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diagnosis differential management fungal betadglucan endocarditis galactomannan infectiousdiseases infective negative perioperative treatment anesthesia anesthesiology bcnie biomarkers bloodculture bloodcultures candida candidemia
Eosinophil Disorders Testing Algorithm INDICATIONS FOR TESTING: • Peripheral blood eosinophilia/hypereosinophilia uncovered incidentally during medical evaluation or
Algorithm INDICATIONS ... evaluation or workup ... 1,500 cells/µL Workup ... for secondary causes ... signs or symptoms (eg
Proposed Algorithm for Diagnosing Sarcoidosis Highly suggestive Clinicoradiological Findings → Clinical diagnosis (without biopsy) e.g. Löfgren's syndrome Suggestive
Clinicoradiological Findings → Clinical ... without biopsy) e.g ... and/or cytology (e.g ... of alternative causes ... #diagnosis #Workup
My Patient with Infective Endocarditis (IE) Has Negative Blood Cultures - Did they receive antibiotics prior
therapy - Number one cause ... Eg: C. burnetii ... -> Serological Testing ... Fungal (Histoplasma/Aspergillus ... Diagnosis #Management #Algorithm
Fungal Biomarkers: Beta-D-Glucan and Aspergillus Galactomannan Beta-D-Glucan: • Polysaccharide cell wall component of many fungi • Pathogens:
Polysaccharide cell wall component ... cut-offs defined in clinical ... formulations (e.g ... beta-glucans (e.g ... Frozen ice-pops (in setting
Hypoglycemia - Differential Diagnosis Algorithm Fasting Hypoglycemia: • Excess Insulin • Medications (e.g. Insulin Secretagogues, ß-Adrenergic Antagonists,
• Medications (e.g ... • Alimentary (e.g ... : • Critical Illness ... (e.g. ... Hyperinsulinemic States (e.g
1,3-Beta-D-Glucan and Galactomannan Testing Sensitivity Specificity and False Positives 1,3-Beta-D-Glucan • Cell wall component of many fungi
Galactomannan Testing ... • Cell wall component ... cut-offs defined in clinical ... formulations (eg ... >90% (In most clinical
Peri-operative Hyperthermia - Guidelines for Crises in Anaesthesia If prolonged or ≥ 39 C this is a
39 C this is a clinical ... Surgical devices, e.g ... Sepsis (→ 3-14) e.g ... malignant syndrome (e.g ... Diagnosis #Management #Workup
Invasive Aspergillus (IA) - Diagnosis and Management Aspergillus is ubiquitous in nature. Most invasive infections are caused
infections are caused ... immunosuppression (eg ... HIV/AIDS, CGD) Clinical ... Diagnosis and Testing ... considered in certain cases
Preoperative Risk Evaluation Major Pre-Op Questions: 1. Does the patient have any modifiable risk factors that could be
Key Components: ... event, follow ACC algorithm ... indicated • EKG ... Obtain EKG if: ... Change in clinical
Blood Culture-Negative Infective Endocarditis (BCNIE) Definition: No etiology found after 3 separate blood cultures remain negative for
antimicrobials, clinical ... but important causes ... whipplei, Fungi (Aspergillus ... special stains (e.g ... #differential #workup
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