Bacteremia

Bacteremia is the presence of bacteria in the circulating blood. This may not require medical attention since the immune system fights off the bacteria. Certain activities such as vigorous tooth brushing may cause bacteremia. It may also take place after a dental or minor medical procedure like catheterization. [1] Those with increased chances of developing bacteremia include people with weakened immune status, alcoholics, individuals suffering from malnutrition and patients on prolonged or serious medical condition. [2]

If left untreated, bacteremia can progress to a more serious sequelae especially for people at risk like HIV patients. Bacteria not eliminated by the immune system may lodge into various body parts such as heart, brain and bones which may disrupt normal functioning of these organs. The bacterial invasion of these organs may result to infections such as pericarditis/endocarditis, meningitis and osteomyelitis respectively. [1] Pneumonia is also possible when respiratory tract gets involved. Signs and symptoms vary depending on the type of infection. Bacteremia can also trigger a life-threatening medical condition called sepsis. Usually bacteremia from ordinary activities is asymptomatic however if there is concomitant fever, rapid heart rate and breathing with various organ involvement, sepsis should be suspected. [2]

A blood culture positive for an infective bacteria is the current standard to identify bacteremia. White Blood Cell (WBC) count is usually obtained in occult bacteremia. Other laboratory parametersthat may be assessed are Absolute Neutrophil Count (ANC), Absolute Band Count (ABC), erthythrocyte sedimentation rate, C-Reactive Protein (CRP) levels, cytokines and procalcitonin level. The physician may also order urinalysis and stool exam. When meningitis is suspected, CerebroSpinal Fluid (CSF) is analyzed. In cases where pneuomonia is considered, chest X-ray is obtained especially for febrile children with unknown source of infection. [3]

High risk people are usually given antibiotics prior to procedures that may generate bacteremia such as dental work-ups and catheter insertion. [1] While the cause of bacteremia is being determined, fever may be treated with antipyretics. [3] If infection or sepsis is identified, antibiotic treatment is immediately started. Depending on the case, the person may be treated as inpatient or outpatient.

References:

1.http://www.merckmanuals.com/home/infections/bacteremia_sepsis_and_septic_shock/bacteremia.html

2. http://www.ahealthstudy.com/diseases/bacteremia-causes

3. http://emedicine.medscape.com/article/961169-workup