Critical care clinics
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Viruses are a common and important cause of severe community-acquired pneumonia, and may lead to severe respiratory disease and admission to the intensive care unit. Influenza is the most common virus associated with severe viral pneumonia, although other important causes include respiratory syncytial virus, adenovirus, metapneumonia virus, and coronaviruses. Viral pneumonias tend to have a seasonal predilection and are often preceded by a typical viral prodrome. This article focuses on severe influenza pneumonia, including the 2009 H1N1 pandemic, and briefly discusses other causes of severe respiratory disease of viral etiology.
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Critical care clinics · Oct 2013
ReviewPrevention, Diagnosis, and Management of Surgical Site Infections: Relevant Considerations for Critical Care Medicine.
Surgical site infection complicates 2% to 5% of all operative procedures. Many of the risk factors for the development of a surgical site infection (eg, old age, major comorbidity, emergency surgery) are present in patients typically requiring postoperative admission to the intensive care unit. This article reviews the risk factors and measures to prevent surgical site infection and diagnostic and management considerations relevant to critical care medicine.
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Patients in the setting of the intensive care unit can develop intra-abdominal complications that may worsen outcome. Clinical suspicion of such complications coupled with early diagnosis and treatment may reduce morbidity and mortality associated with these processes. This article addresses the diagnosis and management of some of the common causes of intra-abdominal catastrophes.
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Critical care clinics · Oct 2013
ReviewBacterial Meningitis and Other Nonviral Infections of the Nervous System.
Bacteria and fungi, owing to their intrinsic properties and the host responses they produce, result in relatively specific clinical syndromes when they infect the central nervous system. The infecting organism may produce symptoms and signs by interfering with the function of the nervous system tissue being invaded or compressed. The definitive treatment of central nervous system infection depends on correct identification and antimicrobial treatment of the infecting organism, relief of excessive pressure or mass effect that it exerts, and modulation of the host's immune response to allow clearance of the organism while minimizing excessive inflammation.