Jd. Gradon et C. Adamson, INFECTION IN THE IMMOBILE HOST - A PRACTICAL REVIEW FOR THE INTENSIVE-CARE PHYSICIAN, Journal of intensive care medicine, 13(3), 1998, pp. 135-143
Immobility in the critically ill patient is a significant risk factor
for infection, independent of the patient's underlying critical illnes
s. Specific causes of infection related to immobility in the intensive
care setting are explored. The pathogenesis, treatment, complications
, and prevention of pressure ulcers, pneumonia, and urinary tract infe
ctions in the immobile patient are emphasized. Featured topics include
the differentiation of colonization versus infection in pressure ulce
rs and the urinary tract, the significance and optimal treatment of po
sitive fungal cultures, as well as a rational clinical approach to the
immobile patient with a fever and no obvious source of infection. The
clinical relevance of anaerobic infections in this population is emph
asized because it influences empiric antibiotic therapy and differenti
al diagnosis.