Infectious diseases

Nice | Detection and management of sepsis

This is a new guideline from NICE on the detection and management of sepsis. None of this is likely to be new, but it is worth looking through. I think the main reason is, sadly, from a medico-legal point of view. I guess if we have not documented obs that have been clearly laid out,…
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Nice | Tuberculosis (TB)

This is an updated guideline from NICE on managing tuberculosis. I guess the relevance will be largely related to where you work. There isn't any really big change here, but there are lots of things that I wasn't aware of, so I will do a general summary of the guideline. There is a lot more detail…
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Viral warts

This BMJ Review looks at management options (BMJ 2014;348:g3339). Here we are considering skin warts not oral/genital lesions. Key points Common condition, with 7-12% prevalence in general population, higher in children. Majority resolve spontaneously, but can take years! No treatments are guaranteed to work, therefore side effects and cost should be minimised. Which warts need…
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RCOG | Chickenpox in pregnancy

This is a new guideline from RCOG on managing chickenpox in pregnancy. It doesn't change our management, but I'm doing a quick summary as I often forget what is classed as significant contact and when immunoglobulin is advised. Why is it important?  Fetal Varicella Syndrome (FVS) can occur if a woman has chickenpox during pregnancy. It's…
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BASHH | HIV testing window

This statement from BASHH advises that new 'fourth generation' HIV tests will detect the majority of infected patients at four weeks post infection, which is much earlier than older tests. These tests look for both HIV antibodies and p24 antigen. I don't know whether this test is being offered locally - so if in doubt -…
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Nice | Chronic hepatitis B

This is a guideline which outlines the diagnosis and management of Hepatitis B in adults and children. Of most importance to us, they advise that after you get a positive Hepatitis B test result back on a patient (Hepatitis B surface antigen - HBsAg), certain further tests should be done. The results of these tests should…
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Hepatitis B and C

This guideline aims to get us to increase testing and identification. A lot of the risk factors are fairly obvious, but it is certainly not something I had previously been thinking about testing for outside of an antenatal or GUM scenario. My advice is that if you are thinking of testing for Hep B /…
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Whooping Cough – HPA Guidance

Bordetella Pertussis from Sanofi Pasteur (flikr website) This is a summary of guidance from the HPA on how to manage Whooping Cough. A member forwarded this on to me and requested I pass on the information as it is so important - so please do the same if you have other stuff you think everyone should know! There is separate guidance for the management…
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Meningitis – HPA advice

This publication from the HPA mostly summaries advice from the NICE guideline. Given it’s importance to us though, here’s a quick summary: Who should you give antibiotics to if you suspect meningitis? If they have a non-blanching rash If you suspect meningococcal septicaemia If transfer to hospital could be delayed (eg in rural areas). NB…
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BASHH | HIV post-exposure prophylaxis following sexual exposure

This guideline looks at the use of Post-Exposure Prophylaxis (PEP) following sexual exposure. For information on the use of PEP following occupational exposure, the following advice is helpful. This isn’t something we’re going to come across very often. This is an excellent resource if faced with an affected patient. It gives tables with risks from different…
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