UTIs: Symptoms, Causes, Treatment, and Prevention

♦Intravenous furosemide in shock with volume overload Whether intravenous furosemide (a loop diuretic) can be used in a patient with shock + volume overload depends on the type of shock and the hemodynamic profile: 🔹 General principles Shock states are usually associated with low tissue perfusion and hypotension. Giving diuretics in shock may worsen hypotension and decrease organ perfusion unless the patient is carefully selected. In shock, the first priority is hemodynamic stabilization (fluids, vasopressors, inotropes depending on cause). 🔹 Scenarios 1. Cardiogenic shock with volume overload (e.g., acute decompensated HF, pulmonary edema) Furosemide can be used, but only after adequate perfusion pressure is restored with vasopressors/inotropes (e.g., norepinephrine, dobutamine). If systolic BP is very low (<90 mmHg), avoid furosemide initially as it can worsen hypotension. Once stabilized, loop diuretics help relieve pulmonary congestion and reduce preload. Ultrafiltration or renal replacement therapy may be considered if diuretics are ineffective. 2. Distributive or septic shock with fluid overload The priority is vasopressor support and infection source control. Furosemide may be used cautiously if patient is fluid-overloaded and perfusion pressure is supported by norepinephrine/vasopressin. 3. Hypovolemic shock Never give furosemide—it will worsen hypovolemia and shock. ★Practical approach Correct shock first (maintain MAP ≥ 65 mmHg with fluids/vasopressors). If patient remains congested (pulmonary edema, high CVP, poor oxygenation), then give IV furosemide carefully, often in small test doses, while monitoring: BP, urine output Renal function Electrolytes ★ Summary: IV furosemide can be given in shock with volume overload, but only after hemodynamic stabilization (adequate MAP with vasopressors/inotropes). In uncompensated or hypovolemic shock, it is contraindicated. : DR.YASSER ALWALI

What Are the Most Common Causes of Vaginal Yeast Infection? Medicines and Treatments Broad-spectrum antibiotics prescribed to treat another infection may also destroy the healthy bacteria which keep candida in check, leading to excessive yeast growth and infection. Often, steroid treatments given for other conditions do the same. Vaginal douches and sprays may change the acidity balance, also harming bacteria and encouraging yeast growth. Hormonal Changes When pregnant, alterations in progesterone and estrogen levels can lead to yeast infections. Likewise, when breastfeeding. Hormone replacement therapy can have a similar effect. Certain forms of birth control that change estrogen levels may also cause a vaginal yeast infection. Tight Clothing Tight clothes that retain heat and sweat, creating the warm, damp conditions ideal for yeast growth, can encourage infections. Loose, cotton panties are safer. Always change out of gym clothes and swimwear as soon as you can and wash and dry yourself well. Pre-Existing Medical Conditions If you suffer from diabetes and your condition isn’t treated, increased sugar in your vagina’s mucus membranes can cause a yeast infection, as yeast feed on sugars. Women who have HIV may be less able to fight off minor infections and so have a higher risk of a yeast infection getting hold. Likewise, women with cancer, organ transplant patients, and women who’ve had a blood transfusion, may be at greater risk of secondary infections, including vaginal yeast infection. Check back on Friday to learn about diagnosis and treatment. You can read the full article here: https://lnkd.in/gcjUnbDU If you have any questions or comments, please reach out to us 🙂 #coasttocoastcompounding #ctocrx #compounding #pharmacy #colorado #supplements #vaginalinfections #yeastinfection #yeastinfectiontreatment #candidiasis #causesofvaginalinfections #causes

✅ What is Wound Drainage? Wound drainage refers to the fluid that comes out of a wound during the healing process. The type, color, and amount of drainage help assess healing or infection. ✅ Types of Wound Drainage 🔹 1. Serous • Clear or pale yellow • Thin and watery • Normal in early healing 🔹 2. Sanguineous • Bright red, bloody fluid • Seen in fresh wounds or trauma • May appear after dressing changes or surgery 🔹 3. Serosanguineous • Pinkish or light red • Watery mix of blood and serum • Common in surgical wounds and early healing 🔹 4. Purulent (Pus) • Thick, cloudy, yellow, green, or brown • Foul odor • Indicates infection 🔹 5. Seropurulent • Watery with some pus • Suggests early or mild infection ✅ Amount of Drainage Term- Description None-Dry wound Scant-Small moisture, no dressing change needed Small/Minimal-<25% of dressing soaked Moderate-25–75% of dressing soaked Large/Heavy->75% soaked or leakage present ✅ Causes of Excessive Drainage • Infection • Hematoma • Poor wound closure • High blood pressure • Diabetes • Malnutrition ✅ Signs of Infection in Wound Drainage Watch for: • Thick yellow, green, or brown discharge • Bad smell • Increased redness or warmth • Pain or swelling • Fever ✅ Types of Wound Drains (if placed surgically) 🔹 Open Drains • Example: Penrose drain • Passive drainage into gauze • Higher infection risk 🔹 Closed Drains • Examples: Jackson-Pratt (JP), Hemovac • Fluid collects in a suction reservoir • Lower infection risk ✅ Management of Wound Drainage • Keep area clean and dry • Change dressings regularly • Use aseptic technique • Monitor color, odor, and amount • Notify healthcare provider for signs of infection • Maintain balanced nutrition and hydration ✅ Documentation Checklist When assessing wound drainage, note: • Type (serous, sanguineous, etc.) • Color • Odor • Consistency • Amount • Progression or changes ✅ When to Seek Medical Attention • Sudden increase in drainage • Pus or foul-smelling fluid • Bleeding that does not stop • Redness and swelling around wound • Fever or chills

