Chapter 115. Approach to the Acutely Ill Infected Febrile Patient (Part 3)
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Adjunctive treatments may reduce morbidity and mortality and include dexamethasone for bacterial meningitis; intravenous immunoglobulin (IVIg) for TSS and necrotizing fasciitis caused by group A Streptococcus; low-dose hydrocortisone and fludrocortisone for septic shock; and drotrecogin alfa (activated), also known as recombinant human activated protein C, for meningococcemia and severe sepsis. Adjunctive therapies should usually be initiated within the first hours of treatment; however, dexamethasone for bacterial meningitis must be given before or at the time of the first dose of antibiotic. Specific Presentations The infections considered below according to common clinical presentation can have rapidly catastrophic outcomes, and their immediate recognition...
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