Multiprofessional Critical Care Review: Adult 2024 (MCCRCA24ON)-2: Severe Infections: Bacterial, Fungal and Viral (George Karam, MD)

Video Transcription

Video Summary

In this video, Dr. George Karam discusses severe infections in the bacterial, fungal, and viral worlds. He presents several patient cases and discusses the most likely pathogens and appropriate management strategies for each case. <br /><br />In the first case, a 62-year-old fisherman with cirrhosis presents with fever, abdominal pain, and diarrhea. He is found to have a necrotizing skin and skin tissue infection. The most likely pathogen causing this is Clostridium septicum. Other pathogens commonly associated with necrotizing infections are also discussed. <br /><br />The second case involves a 35-year-old man who recently traveled to Africa and presents with fever, myalgias, and skin lesions. The most likely pathogen causing his symptoms is Plasmodium falciparum, the parasite responsible for malaria. <br /><br />In the third case, a 59-year-old man who has been taking prednisone develops fever, headache, and photophobia after having surgery. He is diagnosed with meningitis caused by Enterobacter cloacae, likely due to a breach in the mucosa of his GI tract. <br /><br />The fourth case involves a 41-year-old homeless man who develops a perforated duodenal ulcer and subsequently get Candida albicans fungemia. He also develops chorioretinitis. The most appropriate management for this patient would be intravenous fluconazole, as azoles are effective in treating candida infections in the retina. <br /><br />Dr. Karam also discusses other topics such as the approach to meningitis, infectious causes of cellulitis, life-threatening infections of the nervous system, and the management of sepsis caused by candida and aspergillus. He emphasizes the importance of source control in treating infections and tailoring antibiotic therapy based on the specific pathogen and clinical presentation.

Keywords

severe infections

bacterial infections

fungal infections

viral infections

patient cases

appropriate management strategies

Clostridium septicum

Plasmodium falciparum

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