🦟 #LymeDisease #Prophylaxis – #MCCQE1 Tick Bite Triage A patient comes to your clinic after being bitten by a tick. Do you give them antibiotics? Knowing the specific criteria for post-exposure prophylaxis (PEP) is a must for the MCCQE1. Not every bite needs treatment! 🧠 The 5 Key Criteria for Prophylaxis You should ONLY provide prophylaxis if ALL of the following five conditions are met: ✅ 1. Tick Identified: The attached tick is confirmed to be an adult or nymphal Ixodes scapularis (deer tick). ✅ 2. Attachment Time ≥ 36 hours: The tick is estimated to have been attached for 36 hours or more, based on how engorged it is or the patient's history. ✅ 3. Prophylaxis Started Within 72 hours: You can start the antibiotic within 72 hours of the tick being removed. ✅ 4. Endemic Area: The patient acquired the tick in an area where Lyme disease is endemic (local tick infection rate with Borrelia burgdorferi is ≥ 20%). ✅ 5. No Contraindications: The patient has no contraindications to doxycycline (i.e., not pregnant, not lactating, and not under 8 years of age). 💊 Management If all 5 criteria are met: Give a single dose of Doxycycline 200 mg. If ANY criterion is NOT met OR if contraindications exist: Do NOT give prophylaxis. Reassure the patient and instruct them to watch for signs and symptoms of early Lyme disease (fever, malaise, erythema migrans) over the next 30 days. 💡 Key MCCQE1 Exam Points There is no alternative antibiotic recommended for prophylaxis in children < 8 or pregnant/lactating women. The recommendation for these groups is watchful waiting. Blood tests for Lyme disease are NOT useful immediately after a tick bite and are not indicated. 📌 MCCQE1 Takeaway: ✔️ Remember the numbers: Tick attached for ≥ 36 hours, prophylaxis started within 72 hours. ✔️ Drug of choice: Doxycycline 200 mg as a one-time single dose. ✔️ Prophylaxis is an "all or nothing" deal based on the 5 criteria. ✔️ If there are contraindications to doxycycline, the answer is observation, not an alternative antibiotic. Follow 👉 MCCQE1 Study Hub for more high-yield #infectious_disease topics! 🩺 #MCCQE1 #LymeDisease #InfectiousDisease #Doxycycline #IMGSuccess #CanadianMLE #HighYieldMedicine #FamilyMedicine #MedicalEducation

Antibiotic use and C. difficile risk: correlating prescribing with infection A new study in Infection Prevention in Practice from Bern University Hospital in Switzerland offers compelling insights into how antibiotic prescribing patterns correlate with Clostridioides difficile infection (CDI) rates across 17 clinical departments. Over 2.9 million patient-days were analyzed, revealing: -A significant association between overall antibiotic consumption and CDI incidence (no big surprise here!). - Departments like nephrology, pulmonary medicine, and haemato-oncology showed the highest CDI rates. - Specific antibiotics (carbapenems, ceftriaxone, cefepime, macrolides, and piperacillin/tazobactam) were linked to increased CDI risk. Interestingly, some departments with high antibiotic use (e.g., urology) had low CDI rates, suggesting that patient population characteristics and length of stay may also play a role (see image). The key message? Antibiotic stewardship must be tailored to departmental prescribing habits and patient profiles. Surveillance and targeted interventions will help reduce CDI rates and improve patient outcomes. Read the full open-access study here: https://lnkd.in/e_ba98Eg #AntibioticStewardship #InfectionPrevention #HealthcareQuality #CDI #HospitalEpidemiology #AntimicrobialResistance Healthcare Infection Society

