damage tissue or impair healing. Special considerations: 1) geriatric patients 2) pregnant patients 3) immunocompromised patients Epidemiology: - mortality from infectious diseases declined in the U.S. from 1980-2014, but variations in counties exist [5] - counties in the Southeastern & Western U.S. with highest mortality due to infectious disease - factors such as poverty, housing, education, stigma, racism may contribute [5] History: 1) travel a) eastern USA 1] Lyme disease 2] Legionella a) southwestern USA 1] coccidioidomycosis 2] Hantavirus b) midwestern USA 1] Histoplasmosis 2] ehrlichiosis c) international travel 1] malaria 2] hepatitis A 3] Giardia 4] Escherichia coli 5] Salmonella 2) exposure to animals a) parrots; exotic birds - Psittacosis b) cats 1] Pasteurella multocida 2] Coxiella burnetii 3] Toxoplasma gondii 4] Borrelia burgdorferi 5] Bartonella henselae c) dogs 1] Pasteurella multocida 2] Brucella canis 3] Blastomyces dermatitidis d) rats & other rodents 1] Borrelia 2] Leptospira 3] Hantavirus e) sheep, cattle & goats 1] Coxiella burnetii 2] Brucella f) gerbils & hamsters - Lymphocytic choriomeningitis virus g) turtles & iguanas - Salmonella h) chickens & chicken coops - Histoplasma capsulatum 3) insect bites a) ticks 1] Rickettsiae 2] Borrelia burgdorferi 3] babesiosis 4] ehrlichiosis b) mosquitoes 1] arbovirus encephalitis 2] malaria 4) food ingestion a) shellfish 1] Vibrio 2] hepatitis A b) hamburgers, other foods - Escherichia coli O157:H7 5) pharmacologic agents a) antibiotics - Clostridium difficile b) IV drug use 1] endocarditis 2] disc-space disease 3] HIV 7) leisure activities a) whirlpools/hot tubs 1] Legionella 2] Pseudomonas b) gardening & peat moss exposure - Sporothrix schenckii c) hunting 1] Francisella tularensis 2] Yersinia pestis 3] Borrelia burgdorferi 8) lifestyle a) homeless or incarceration 1] tuberculosis 2] Streptococcus pneumoniae 3] Bartonella b) sexual promiscuity - HIV 9) dental procedures Management: - common errors 1) failure to obtain complete immunization history 2) antibiotic ineffective for etiologic agent 3) undrained pus, especially abdomen or pelvis 4) antibiotic therapy is too brief for infection a) endocarditis b) osteomyelitis c) lung abscess d) tuberculosis e) fungal infection 5) patient non compliance 6) colonization of foreign body a) intravenous catheter b) prosthetic joint c) heart valve 7) inappropriate drug dosage or drug delivery 8) failure to recognize immunodeficiency 9) incorrect diagnosis Notes: - after safety breaches involving anthrax & influenza at federal laboratories in 2014, the U.S. government is pausing funding for new "gain-of-function" studies involving influenza, SARS, & MERS [3]

Related

factors predisposing to infection infection control infectious disease specialty(ID)

Specific

arthropod-borne infection bacterial infection catheter-related infection childhood infection chronic infection (chronic infectious disease) coinfection; superinfection cyst infection deep neck infection device infection; implant infection; stent infection ear infection eye infection (ocular infection) eyelid infection foot infection gastrointestinal infection healthcare-associated infection hepatobiliary infection infection in pregnant patients infections in the elderly infectious arthritis (septic arthritis) intra-abdominal infection malakoplakia mycosis; fungal infection neonatal infection nervous system infection opportunistic infection oral cavity infection parasitic infection postoperative infection recurrent infection respiratory tract infection retroperitoneal infection septic bursitis sexually-transmitted disease; sexually-transmitted infection; venereal disease (STD, STI) skin infection soft tissue infection spinal infection superinfection transfusion-associated infection urogenital infection vaginal infection viral infection wound infection zoonosis; zoonotic infection

General

disease

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 11, 16, 18. American College of Physicians, Philadelphia 1998, 2012, 2018.
  2. Baron EJ et al A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2013 Recommendations by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM). Clin Infect Dis. July 10, 2013 PMID: 23845951 http://cid.oxfordjournals.org/content/early/2013/06/24/cid.cit278.full
  3. Office of Science and Technology Assessment. Oct. 17, 2014 Doing Diligence to Assess the Risks and Benefits of Life Sciences Gain-of-Function Research. http://www.whitehouse.gov/blog/2014/10/17/doing-diligence-assess-risks-and-benefits-life-sciences-gain-function-research
  4. Choosing Wisely. Feb 23, 2015 Infectious Diseases Society of America Five Things Physicians and Patients Should Question http://www.choosingwisely.org/doctor-patient-lists/infectious-diseases-society-of-america/
  5. El Bcheraoui C, Mokdad AH, Dwyer-Lindgren L et al. Trends and patterns of differences in infectious disease mortality among US counties, 1980-2014. JAMA 2018 Mar 27; 319:1248-1260 PMID: 29584843 - Shuman EK, Malani PN. Infectious diseases mortality in the United States: Ongoing investment needed for continued progress. JAMA 2018 Mar 27; 319:1205-1206 PMID: 29584824
  6. Fishman JA. From the classic concepts to modern practice. Clin Microbiol Infect. 2014 Sep;20 Suppl 7:4-9. Review. PMID: 24528498 Free Article
  7. National Cancer Institute: Infectious Agents https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents