Multiprofessional Critical Care Review: Adult (2023)-3: ICU Presentations of Infectious Diseases and Their Complications (George Karam, MD)

Video Transcription

Video Summary

In this video, the presenter discusses various scenarios involving infectious diseases in the intensive care setting. The first case involves a 38-year-old man with HIV who presents with fever, shortness of breath, and rectal bleeding. Based on the symptoms and lab data, the most likely pathogen causing his presentation is histoplasma capsulatum. The presenter also discusses adrenal insufficiency as an endocrine emergency in HIV-infected individuals. <br /><br />The second case involves endocarditis and the management of valve replacement. The presenter highlights the indications for valve replacement, such as large vegetations, recurrent emboli, and persistent bacteremia. They also discuss the role of cephalosporins in enterococcal endocarditis. <br /><br />The presenter then discusses different infectious diseases that can present as endocrine emergencies, such as adrenal insufficiency and the involvement of granulomatous processes like tuberculosis and fungal infections like histoplasmosis. <br /><br />Next, the presenter talks about different guidelines for managing hospital-acquired pneumonia, focusing on the size and mobility of vegetations and the presence of recurrent emboli as important findings. They also discuss the role of cephalosporins in enterococcal endocarditis and the importance of considering fungal etiology as an indication for valve replacement. <br /><br />The presenter then discusses the names of nutritionally deficient streptococci, specifically streptococcus galiliticus and enterococcus faecalis. They also talk about the role of cephalosporins in treating enterococcal endocarditis. <br /><br />The presenter moves on to discuss different pathogens that can cause life-threatening pulmonary infections, such as Hantavirus, influenza H1N1, and SARS-CoV-2. They also mention the importance of considering unusual pathogens in patients with life-threatening community-acquired pneumonia. <br /><br />They discuss the management of end-stage renal disease in transplant patients, focusing on the risk of infection due to immunosuppression and foreign bodies. <br /><br />Lastly, the presenter discusses different mechanisms of antibiotic resistance and the importance of infection prevention, specifically highlighting Acinetobacter and Candida auris as organisms that require isolation and infection prevention measures. They also mention different recommendations for infection prevention in the ICU setting.

Keywords

infectious diseases

intensive care setting

HIV

histoplasma capsulatum

adrenal insufficiency

endocarditis

valve replacement

cephalosporins

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