the care of diabetic foot ✅ 1. Initial Assessment Before treatment, evaluate: • Size, depth, and location of wound • Presence of infection (redness, warmth, swelling, pus, odor) • Neuropathy (loss of sensation) • Vascular status (pulses, capillary refill, ABI) • Glycemic control • Any exposed bone or signs of osteomyelitis ✅ 2. Wound Cleansing • Clean with normal saline or clean water. • Avoid hydrogen peroxide or iodine unless specifically indicated (can delay healing). • Gently remove debris. ✅ 3. Debridement To remove dead tissue and promote healing: Types: • Sharp/surgical (preferred in infected or deep wounds) • Enzymatic (e.g., collagenase) • Autolytic (moist dressings) • Mechanical (wet-to-dry dressings, low-pressure irrigation) Repeated debridement may be needed. ✅ 4. Infection Control Look for: • Pus • Odor • Surrounding erythema • Cellulitis • Fever Management: • Mild infection: oral antibiotics (e.g., amoxicillin-clavulanate, cephalexin, clindamycin) • Moderate to severe or deep infection: IV antibiotics (e.g., piperacillin-tazobactam, ceftriaxone + metronidazole) • Suspected osteomyelitis: MRI & long-course antibiotics Culture if purulent discharge is present. ✅ 5. Dressings Goal: maintain a moist but not wet environment. Based on wound type: • Dry wounds: hydrogel, moist gauze • Exudative wounds: foam dressings, alginates • Infected wounds: iodine, silver, honey dressings (if indicated) • Deep wounds: pack with saline gauze or special fillers Dressings should be changed daily or as needed. ✅ 6. Offloading (Pressure Relief) Critical for healing. Options: • Total contact cast (TCC) – gold standard • Removable cast walkers • Orthotic shoes or custom insoles • Wheelchair/crutches if needed • Avoid walking barefoot ✅ 7. Glycemic Control Poor sugar control delays healing and increases infection risk. • Monitor and adjust insulin or oral hypoglycemics • Aim for fasting glucose < 140 mg/dL (or < 7.8 mmol/L) • Manage hypertension, lipids, and weight ✅ 8. Vascular Assessment & Intervention If pulses are weak or wound is not healing, evaluate: • Doppler ultrasound or ABI • CT angiography or MR angiography • Consider revascularization (angioplasty or bypass) if needed ✅ 9. Pain Control • Paracetamol or NSAIDs if no contraindications • Avoid excessive pressure on the wound ✅ 10. Patient Education & Prevention • Daily foot inspection • Keep feet clean and dry • Trim nails carefully • Proper footwear (wide, cushioned) • Control blood sugar • No barefoot walking ✅ 11. When to Refer • Deep ulcers • Gangrene • Abscess or osteomyelitis • Peripheral arterial disease • Non-healing wound >4 weeks Referral may be to a wound care specialist, podiatrist, vascular surgeon, or endocrinologist. ✅ Summary Effective diabetic foot wound care includes: ✔ Debridement ✔ Infection control ✔ Moist dressings ✔ Offloading ✔ Glycemic control ✔ Vascular support ✔ Patient education

⚙️ An "intra-abdominal drain culture" is the laboratory analysis of fluid collected from a drain placed inside the abdomen to check for the presence of infection-causing microorganisms. 🔎 While useful, drain cultures can be misleading because the fluid can become contaminated or not accurately represent a deeper infection. 🧫 Cultures are most helpful in the first 12–24 hours after placement, with a high negative predictive value but low positive predictive value, meaning they are good at ruling out infection but poor at confirming it. 💧 Routine sampling of abdominal drains is generally not recommended, as colonization is common and can increase over time, potentially leading to misleading results and prolonging treatment unnecessarily. 🎯 Culturing every intra-abdominal drain too early can lead to false positives, unnecessary antibiotics, and clinical confusion. 🚫💉 ✅ Best Practice: 1️⃣ Avoid routine drain cultures in the first 24 hours post-op, unless the patient is deteriorating or shows clear infection signs. 2️⃣ Wait ≥24–48 hours and culture only if #clinical red flags appear: fever, leukocytosis, cloudy/foul-smelling output, or new abdominal tenderness. 3️⃣ Use aseptic technique: withdraw directly from the tubing with a sterile syringe — never from the collection bag. 📖 Reference: UpToDate. Management of surgical drains and collections: Indications for culture and interpretation of results. Accessed Sept 2025.

