caso clinico listeria monocytogenes.pptx

listeria monocytogenes

1. Listeria monocytogenes Caso clínico

2. Generalidades. 01 Es un bacilo o cocobacilo grampositivo, móvil, anaerobio, facultativo e intracelular 03 Es pequeño no ramificado y anaerobio facultativo capaz de proliferar dentro de un amplio abanico de temperaturas (1 °C a 45 °C) y una elevada concentración de sal. 02 Está formado por 10 especies, de las que Listeria monocytogenes y Listeria ivanovii son los únicos patógenos reconocidos. 04 L. monocytogenes representa un destacado patógeno del ser humano. 05 Son móviles a temperatura ambiente, pero no a 37 °C.

3. Epidemiología L. monocytogenes se aísla de diversas fuentes ambientales y de las heces de mamíferos, aves, peces y otros animales. Fuente principal de la infección es el consumo de alimentos contaminados por ejempl o: 1.Consumo de carne poco hecha Leche o queso no pasteurizados o contaminados. 2. V egetales crudos mal lavados y repollo.

4. Puede producirse la transmisión entre humanos principalmente de la madre al hijo en el útero o en el momento del nacimiento. Las poblaciones de alto riesgo, como los neonatos, los ancianos, las mujeres embarazadas y los pacientes con deficiencias graves de la inmunidad celular.

5. CASO CLÍNICO

6. Paciente de 28 años de edad Primigesta Cursa con embarazo de 19 semanas S in antecedentes patológicos ni quirúrgicos de importancia. CASO CLÍNICO Sin causa aparente, alza térmica acompañada de escalofrío, cefalea, malestar general y dolor hipogástrico de intensidad EVA (escala visual analógica) 3/10, de aproximadamente 12 horas de evolución. La paciente toma 1 gramo de paracetamol, con el cual no logra alivio por lo que acude a consulta médica donde se evidencia temperatura de 39ºC y taquicardia fetal y materna, por lo cual se la hospitaliza .

7. SIGNOS Y SÍNTOMAS F recuencia cardíaca 115 por minuto. F recuencia cardíaca fetal de 180 por min T emperatura 39ºC A ctividad uterina negativa, puño percusión renal bilateral negativa. . Región inguinogenital: no hay sangrado; secreción vaginal blanquecina escasa. Abdomen: gestante blando, depresible, doloroso a la palpación en el hipogastrio .

8. PRUEBAS DE LABORATORIO Biometría hemática. Número de leucocitos aproximadamente 22.560 y neutrofilia. 01 02 PCR 74 mg/l, 05 Ecografía abdómino-pélvica N ormal y s e descarta abdomen agudo quirúrgico e instaura tratamiento antibiótico. 04 Examen de orina N o infeccioso 03 Interleucina-6 349,4 pg /ml.

9. DIAGNÓSTICO Se realiza ecografía obstétrica y amniocentesis transplacentaria porque se sospecha corioamnionitis.

10. EVALUACIÓN FETAL Peso fetal estimado: 385 g, edad gestacional (por ecografía) 20 semanas 2 días; FCF: 126 lpm , AFI: 12,4 cm, placenta anterior, feto pelviano, sexo femenino, movimientos fetales ausentes. PRUEBAS DE LABORATORIO Líquido amniótico amarillo C élulas totales 22.860 leucocitos, hematíes 20.000, polimorfonucleares 94, mononucleares 6, proteínas 0,7, glucosa no detectable. Tinción de Gram Leucocitos abundantes, cocos grampositivos abundantes.

11. Se inicia tratamiento 1 : antibiótico con ceftriaxona 1 gramo IV cada 12 horas, clindamicina 900 mg IV cada 8 horas y azitromicina 1 gramo. dosis única. Horas más tarde se evidencia la ausencia de vitalidad fetal y se decide terminar el embarazo. T ratamiento y evolución Al siguiente día persiste la leucocitosis con neutrofilia. Al tercer día de su hospitalización ha disminuido notablemente la leucocitosis.

12. Exámenes de laboratorio S e observa anemia normocítica normocrómica moderada a pesar de no haber habido sangrado importante ni persistente, por lo que se transfunde 2 concentrados de glóbulos rojos. Reporte del cultivo de líquido amniótico: Listeria monocytogenes sensible a ampicilina y gentamicina.

