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[肿瘤学中的感染相关急症]

[Infection-related emergencies in oncology].

作者信息

Schiel X, Rieger C, Ostermann H

机构信息

Medizinische Klinik und Poliklinik III-Grosshadern, Ludwig-Maximilians-Universität München.

出版信息

Internist (Berl). 2005 Jan;46(1):39-47. doi: 10.1007/s00108-004-1317-1.

Abstract

Infections in immunosuppressed patients have always to be regarded as emergencies, as they have a high rate of complications and mortality. The most important risk factor is severity and duration of granulocytopenia. Risk scores help to identify patients who, despite their immune deficiency have a low risk of complications. Diagnostic measures to identify the causative microorganism and the source of infection is necessary. However, diagnostic investigation must not delay the immediate onset of antimicrobial treatment. Patients often have to be treated empirically as the identification of the causative microorganism or the source of infection are often unknown at the beginning of clinical symptoms. Empirical treatment has to be broad to cover possible microorganisms. Especially meningitis, abdominal infections, sepsis and pneumonia can be regarded as infectiological emergencies. Patients with these infections have to be treated with intensive antimicrobial treatment, taking into account the possible causative agents.

摘要

免疫抑制患者的感染始终应被视为紧急情况,因为它们具有很高的并发症发生率和死亡率。最重要的危险因素是粒细胞减少的严重程度和持续时间。风险评分有助于识别那些尽管存在免疫缺陷但并发症风险较低的患者。识别致病微生物和感染源的诊断措施是必要的。然而,诊断调查绝不能延误抗菌治疗的立即开始。由于在临床症状出现之初往往不知道致病微生物或感染源,患者常常需要接受经验性治疗。经验性治疗必须广泛,以覆盖可能的微生物。特别是脑膜炎、腹腔感染、败血症和肺炎可被视为感染性紧急情况。患有这些感染的患者必须接受强化抗菌治疗,并考虑可能的病原体。

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