A couple of weeks ago, I heard someone narrate the pathetic story of a child of about 10 years old who had a bacterial infection (not quite sure of which exactly now), and for whom the doctors couldn't find an effective antibiotics. She was reported to have pleaded, "Doctor, please help me. Don't let me die." The doctors wanted to help her, except that they were handicapped. Sadly, the child didn't make it out of the hospital alive. During the years I spent in community practice, I saw a lot of wrong approaches to medicine use by patients. In commemoration of World Pharmacists Day, I thought to share a few common practices pertaining to medication use that you should stop today: ❎️Self-Medication. This is very common, and it involves being a doctor to yourself (without going to a medical school, of course) and deciding on what medication to take when you're ill. ❎️Stopping your medication before time. If the prescription says, "Take for 1 week," ensure you stick to the duration. Failure to do this leads to antimicrobial resistance. This makes your body so used to antibiotics that they fail to work when we need them to. This was the situation of the child I mentioned earlier. ❎️Sharing medication with family and friends who have similar symptoms. This is why you should desist from this: several disease conditions present with similar signs and symptoms. Only through proper medical tests and examination can a doctor arrive at a correct diagnosis. ❎️Using antibiotics for viral infections. Viral infections like cold, flu, chicken pox, measles, etc., do not require an antibiotic. Speak to your doctor or pharmacist about your concerns. ❎️Taking herbal meds with orthodox meds. This is why it's important you let your pharmacist know about every meds that you're currently on at every visit. ❎️Failing to take your meds at specified times. Instructions like, "take at specific times daily, every 8 hours, take with or without food, or take 1 hour after meals" were intentionally given. Ensure to stick with them. PS: For want of writing space, I'll share two more in the comments section. This is the conclusion of the whole matter: Whenever you're in doubt about your meds, speak with your pharmacist. Happy World Pharmacists Day to me and every pharmacist in my circle. I celebrate you!🫡🥰 Keep doing the great work you're doing.👏✌️🥰 Think Health, Think Pharmacist🤗 #WorldPharmacistDay #ThinkHealthThinkPharmacist #Healthcare #ClinicalPharmacist #MedicationUse #AntimicrobialResistance International Pharmaceutical Federation (FIP)

🎯35/365 🌿 Rheumatic Fever: A Preventable Threat to Young Hearts ⚡Rheumatic fever is an inflammatory disease that can develop after an untreated or inadequately treated Group A Streptococcal throat infection (commonly known as strep throat or scarlet fever). Though less common in developed countries, it remains a major public health concern in many parts of the world, especially affecting children and adolescents. 🔹 How it develops ✨The body’s immune response to streptococcal infection mistakenly attacks healthy tissues. ✨This immune cross-reaction damages the heart, joints, skin, and nervous system. ✨Repeated episodes can cause Rheumatic Heart Disease (RHD), leading to permanent valve damage. 🔹 Key Clinical Features (Jones Criteria) Major manifestations: 📌Carditis (inflammation of heart layers/valves) 📌Polyarthritis (migratory joint pain and swelling) 📌Sydenham’s chorea (abnormal involuntary movements) 📌Erythema marginatum (distinct skin rash) 📌Subcutaneous nodules (small, firm lumps under skin) Minor manifestations: 📌Fever 📌Arthralgia 📌Elevated ESR/CRP 📌Prolonged PR interval on ECG 🔹 Complications ⚡Rheumatic Heart Disease: Mitral valve stenosis/regurgitation is most common. ⚡Heart failure, arrhythmias, and increased risk of stroke. 🔹 Prevention & Management ✅ Primary prevention: Early diagnosis and complete antibiotic treatment of strep throat (usually penicillin). ✅ Secondary prevention: Long-term prophylactic antibiotics to prevent recurrence. ✅ Management: Anti-inflammatory treatment (aspirin, corticosteroids in severe cases), supportive cardiac care, and surgical intervention for advanced RHD. 🔹 Why it matters ⚡Affects over 33 million people worldwide. ⚡Causes over 300,000 deaths annually, mostly in low- and middle-income countries. ⚡Yet, it is largely preventable with timely medical care and awareness. 🌍 By strengthening early detection, antibiotic compliance, and preventive strategies, we can significantly reduce the global burden of rheumatic fever and protect young hearts from lifelong damage. 💡 Awareness today ensures healthier generations tomorrow.

ASO Test (Antistreptolysin O Test) What is it? The ASO test measures the level of antistreptolysin O antibodies in the blood. These antibodies are produced by the immune system in response to infection with Group A Streptococcus bacteria (e.g., Streptococcus pyogenes), which cause illnesses like strep throat, scarlet fever, or skin infections. Purpose of the ASO Test It is not used to diagnose current infection, but rather to confirm a recent streptococcal infection, especially when complications are suspected. It helps diagnose post-streptococcal complications, such as: • Rheumatic fever • Post-streptococcal glomerulonephritis (kidney inflammation) • Scarlet fever complications When is it Ordered? Doctors order an ASO test when a person presents with: • Joint pain, heart symptoms, or fever (suggestive of rheumatic fever) • Swelling or blood in urine (suggestive of post-streptococcal kidney disease) • History of recent sore throat or skin infection Often paired with Anti-DNase B test for better accuracy. Limitations • Does not confirm active infection • Not useful for skin infections, where ASO response may be lower • Must be correlated with clinical findings and other investigations Conclusion The ASO test is a helpful tool to detect a recent past streptococcal infection, especially when evaluating rheumatic fever or post-streptococcal kidney complications.