Indiana University Infectious Diseases Fellowship
14 Feb,
7 tweets, 4 min read
#idboardreview 50 M AML neutropenic on FQ, mucositis, presents w/ fever, hypotension, diffuse rash, tissue necrosis, AKI, respiratory failure, blood cultures+ diagnosis? #medEd #idmedEd #idtwitter 
#viridans #streptococcus #mitis #bacteremia #tss toxic shock syndrome in neutropenic patients: risk factors mucositis and prophylaxis with FQ or tmp-smx
#viridans #streptococcus neutropenia, mucositis, high dose cytosine arabinoside, FQ: can present w/ fever, flushing, chills, stomatitis, pharyngitis. TSS 24-48hr, hypotension in 1/3 cases, rash, shock, ARDS (1/4 pts), strep mitis, strep oralis, mortality 15-20%
Breakthrough BSI/sepsis in neutropenia
-ARDS, rash, FQ, mucositis: viridans strep
-sepsis on B-lactams: stenotrophomonas, ESBL
-lung/skin lesions: Pseudomonas, fungi
-Skin lesions gm+: coryne
-Mucositis upp+lower: fusobacterium, clostridium, stomatococcus
Ref: GW IDBR
-ARDS, rash, FQ, mucositis: viridans strep
-sepsis on B-lactams: stenotrophomonas, ESBL
-lung/skin lesions: Pseudomonas, fungi
-Skin lesions gm+: coryne
-Mucositis upp+lower: fusobacterium, clostridium, stomatococcus
Ref: GW IDBR
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