Explore Health AI Prompts for Infectious Disease

Identifying Infection in Organ Transplant Recipients (OTR)

Systematically review the patient's chart for any data—historical, clinical, or laboratory—that may indicate an active or occult infection, especially given the blunted immune response typical of immunosuppressed patients. Include in search: Organ(s) Transplanted, surgical complications, nosocomial/hospital-acquired infections (SSI, UTI, HAP, C. diff), and donor-derived infections, opportunistic infections (CMV, PCP, Aspergillus, Nocardia, EBV, Toxoplasmosis, Cryptococcus), Community-acquired infections, but also possible late opportunistic infections (CMV, BK virus, Herpes Zoster) and malignancy (PTLD), Immunosuppression Regimen/Changes, Any recent escalations/increases in dose, any recent dose hold or reduction due to toxicity, prophylaxis status: Is the patient currently receiving or has recently completed prophylaxis for CMV (Valganciclovir), PCP (Bactrim), or Fungi (Fluconazole, Rejection History: Any episodes of allograft rejection (acute or chronic) Date and treatment given (especially T-cell depleting agents like ATG). Fever: Highest documented temperature, Vitals: New or worsening tachycardia, tachypnea, or hypotension (qSOFA criteria), Fatigue/Malaise: New, unexplained, or progressive weakness/lethargy, Allograft Dysfunction (Organ-Specific): Look for functional decline, which can be the only sign of infection. Kidney: Decreased urine output, rising creatinine/BUN. Liver: Rising LFTs (AST, ALT, Bilirubin), worsening synthetic function. Lung: New or increased O2 requirement, progressive cough, dyspnea. Heart: Signs of heart failure, new dysrhythmias. Identify the primary site of infection and review the chart for these specific findings: Review most recent Chest X-ray or CT for infiltrates, nodules, or ground-glass opacities (classic for PJP/Viral). Labs: Respiratory viral PCR panel (Flu, RSV, COVID), CMV/EBV PCR. Stool Studies: C. diff toxin PCR, CMV PCR in blood/tissue (if endoscopy performed). Labs: Liver enzymes (if hepatic involvement). Imaging: Review recent MRI/CT Head. Labs: Documented CSF analysis (if LP performed), Cryptococcal Antigen, Toxoplasmosis serology, EBV PCR (for PTLD). Urine: Urinalysis (UA) for pyuria/leukocytes (often subtle). Cultures: Status of Urine Culture & Sensitivity. Labs: BK Virus PCR/Viral Load (Kidney OTR). Cultures: Wound/Drainage Culture & Sensitivity. Labs: Status of Blood Cultures. Imaging: Ultrasound/CT for deep fluid collections (abscess/lymphocele). Leukopenia/Neutropenia: Low white blood cell or neutrophil count (increases susceptibility to bacteria/fungi). Lymphopenia: Low lymphocyte count (<1000/mm³) (indicates T-cell suppression and high risk for viral/opportunistic infections). Infection Surveillance Labs: CMV PCR/Viral Load: Is the patient viremic? What is the trend? (Most common viral opportunistic infection). EBV PCR/Viral Load: Elevated load is a risk factor for PTLD (which presents like an infection). Galactomannan or Beta-D-Glucan: Elevated fungal markers. Immunosuppressant Levels: Trough Levels: Document recent Calcineurin Inhibitor (Tacrolimus/Cyclosporine) trough levels. High levels correlate with higher infection risk. Cultures/Swabs: Status of all pending or recent cultures (Blood, Urine, Sputum, Wound). Any positive results, including the last sensitivity report.

Specialty:

Infectious Disease

AI Tool:

Evidently