Bacteremia

Bacteremia: Description, Causes and Risk Factors:

The presence of viable bacteria in the circulating blood; may be transient following trauma such as dental or other iatrogenic manipulation or may be persistent or recurrent as a result of infection.

ICD-9-CM: 790.7.

Alternative Names: Blood poisoning, bacteremia with sepsis, systemic infammatory response syndrome (SIRS).

BacteremiaBacteremia refers to the presence of bacteria in the bloodstream. This occurs when there is a break in the body's natural barrier, usually for two reasons:

Trauma, like dental work.

  • Worsening bacterial infection.

Dental or medical procedures can lead to bacteremia. During dental procedures (as during tooth cleaning by a dental hygienist), bacteria living on the gums may become dislodged and enter the bloodstream. Bacteremia may also occur when catheters are inserted into the bladder or tubes are inserted into the digestive or urinary tract. Bacteria may be present at the site of insertion (such as the bladder or intestine). So even though sterile techniques are used, these procedures may move bacteria into the bloodstream. Surgical treatment of infected wounds, abscesses, and pressure sores can dislodge bacteria from the infected site, causing bacteremia.

In some bacterial infections, such as pneumonia and skin abscesses, bacteria may periodically enter the bloodstream, causing bacteremia. Many common childhood bacterial infections cause bacteremia.

Symptoms:

Bacteremia can begin with spiking fevers, chills, rapid breathing, and rapid heart rate. The person looks very ill. The symptoms rapidly progress to shock with fever or decreased body temperature (hypothermia), falling blood pressure, confusion or other changes in mental status, and blood clotting problems that lead to a specific type of red spots on the skin (petechiae and ecchymosis). There may be decreased or no urine output.

Diagnosis:

If bacteremia is suspected, doctors usually do blood tests to try to grow the bacteria in the laboratory (blood cultures). Bacteremia is diagnosed by culturing the blood for bacteria. Samples may needto be tested several times over several hours. Blood analysis may also reveal an elevated number of white blood cells. Blood pressure is monitored closely; a decline in blood pressure may indicate the onset of septic shock.

Treatment Options:

Bacteremia is a serious condition that requires a hospital stay. You may be admitted to an intensive care unit (ICU).

Antibiotics are the mainstay of treatment, and are often begun before positive identification of the bacteria is made. Close observation is required to guard against septic shock. Since bacteremia is usually associated with an existing infection elsewhere in the body, finding and treating this infection isan important part of treatment.

Prompt antibiotic therapy usually succeeds in clearing bacteria from the bloodstream. Recurrence may indicate an undiscovered site of infection. Untreatedbacteria in the blood may spread, causing infection of the heart (endocarditis or pericarditis) or infection of the covering of the central nervous system (meningitis).

Fluids and medicines are given by an IV to maintain the blood pressure. Oxygen will be given. Antibiotics are used to treat the infection. Plasma or other blood products may be given to correct any clotting abnormalities.

Bacteremia can be prevented by preventing the infections which often precedeit. Good personal hygiene, especially during viral illness, may reduce the risk of developing bacterial infection. Treating bacterial infections quickly and thoroughly can minimize the risk of spreading infection. During medical procedures, the burden falls on medical professionals to minimize the number and duration of invasive procedures, to reduce patients' exposure to sources ofbacteria when being treated, and to use scrupulous technique.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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