چاپ صفحه |  صفحه نخست سامانه |  نویسندگان |  اطلاعات تفضیلی |  دانلود مقاله | دانشگاه علوم پزشکی تبریز |
| نویسنده | نفر چندم مقاله |
|---|---|
| آلکا حسنی | اول |
| آیتک خباز | دوم |
| مهدی فرهودی | سوم |
| سمیه احمدی | چهارم |
| اکبر حسنی | پنجم |
| عنوان | متن |
|---|---|
| کلمات کلیدی | Stroke; Acute Ischemic stroke; Post stroke; Antibiotics; Predictors |
| خلاصه مقاله | Background Besides initial stroke severity and comorbid conditions, infections in acute ischemic stroke or post stroke patients is a grave concern in view of mortality and poor functional outcome. Infections after stroke are more common, and the prevalence has been reported to be as high as 30%; one third consisting of pneumonia and another third of urinary tract infections (UTI). Presence of fever, also called as “central fever”, after stroke is another clinical condition which requires medical attention. Antibiotics are the traditional approach used to manage infections, however, emergence of antibiotic resistant pathogens and use of prophylactic antibiotic management lacks success. Therefore, there is an urgent need to better understand aspect of stroke-associated infections and identify viable approaches to combat infectious complications. This review discuss the various infections in stroke patients, the strategies used for either prophylaxis or treatment and predictors of acute ischemic stroke and post stroke infections. Materials and Methods “PubMed”, “Google Scholar” and “MedLine” were searched using the MeSH terms “Cerebral Infarction”, “Stroke”, “Cerebral Hemorrhage”, “fever”, “infection”, “pneumonia”, “sepsis/ Fever” and “urinary tract infection”, “Stroke/complications”, “Antimicrobial strategies and Stroke” and “Infection”. More searches were performed naming different class of antibiotics to find their relation with stroke and type of stroke. Results Rate of pneumonia in stroke patients has been reported in 5–22% cases and is the most common cause of death. The risk of infection is highest in the acute phase after stroke which may be attributed to stroke-induced immunodepression syndrome (SIDS). UTIs has been observed as a post stroke complication and are associated with poorer outcomes with increased odds of decline in neurological status during hospitalization, death or disability at 3 months as well as increased length of hospital stay. Though fever is considered as “endogenous” origin caused by immune system activation or effects of the brain lesion on thermoregulatory centers, nevertheless such episodes are often difficult to distinguish from infections. Central fever has not been very well characterized, but is probably resistant to antibiotic treatment and antipyretic treatment and probably appears early after stroke. Fever without an identified infection has been reported to occur in 14.8% of stroke patients, but this number is uncertain, and reasonably depends on how thoroughly the patients have been investigated for focal signs of infections. Regardless of the causes, elevated body temperature after stroke is associated with poor prognosis. Thus, effective management is a priority in stroke- associated infections has been suggested. Several factors which account for the development of stroke has been pinpointed, namely, diabetes, atrial fibrillation, hypertension, chronic heart disease, age, gender, dysphagia, smoking and COPD. Some clinical findings furnished data regarding appropriate use of antibiotics. Although these clinical studies indicated that several antibiotics in different patients with stroke are safe, however, neurotoxic effects limits the selection of them for patients with stroke. Conclusion A thorough understanding of infection aspect in stroke patients facilitates greater vigilance, monitoring, prevention and treatment. |
| نام فایل | تاریخ درج فایل | اندازه فایل | دانلود |
|---|---|---|---|
| Hasani bcnc_certificate.pdf | 1400/10/21 | 2969077 | دانلود |
| Hasani Abstract Stroke and Infections.pdf | 1400/10/21 | 353488 | دانلود |
