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Infectious Diseases: General Infections Presented by: APS Healthcare Southwestern PA Health Care Quality Unit (HCQU) December 2010 ak Disclaimer Information or education provided by the HCQU is not intended to replace medical advice from the consumer’s personal care physician, existing facility policy or federal, state and local regulations/codes within the agency jurisdiction. The information provided is not all inclusive of the topic presented. Certificates for training hours will only be awarded to those who attend a training in its entirety. Attendees are responsible for submitting paperwork to their respective agencies. © 2009 APS Healthcare, Inc. 2 Note of Clarification While mental retardation (MR) is still recognized as a clinical diagnosis, in an effort to support the work of self-advocates, the APS SW PA HCQU will be using the terms intellectual and/or developmental disability (ID/DD) to replace mental retardation (MR) when feasible. © 2009 APS Healthcare, Inc. 3 Objectives Identify signs and symptoms of common bacterial, viral, fungal and parasitic infections. List the various cycles in the infection process Describe when medical treatment should be sought Discuss preventative measures that reduce the risk of infection. © 2009 APS Healthcare, Inc. 4 Definition of Infection The invasion of the human body by a pathogen, such as a bacterium, fungus, virus or parasite, resulting in an infectious process. © 2009 APS Healthcare, Inc. 5 Infectious Process: Chain of Infection Infectious Agent Susceptible Host Portal of Entry Reservoir Mode of Transmit © 2009 APS Healthcare, Inc. Portal of Exit 6 Contributing Factors: Individuals Most at Risk • Individuals most at risk • Age • General health • Risks of exposure Individuals most at Risk © 2009 APS Healthcare, Inc. 7 Four Main Types of Infections 1. Bacterial 2. Viral 3. Fungal 4. Parasitic © 2009 APS Healthcare, Inc. 8 Infections: Medical Therapies and Home Remedies Medical Therapies Home Remedies © 2009 APS Healthcare, Inc. 9 Bacterial Infection: Definition Invasion of bacteria into the body or bodily tissues resulting in an infectious process. © 2009 APS Healthcare, Inc. 10 Bacterial Infections: Common Infections • Streptococcal Sore Throat • Bacterial “Sinusitis” • Otitis Media • Bacterial Conjunctivitis • Urinary Tract Infection © 2009 APS Healthcare, Inc. 11 Streptococcal Sore Throat / Strep Throat: Definition Acute bacterial inflammation: sore throat caused by the bacterium Streptococcus © 2009 APS Healthcare, Inc. 12 Strep Throat: Signs and Symptoms Throat pain Difficulty swallowing Inflamed tonsils – red with signs of pus Swollen tender lymph glands (nodes) Fever Headache Fatigue © 2009 APS Healthcare, Inc. 13 Strep Throat: Diagnosis Physical exam Throat culture © 2009 APS Healthcare, Inc. 14 Strep Throat: Treatment Medical Therapies – Antibiotics – Pain/fever reducers Home Remedies: – – – – – © 2009 APS Healthcare, Inc. Rest Increase fluids Bland/soft diet Humidification of air Avoidance of irritants 15 Strep Throat: Prevention Hand washing Covering of mouth Replacement of toothbrushes Avoid sharing personal Items © 2009 APS Healthcare, Inc. 16 Bacterial “Sinusitis”: Definition An infection and inflammation of the sinus cavities by a disease causing bacterial agent. © 2009 APS Healthcare, Inc. 17 Bacterial “Sinusitis”: Signs and Symptoms Drainage of a thick yellow or greenish discharge (nose or throat) Nasal congestion Pain/tenderness around eyes, cheeks, nose or forehead Aching in upper jaw or teeth Reduced sense of smell or taste Cough Fatigue Fever © 2009 APS Healthcare, Inc. 18 Bacterial “Sinusitis”: Diagnosis Physical exam Nasal & Sinus cultures Imaging studies © 2009 APS