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Section 9 - Infectious disease emergencies

Published online by Cambridge University Press:  05 November 2013

Kaushal Shah
Affiliation:
Department of Emergency Medicine, Mount Sinai School of Medicine, New York
Jarone Lee
Affiliation:
Department of Emergency Medicine, Massachusetts General Hospital, Boston
Kamal Medlej
Affiliation:
American University of Beirut
Scott D. Weingart
Affiliation:
Department of Emergency Medicine, Mount Sinai School of Medicine, New York
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Summary

This chapter discusses the management of infectious disease emergencies that includes severe sepsis and septic shock. The clinical presentation includes hypotension, encephalopathy, acute kidney injury, cardiogenic shock, lung injury or acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC). Early goal-directed therapy (EGDT) is the mainstay of treatment of sepsis. Patients with persistently low blood pressure despite adequate fluid administration or whose resuscitation goals are not met require additional interventions. The risk factors for healthcare-associated infections that may be multidrug resistant are: hospitalization within the last 90 days, residence in a nursing home or long-term care facility, presence of indwelling catheters, intravenous therapy, wound care, or intravenous chemotherapy within the prior 30 days, and attendance at a hospital or hemodialysis clinic within the prior 30 days. Urgent surgical consultation should be sought when indicated by the source of infection (e.g. abscess, ruptured viscus).
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Publisher: Cambridge University Press
Print publication year: 2013

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