13. Physical Examination Mars 78% Mars is a cold place full of iron oxide dust, which gives the planet its reddish cast Mercury 62% Mercury is the closest planet to the Sun and the smallest one our the Solar System Venus 36% Venus has a beautiful name and is the second planet from the Sun. It’s terribly hot Saturn 12% Yes, Saturn is the ringed one. It’s a gas giant, composed mostly of hydrogen and helium Neptune 45% To change the size of the graph, click the arc of the circle and drag one of the orange handles

14. Findings Evolution Prevalence 200,000,000 Big number If you want to modify this graph, click on it, follow the link, change the data and replace it Saturn 12% Pluto 32% Mars 32% Venus 24%

15. Discussion 02 You could enter a subtitle here if you need it

16. Discussions Summary 01 Venus has a beautiful name and is the second planet from the Sun. It’s terribly hot and its atmosphere is extremely poisonous 02 Jupiter is a gas giant and the biggest planet in our Solar System. It’s also the fourth-brightest object in the sky 03 Mercury is the closest planet to the Sun and also the smallest one in our Solar System. It’s only a bit larger than our Moon

17. Diagnosis 03 You could enter a subtitle here if you need it

18. Diagnosis Neptune Neptune is the fourth-largest planet by diameter in our Solar System Saturn Saturn is the ringed one. It’s a gas giant, composed mostly of hydrogen and helium Venus Venus has a beautiful name and is the second planet from the Sun. It’s terribly hot Mercury Mercury is the closest planet to the Sun and the smallest one in our Solar System Mars Despite being red, Mars is actually a cold place. It’s full of iron oxide dust Jupiter It’s the fourth-brightest object in the sky and the biggest planet in our Solar System

19. Comparison 01 02 03 04 Saturn Venus Jupiter Pluto

20. Treatment 4 You could enter a subtitle here if you need it

21. Treatment Week 1 Mars is full of iron oxide dust, which gives the planet its reddish cast Week 3 Venus has a beautiful name and is the second planet from the Sun Week 2 Saturn is the ringed one. It’s a gas giant, composed of hydrogen and helium Week 4 Jupiter is a gas giant and the biggest planet in our Solar System

22. A Picture Always Reinforces the Concept

23. A Picture Is Worth a Thousand Words

24. Patient Monitoring 05 You could enter a subtitle here if you need it

25. Patient Monitoring Week 1 Week 2 Week 3 Venus has a beautiful name and is the second planet from the Sun To change the size of the graph, click the circle and drag the colored handle Mercury is the closest planet to the Sun Venus Mars Saturn Pluto Venus Mars Saturn Pluto Venus Mars Saturn Pluto

26. Contraindications - Indications Jupiter is a gas giant and the fourth-brightest object in the sky Saturn is the ringed one. It’s a gas giant, composed of hydrogen and helium Venus has a beautiful name and is the second planet from the Sun Mercury is the closest planet to the Sun and the smallest in our Solar System Neptune is the fourth-largest planet in our Solar System Despite being red, Mars is actually a cold place. It’s full of iron oxide dust Pluto is in the Kuiper belt and is considered a dwarf planet since 2006 Ceres is a dwarf planet and the biggest object in the asteroid belt

27. Post-prevention Jupiter Jupiter is a gas giant and the biggest planet in our Solar System Neptune Neptune is the fourth-largest planet in our Solar System Venus is terribly hot and its atmosphere is extremely poisonous Venus Mercury Mercury is the smallest planet in our Solar System Saturn It’s a gas giant, composed mostly of hydrogen and helium Despite being red, Mars is actually a cold place Mars

28. Case Timeline Phase 1 Neptune is the fourth-largest planet in our Solar System Phase 2 Saturn is the ringed one. It’s a gas giant, composed of hydrogen and helium Phase 3 Venus has a beautiful name and is the second planet from the Sun Phase 4 Mars is full of iron oxide dust, which gives the planet its reddish cast

29. Conclusions Mercury is the closest planet to the Sun and the smallest one in the Solar System—it’s only a bit larger than our Moon. The planet’s name has nothing to do with the liquid metal, since it was named after the Roman messenger god, Mercury

30. References AUTHOR (YEAR). Title of the publication. Publisher AUTHOR (YEAR). Title of the publication. Publisher AUTHOR (YEAR). Title of the publication. Publisher AUTHOR (YEAR). Title of the publication. Publisher AUTHOR (YEAR). Title of the publication. Publisher AUTHOR (YEAR). Title of the publication. Publisher

31. Our Team John Doe Here you can talk a bit about this person Jenna Patterson Here you can talk a bit about this person Helena James Here you can talk a bit about this person

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33. Alternative Resources

34. Resources M edical equ ipmen t icons Flat nurse team Flat nurse team Flat nurse team Flat nurse team Flat nurse team Hand drawn nurse team Health elements medical tools Vectors Human anatomy icon pack Health icon pack Health care icon pack Icons Senior woman looking female nurse wheelchair N urse holding checklist Photos