Healthcare, Inc. 19 Bacterial “Sinusitis”: Treatment Medical Therapies – – – – Antibiotics Nasal Corticosteroids Decongestants Pain/fever reducers Home Remedies – Rest – Increase of fluids – Warm compresses to face © 2009 APS Healthcare, Inc. 20 Bacterial “Sinusitis”: Prevention Proper Hand washing Avoid upper respiratory infections Avoid smoking or other air pollutants Humidification of air © 2009 APS Healthcare, Inc. 21 Otitis Media: Definition An infection and inflammation of the middle ear caused by a bacterial agent. © 2009 APS Healthcare, Inc. 22 Otitis Media: Signs and Symptoms Ear pain Drainage of fluid from ears Diminished hearing Sore throat Fever © 2009 APS Healthcare, Inc. 23 Otitis Media: Diagnosis Physical Exam – Pneumatic Otoscope Tympanocentesis Hearing evaluation © 2009 APS Healthcare, Inc. 24 Otitis Media: Treatment Medical Therapies – Antibiotics – Medicated ear drops – Fever/pain reducers Home Remedies – Warm compresses to ear © 2009 APS Healthcare, Inc. 25 Otitis Media: Prevention Proper hand washing techniques Avoidance of upper respiratory infections Avoid smoking or air pollutants © 2009 APS Healthcare, Inc. 26 Bacterial Conjunctivitis “Pink Eye”: Definition An inflammation and infection of the conjunctiva of the eye due to a bacterial agent. © 2009 APS Healthcare, Inc. 27 Bacterial Conjunctivitis “Pink Eye”: Signs and Symptoms Redness in one or both eyes Itchiness in one or both eyes A gritty feeling in one or both eyes Yellow discharge in one or both eyes that forms a crust during the night Tearing © 2009 APS Healthcare, Inc. 28 Bacterial Conjunctivitis “Pink Eye”: Diagnosis Physical exam Eye culture © 2009 APS Healthcare, Inc. 29 Bacterial Conjunctivitis “Pink Eye”: Treatment Medical Treatment – Antibiotic eye drops/ointments Home Remedies – Warm compresses to eye – Avoiding contact lens wear © 2009 APS Healthcare, Inc. 30 Bacterial Conjunctivitis “Pink Eye”: Prevention Hand washing Avoid touching eyes Use a clean washcloth and towel daily Do not share personal eye items © 2009 APS Healthcare, Inc. 31 Urinary Tract Infection (UTI): Definition An infection or inflammation of the urinary tract system caused by a bacterial agent. © 2009 APS Healthcare, Inc. 32 Urinary Tract Infection: Signs and Symptoms Urinary urgency Burning sensation upon urination Passing frequent small amount of urine Cloudy urine Foul-smelling urine Pelvic Pain © 2009 APS Healthcare, Inc. 33 Urinary Tract Infection: Diagnosis Physical exam Urinalysis Urine culture © 2009 APS Healthcare, Inc. 34 Urinary Tract Infection: Treatment Medical Therapies – Antibiotic therapy – Urinary pain relievers (Pyridium, Uristat) – Fever / pain reducers Home Remedies – Rest – Increase fluids – Heat application for pain © 2009 APS Healthcare, Inc. 35 Urinary Tract Infection: Prevention Genital cleansing technique Cotton underwear Avoid irritants Frequent changing of incontinent aids © 2009 APS Healthcare, Inc. 36 Viral Infections: Definition Invasion of a virus into the body or bodily tissues resulting in an infectious process. © 2009 APS Healthcare, Inc. 37 Viral Infections: Common Viruses Rhinovirus “Common Cold” Influenza Viral Gastroenteritis © 2009 APS Healthcare, Inc. 38 Rhinovirus “Common Cold”: Definition A viral infection of the upper respiratory tract (nose and throat). © 2009 APS Healthcare, Inc. 39 Rhinovirus “Common Cold”: Signs and Symptoms Runny or stuffy nose Itchy or sore throat Cough Congestion Slight body aches Sneezing Watery eyes Low – grade fever © 2009 APS Healthcare, Inc. 40 Rhinovirus “Common Cold”: Diagnosis Physical exam © 2009 APS Healthcare, Inc. 41 Rhinovirus “Common Cold”: Treatment Medical Therapies – Antibiotics Not Effective!!! – – – – Decongestant nasal spray Cough reducers Saline