The Clinical Problem Solvers Episode 65 – Spaced Learning Series – Hemolysis and Infection
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Feb 12, 2020 The discussion kicks off with a gripping clinical case of a 25-year-old man with sickle cell disease, grappling with fever and systemic symptoms. It dives into the risks of infections and transfusion issues tied to sickle cell complications. A thorough exploration of diagnosing hemolytic anemia amid alarming lab results reveals crucial connections between hemolysis and infections. The complexities of antibiotic failures are dissected, along with a case study on babesiosis, underscoring the need for precise diagnostics in immunocompromised patients.
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Use Infection Schema for Fever
- When evaluating fever in hospitalized patients, use the clinical problem solver's infection schema to consider common infection sources systematically.
- Focus first on respiratory, urinary, skin/soft tissue, gastrointestinal, and bacteremia as potential infection sites.
Interpreting Elevated Bilirubin
- Worsening hemolysis with high bilirubin is partly explained by hemolysis but usually not enough alone to raise bilirubin above 5.
- Underlying Gilbert syndrome and sickle cell hepatopathy also contribute to bilirubin elevation in this patient.
Fever and Tachycardia Signal Infection
- Fever and tachycardia require urgent consideration of infection as the driver of inflammation.
- Lack of localizing exam findings makes identifying infection source challenging but essential for targeted therapy.