Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- 107 Postoperative Wound Infections
- 108 Trauma-Related Infection
- 109 Infected Implants
- 110 Infection in the Burn-Injured Patient
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
110 - Infection in the Burn-Injured Patient
from Part XIV - Infections Related to Surgery and Trauma
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- 107 Postoperative Wound Infections
- 108 Trauma-Related Infection
- 109 Infected Implants
- 110 Infection in the Burn-Injured Patient
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
Summary
The diagnosis of infection in the patient with major burn injury is especially problematic because the signs of infection are the same as those of the response to injury.
The tissue injury that occurs with a major burn and the associated inflammatory response to it cause one of the greatest perturbations of homeostasis that occurs in any disease state. Thus the greatest challenge in developing a differential diagnosis in the burn-injured patient is to distinguish between the injury state and infection. That the manifestation of infection may be blunted by diminished immune response further complicates evaluation of the patient while also contributing to an increased susceptibility to infection.
The challenge posed in the clinical and laboratory evaluation of the burn-injured patient is summarized in the outline of injury-related changes in Table 110.1.
INJURY PATHOPHYSIOLOGY AND SUCEPTIBILITY TO INFECTION
The initial approach to the burn-injured patient is oriented toward limiting the progression of the injury by stabilization of the patient and maintenance of blood flow to the wound. The zone of coagulative necrosis consists of tissue that has been irreversibly damaged, whereas the surrounding zone of stasis contains areas of potentially reversible injury. Adjacent areas, known as the hyperemic zone, may also evolve to become necrotic if the blood flow is not maintained. For this reason, the primary goal of early burn therapy is to ensure adequate delivery of oxygen, nutrients, and circulating cells to the wound.
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- Information
- Clinical Infectious Disease , pp. 783 - 788Publisher: Cambridge University PressPrint publication year: 2008