Sandbox: Fatima: Difference between revisions
Jump to navigation
Jump to search
| Line 45: | Line 45: | ||
{{familytree | E01 | |E02| | | E03 | | | | | E04 | | | |E01='''Negative Culture'''<br>❑ Complete 5 day Antibiotic Course|E02='''Confirmed SBP'''<br>❑ Narrow the spectrum based on the susceptibility to complete the 5 day course|E03='''Culture Negative'''<br>❑ No Antibiotics indicated| E04= '''Culture Positive'''<br>❑ Bacterascites: Repeat diagnostic paracentesis when the culture growth is discovered}} | {{familytree | E01 | |E02| | | E03 | | | | | E04 | | | |E01='''Negative Culture'''<br>❑ Complete 5 day Antibiotic Course|E02='''Confirmed SBP'''<br>❑ Narrow the spectrum based on the susceptibility to complete the 5 day course|E03='''Culture Negative'''<br>❑ No Antibiotics indicated| E04= '''Culture Positive'''<br>❑ Bacterascites: Repeat diagnostic paracentesis when the culture growth is discovered}} | ||
{{familytree/end}} | {{familytree/end}} | ||
==Diagnostic Paracentesis== | |||
Revision as of 21:27, 25 January 2017
Sputum Analysis
| Sputum Analysis | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Acid Fast Stain | Culture on Sabourad's medium | Direct Microscopic Examination | Gentain Voilet Stain | Aerobic Culture | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Tuberculosis | Yeast and Fungi | Actinomyces and other mycelia of Fungi | Fusiform Bacteria and Spirochetes | Pyogenic organsims | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
DD
| Rhinitis | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Positive Skin Prick or RAST | Negative Skin Prick or RAST | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Allergic Rhinitis | Non Allergic | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Infectious | Vasomotor | Gustatory | Nonallergic eosinophilic rhinitis syndrome (NARES) | ||||||||||||||||||||||||||||||||||||||||||||||||||
| Acute Rhinosinisitis | Chronic Rhinosinusitis | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Approach
| Diagnostic Paracentesis ❑ Perform ascitic fluid cell count and differential ❑ Perform ascitic fluid culture (Inoculated at bedside) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| PMN ≥ 250cells/mm³ | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| If YES ❑ Presumptive SBP ❑ Begin empiric antibiotic therapy(eg:Cefotaxime 2g IV q8H and ❑ IV Albumin on day 1 & day 3 IF serum creatinine 1mg/dl, BUN > 30mg/dl or total albumin > 4mg/dl | IF NO ❑ Look for the signs/symptoms of Infection | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Is Culture Positive ? | Absent Symptoms ❑ Is Culture Positive? | Symptoms Present ❑ Begin Empiric Antibiotic Therapy for SBP | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Negative Culture ❑ Complete 5 day Antibiotic Course | Confirmed SBP ❑ Narrow the spectrum based on the susceptibility to complete the 5 day course | Culture Negative ❑ No Antibiotics indicated | Culture Positive ❑ Bacterascites: Repeat diagnostic paracentesis when the culture growth is discovered | ||||||||||||||||||||||||||||||||||||||||||||||||||