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EM@3AM: Murine Typhus

EMDocs

Clinical Infectious Diseases , vol. Gershman, Mark D., and Sarah L. Epidemiology and Clinical Manifestations of Murine Typhus in the United States: A Review of the Literature and New Data from California.” 6, 2008, pp. Oxford University Press. Accessed 19 Aug. Berry M, Wang AM, Lahham RF, Zhang X, Pacheco LD.

EMS 104
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EM@3AM: Leukopenia

EMDocs

PCP Pneumonia, Sepsis) can be discharged with initiation of Antiretroviral Therapy in consultation with Infectious Disease (ID) physician with full ID evaluation outpatient. Management is directed based on underlying etiology, but consider fluid resuscitation, antipyretics, and antibiotics as indicated. In: Temesgen Z, ed.

EMS 94
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"Sepsis bundles": No good evidence of benefit

PulmCCM

The Infectious Diseases Society of America (IDSA) has consistently opposed SEP-1 since at least 2016. It appears the agency did so in 2020 for the PCORI-funded CLOVERS randomized trial comparing fluid strategies in septic shock, in which patients were routinely exempted from receiving crystalloid resuscitation if they were improving.

Sepsis 59
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emDOCs Podcast – Episode 115: Adult Meningitis

EMDocs

Start resuscitating with fluids, and add a vasopressor like norepinephrine. What about a CT before a Lumbar puncture? MAP minus the ICP equals CPP. The target CPP is at least 60. So, if the patient has an elevated ICP of 20, you want a MAP of about 80. That gives a CPP of 60. MAP 80-ICP 20= CPP 60).

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Journal Feed Weekly Wrap-Up

EMDocs

Spoon Feed This external validation compared the 2023 Duke-International Society for Cardiovascular Infectious Diseases Diagnostic (ISCVID) Criteria against various other criteria for diagnosing infective endocarditis (IE) and found the 2023 Duke-ISCVID Criteria had the best test characteristics. Prehosp Emerg Care. 2024 Mar 26:1-8.

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2023 Critical Care Year in Review (Part 1)

PulmCCM

Sepsis, infectious disease Managing septic shock with a restrictive-fluids approach (preferentially using vasopressors after a single liter crystalloid bolus) led to similar outcomes as the usual practice of bolusing large volumes of fluids first. I hope you continue to find it valuable. Wishing you all a safe and happy holiday season!

Sepsis 94
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First10EM Journal Club: December 2023

Broome Docs

Antibiotic Myths for the Infectious Diseases Clinician. N Engl J Med. 2023 Mar 23;388(12):1092-1100. doi: 10.1056/NEJMoa2204737. PMID: 36947466 McCreary EK, Johnson MD, Jones TM, Spires SS, Davis AE, Dyer AP, Ashley ED, Gallagher JC. Clin Infect Dis. 2023 Jun 13:ciad357. doi: 10.1093/cid/ciad357. Epub ahead of print.