Infections in Radiation Accidents
Although the radiation-injured patient may develop cellular immune deficiency or humoral immune deficiency, the major predisposing factor to infection, especially in the short term, is granulocytopenia. Infections associated with intravascular devices and as a consequence of blood product infusions occur too. As a result, most infections are caused by the aerobic gram-negative rods Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae, along with the gram-positive cocci Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus species. The sites of infection are principally the oral cavity and associated structures (for example, sinusitis, periodontitis, pharyngitis, and local mucositis); the distal third of the esophagus; the lungs (pneumonitis); the colon (bacteremia related to translocation); perianal lesions; and sites of skin damage, such as vascular catheter exit sites. Other infections, especially bacteremias, are associated with the catheter itself. Most infections are caused by organisms colonizing the patient, and more than half of these are acquired during hospitalization. Treatment of infections during granulocytopenia has been discussed in detail.1,2
KeywordsAlimentary Canal Granulocyte Count Radiation Accident Exit Site Infection Granulocyte Transfusion
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