The Clinical Problem Solvers Episode 371 – Spaced Learning Series – Infectious Curiosity
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Dec 27, 2024 Seyma Yildirim, a recent medical school graduate and newest member of the Space Learning Series team, joins seasoned hosts for an enlightening discussion. They dive into a challenging case of altered mental status in a cancer patient, exploring factors like opioid use and immunotherapy effects. The group emphasizes collaborative learning, the nuances of diagnosing complicated infections, and the critical role of detailed patient evaluations. Insights on antibiotic resistance and the importance of teamwork in patient care round out this engaging conversation.
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Approaching Altered Mental Status
- Approach altered mental status (AMS) by considering factors inside vs. outside the CNS, and physiologic vs. anatomic issues.
- Systematically investigate with basic labs, cultures, imaging, CSF, and EEG if needed.
Batson-Venus Complex and Infection Spread
- The Batson-Venus complex, a network of valveless veins along the vertebral column, can facilitate infection spread.
- It connects pelvic, abdominal, and thoracic regions to the cranial venous system, explaining potential UTI spread to vertebral bones.
Inducible AMC Resistance in Citrobacter
- Citrobacter freundii, an enterobacteria, can develop inducible AMC resistance to certain antibiotics.
- Initial susceptibility may be misleading, as exposure can induce resistance; carbapenems or cefepime often remain effective.