Dr Ira Shah talks about Unusual manifestations of Usual Infections.
Lecture starts with explanation about usual infections and unusual patterns and the reasons: Organism based factors, host factors, doctor factors, outcome of these unusual manifestations, what could be the cause of persistent fever, complications of Hib meningitis, what could be the cause of acute flaccid paralysis (AFP) in this child, what is the cause kind of unusual presentation, should antibiotics be changed, duration of fever in Hib meningitis, Prolonged fever, on examination cases of child, is this unusual manifestation of pulse polio, is this vaccination associated polio immunization, Polio virus eradication, how to diagnose enterovirus infection, what could be the cause of persistent fever, how should this child be treated, edema feet, pallor, hepatosplenomegaly, investigation, how to treat this child now and conclusion. It’s consists of four Case discussions on the topic.
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An organism that has to cause certain infections in the manner that has been described in the literature, Unusual-deviation from the Unusual patterns: Disease not responding in the set time period, Meningitis that takes a longer time to respond, TB that is not responding to 1st line AKT in the intensive phase, an organism that is presenting with a weirder symptom, an organism that is not meant to cause a disease(UNUSUAL ORGANISMS). Why these unusual patterns: Complication of the disease, subdural empyema in a meningitis, Factors that predispose the infection to persist longer, CVC lines in hospital acquired infections, Proton pump inhibitors for fungal infections, Umbilical lines in NICU infections, improper treatment, Under dosing, wrong choice of antimicrobials Organism based factors: The bug is a resistant bug, drug resistant TB, MDR typhoid, ESBL carbapenem resistant infections, organism has become more virulent, dengue epidemics, H1N1-changing pattern Host factors: Patient in immunocompromised-uncommon infections become common, cryptosporidia in HIV, cryptococcal meningitis, toxoplasmosis, the usual organisms make take longer time to respond due to poor immunity, IRIS in HIV Paradoxical reactions in TB, host associated disease, renal stones-can lead to UTI due to proteus.
Doctor factors: What the mind does not know, the eyes do not see, The ears do not hear, What the mind does not want to know the information may be serp citoibitna lanoitar ,nerdlihc detcefni VIH ni sixalyhporp HNI ,sixalyhporp evitneverP ,regnol emoceb yam noitarud tnemtaert ,sitigninem cinegoyp ni tnemtaert laciripme sa sniropsolahpec noitareneg dr3 ot nicymocnaV fo noitiddA ,egnahc yam stcetorp tnemtaerT :snoitatsefinam lausunu eseht fo emoctuO elbaliava ton llits tub ereht thgircribing, Hospital practices in ICUs change, Stricter monitoring for disease, immunized, started on ceftriaxone and dexamethasone.
Complications of Hib meningitis: Subdural effusion or empyema, Ischemic or hemorrhagic cortical infarction, Cerebritis, Ventriculitis, Intracerebral abscess and hydrocephalus Conclusion: Most of the unusual manifestations are actually known manifestations are actually known manifestations of that infection.Awareness of the same is essential. Rational prescribing practices will prevent unusual complications.Mind must strive to know these unusual presentations.
Please watch: "Dr. Rakesh Kumar : About India's Vaccine Scenario | pediatric Oncall "