Infections

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Treating Infections

Almost all short gut patients (especially infants?) get infections from bacteria of one sort or another. These come from overgrowth of bacteria in the gut (often gram-negative and virulent bugs) and from contamination of the IV from skin contact or other bacteria (often gram positive). It is also possible to get an infection of the Central line that is caused by yeast.

  • The gram positive drug of choice appears to be vancomycin. If that doesn't work, you may get rifampin.
  • The gram negative ones are more specific, but often start with a "c" and are hard to keep straight, including:.. (fill in!) Cefazolin, Ceftazadine.
  • A yeast infection of the CVL is usually caused from translocation from the gut. Yeast overgrowth in the gut transfers to the blood stream and settles on the CVL. Usually the child will be put on IV antifungals to treat the yeast in the blood stream and oral antifungals to treat the overgrowth in the intestines. Alcohol locks in combination with aggressive antifungal therapy can be an effective way to clear yeast from CVLs, but sometimes the only way to completely rid the body of the yeast in the blood is to remove the CVL. A few days of IV antifungals with no CVL usually takes care of the problem.
  • Leuconostoc can be misidentified as enterococcus or streptococcus. It is vancomycin-resistant, and is usually treated with some form of penicillin (e.g., ampicillin) with or without gentamicin. Pdf icon.png PIDJ.pdf - Florescu et al. 2008, Pediatric Infectious Disease Journal.

Prevention

Prediction

  • InfectionPrediction What signs predict the onset of an infection prior to a fever of 100.5/38 or greater? Share your stories -- catching it early will limit damage to the liver.. (click link for details)

Effects on the Liver

  • Liver Impact from Infection How much of an effect does an infection have on the liver? Is it permanent or transient? How much does that depend on the current overall health state? Share your stories..