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• W2095212077 abstract "Faire le point sur les différentes urgences thérapeutiques qui peuvent être rencontrées en infectiologie. Revue des moyens diagnostiques en infectiologie et des principales urgences (chocs septiques, méningites purulentes et méningoencéphalites, fasciites nécrosantes, neutropénies fébriles, paludisme) et de la littérature. La prise en charge de ce type de pathologie nécessite de poser un diagnostic sans équivoque. En effet, de ce dernier va découler la meilleure option thérapeutique. En infectiologie, ce diagnostic repose sur trois éléments : l’organe infecté, le terrain sur lequel survient l’infection et le germe en cause ou potentiellement en cause. Ces trois paramètres vont permettre au prescripteur d’optimiser le type de molécule(s) à utiliser, la posologie et le mode d’administration. Ceux-ci vont aussi permettre de juger du niveau de gravité de l’infection. Ils sont obtenus au moyen d’un examen clinique, et si nécessaire, de l’utilisation de la biologique, de l’imagerie et de la microbiologie. Le traitement de ces urgences va reposer sur l’antibiothérapie. En général, celle-ci est débutée alors que le germe n’est pas encore connu. Celui-ci est suspecté et il faut donc connaître l’écologie habituelle de l’infection afin de choisir au mieux les molécules qui permettront de le couvrir. Il faut aussi tenir compte de la pharmacodynamie du traitement et s’assurer que celui-ci va diffuser en concentration suffisante au niveau de l’infection. Dans certaines circonstances, il faut savoir recourir à la chirurgie ou à des traitements non antibiotiques comme la corticothérapie ou la protéine C activée. Update on different kind of emergencies in infectious diseases. 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. 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. 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." @default.
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• W2095212077 date "2008-09-01" @default.
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• W2095212077 title "Urgences en infectiologie" @default.
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• W2095212077 doi "https://doi.org/10.1016/j.antib.2008.06.005" @default.
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