nasal drops Fever/pain reducers Home Therapies – – – – Rest Increase fluids Chicken soup Humidification of air NO CURE!!!! © 2009 APS Healthcare, Inc. 42 Rhinovirus “Common Cold”: Prevention Hand washing Disinfection of everyday items Proper disposal of tissues Cover mouth when coughing © 2009 APS Healthcare, Inc. 43 Influenza (Flu): Definition An acute contagious viral infection characterized by inflammation of the respiratory tract. © 2009 APS Healthcare, Inc. 44 Influenza: Signs and Symptoms Fever over 100 degrees Chills and sweats Headache Dry cough Aching muscles Fatigue and weakness Nasal congestion © 2009 APS Healthcare, Inc. 45 Influenza: Diagnosis Physical exam Nasal cultures © 2009 APS Healthcare, Inc. 46 Influenza: Treatment Medical Therapies – – – – Fever/pain reducers Decongestants Cough medicine Antiviral medications Home Remedies – REST – Increase of fluids © 2009 APS Healthcare, Inc. 47 Influenza: Prevention Influenza vaccination Hand washing Proper sneezing and coughing techniques Avoidance of crowds © 2009 APS Healthcare, Inc. 48 Viral Gastro-enteritis: Definition An inflammation and infection of the stomach and intestines, caused by a viral agent. © 2009 APS Healthcare, Inc. 49 Viral Gastro-enteritis: Signs and Symptoms Watery, loose stools Abdominal cramps and pain Nausea Vomiting Occasional muscle aches Low- grade fever © 2009 APS Healthcare, Inc. 50 Viral Gastro-enteritis: Diagnosis Physical exam Stool culture © 2009 APS Healthcare, Inc. 51 Viral Gastro-enteritis: Treatment Medical Therapies – No medical therapies unless complications Home Remedies – – – – © 2009 APS Healthcare, Inc. Rest Increase fluids slowly (clear fluids only) BRAT Diet (Bananas, Rice, Applesauce, Toast) Avoid food and drink irritants 52 Viral Gastro-enteritis: Prevention Hand washing Proper disposable of incontinent briefs © 2009 APS Healthcare, Inc. 53 Fungal Infection: Definition An Inflammation and infection of the body or bodily tissues caused by a fungal agent. © 2009 APS Healthcare, Inc. 54 Fungal Infection: Common Infections Candida “Yeast” – Oral “Thrush” – Vaginal Tinea “Ringworm” – – – – © 2009 APS Healthcare, Inc. Tinea Corporis (Body) Tinea Pedis (Foot) Tinea Cruris (Perineal Area) Tinea Capitis(Scalp) 55 Fungal - Candida Yeast Infections: Signs and Symptoms Oral Yeast – “Thrush” – – – – – Creamy white lesion in oral cavity Cottage cheese consistency Pain Bleeding of sores Loss of taste Vaginal Yeast – – – – © 2009 APS Healthcare, Inc. Itching/Irritation of tissues of vagina Redness/swelling of vaginal tissues Burning sensation on urination Thick white/cottage cheese discharge 56 Fungal - Candida Yeast Infections: Diagnosis Physical exams Cultures (oral, vaginal) © 2009 APS Healthcare, Inc. 57 Fungal - Candida Yeast Infections: Treatment Medical Therapies – Oral Yeast • Anti-fungal medication • Anti-inflammatory/pain reducers – Vaginal Yeast • Anti-fungal medication • Anti-inflammatory/pain reducers Home Remedies – Follow good oral care – Keep vaginal area clean and dry © 2009 APS Healthcare, Inc. 58 Fungal - Candida Yeast Infections: Prevention Oral Yeast – Good oral hygiene – Rinsing of mouth after inhaler use – Salt water rinses Vaginal Yeast – – – – © 2009 APS Healthcare, Inc. Avoid use of bubble baths Avoid use of scented feminine hygiene products Use of cotton underwear Frequent changing of incontinent briefs/pads 59 Fungal Infection – Ringworm (Tinea): Definition Ringworm is a fungal infection called “Tinea” that affects the top outer layer of the skin. Types – Tinea Corporis (Body) – Tinea Pedis (Foot) – Tinea Cruris (Perineal Area) – Tinea Capitis(Scalp) © 2009 APS Healthcare, Inc. 60 Fungal Infection – Ring worm (Tinea): Signs and Symptoms Red and inflamed circular rash