Urgences en infectiologie Infectious diseases emergencies in adults

摘要

Update on different kind of emergencies in infectious diseases.Methods.-Review of the literature,of the way to make the good diagnosis in infectious diseases and on several emergencies such as septic shock,meningitis and meningoencephalitis,necrotizing fasciitis,febrile neutropenia and malaria.Diagnosis.-To give the better treatment,we need to do the right diagnosis.All the treatment strategy will rely on this diagnosis.In infectious diseases,it is supported by three parameters:the organ where infection takes place,the patient with its past medical history and clinical signs,the bacteria which is involved.These three essential elements are the warrant of an optimized prescription:the good molecule(s)with the right dosage.They are also a part of the emergency evaluation.They are usually obtained with a clinical examination,and if necessary,the use of biology,radiology and microbiology.Treatment.-The treatment of such emergencies relies on antibiotics.Usually this latter is started while the bacteria are not known.So it is necessary to have the knowledge of the usual bacteria involved in each kind of infection to use the antibiotic with the right action spectrum.It is also necessary to know the pharmacodynamic of the antibiotic used to be sure that a sufficient concentration will be reached in the infected organ.In some circumstances,antibiotics are not enough and a surgery may be required.Some other drugs such as corticosteroids in meningitis or activated protein C in severe sepsis can improve outcomes.