Raised expanding rings of red & scaly skin Round flat patch of itchy skin © 2009 APS Healthcare, Inc. 61 Fungal Infection – Ringworm (Tinea): Diagnosis Physical exam Skin culture © 2009 APS Healthcare, Inc. 62 Fungal Infection – Ringworm (Tinea): Treatment Anti-fungal Medications (topical / oral) – Non-prescription – Prescription © 2009 APS Healthcare, Inc. 63 Fungal Infection – Ringworm (Tinea): Prevention Frequent hand washing Diligent drying of skin after bathing Wear appropriate clothing – Avoid excessive sweating Avoid infected animals No sharing of personal items © 2009 APS Healthcare, Inc. 64 Parasitic Infections: Definition A growth of a parasitic organism within or on the human body. © 2009 APS Healthcare, Inc. 65 Parasitic Skin Infections/Infestations: Types Lice – Head – Body – Pubic Scabies © 2009 APS Healthcare, Inc. 66 Parasitic Skin Infections/Infestations: Signs and Symptoms Lice – – – – – Intense itching Tickling feeling from movement of hair Lice eggs on scalp, body, clothing or pubic region Lice eggs (nits) on hair shaft Small, red bumps on the scalp, neck and shoulders Scabies – Itching, often severe, worse at night – Thin, irregular burrow tracks made up of tiny blisters or bumps on your skin – Burrows on folds of skin © 2009 APS Healthcare, Inc. 67 Parasitic Skin Infections/Infestations: Diagnosis Physical exam Skin Scraping © 2009 APS Healthcare, Inc. 68 Parasitic Skin Infections/Infestations: Treatment Medical Therapies – Lice • Over the Counter Medications • Prescription Medications – Scabies • Prescription Medication Home Remedies – Keep body and hair clean at all times © 2009 APS Healthcare, Inc. 69 Parasitic Skin Infections/Infestations: Prevention Lice Wash contaminated items Seal unwashable items Vacuum Cover Furniture Do not share personal belongings Wash combs and brushes Scabies © 2009 APS Healthcare, Inc. Clean all bedding and linens Seal unwashable items Do not share personal clothing items 70 Tips for Caregivers Keep all areas of the environment clean Assist individuals with good oral and personal hygiene daily Watch for signs and symptoms Seek immediate medical treatment Administer all medications as directed © 2009 APS Healthcare, Inc. 71 References © 2009 APS Healthcare, Inc. Center of Disease Control. Influenza Topics: Seasonal Flu. Retrieved. 11/03/2010. From http://www.cdc.gov/flu/ Maryland Office of Infectious Disease and Occupational Health Division. Fact Sheets. Strep Throat. Retrieved 10/28/2010 from http://www.edcp.org/factsheets/strepthr.cfm National Institute of Health. Medline Plus Division. Diseases. Bacterial Infections. Retrieved 10/28/2010. From http://www.nlm.nih.gov/medlineplus/bacterialinfections.html Common Cold. Testing Cold Treatments. Retrieved 10/30/2010. From http://www.commoncold.org/special.htm Mayo Clinic Staff. Diseases and Conditions. Strep Throat. Retrieved 10/25/2010. From http://www.mayoclinic.com/health/Strep-throat 72 References © 2009 APS Healthcare, Inc. Mayo Clinic Staff. Diseases and Conditions. Acute Sinusitis. Retrieved 10/27/2010. From http://www.mayoclinic.com/health/Acute-Sinusitis Mayo Clinic Staff. Diseases and Conditions. Pink eye: Conjunctivitis. Retrieved 11/02/2010. From http://www.mayoclinic.com/health/Pink Eye Mayo Clinic Staff. Diseases and Conditions. Urinary Tract Infections. Retrieved 10/28/2010. From http://www.mayoclinic.com/health/Urinary-tract-infections Mayo Clinic Staff. Diseases and Conditions. Ringworm. Retrieved 11/06/2010. From http://www.mayoclinic.com/health/Ringworm Mayo Clinic Staff. Diseases and Conditions. Lice. Retrieved 11/09/2010. From http://www.mayoclinic.com/health/lice Wikipedia. The Free Encyclopedia. Scabies. Retrieved 11/09/2010 From http://en.wikipedia.org/wiki/Scabies 73