1. Step 9
1.1. Review session 2
1.2. mechanism flow chart
1.3. 20 minutes
2. Step 10
2.1. Management
2.1.1. concepts
2.1.1.1. not to give bacteral static
2.1.1.2. wide spectrum therapy
2.1.2. goals of treatment
2.1.2.1. eradicate the infection and avoid any further damage
2.1.2.2. prevent mortality
2.1.2.3. vital signs and neurological deficite
2.1.2.4. prevent any spreading
2.1.3. initial
2.1.3.1. need to be diagnosed imediatly
2.1.3.2. antibiotec giving immediatly
2.1.3.2.1. door to antibiotic 30 min
2.1.3.3. CT is indicated when LP in contraindicated
2.1.3.4. embrical therapy
2.1.3.5. embrical therapy
2.1.3.6. start with
2.1.3.6.1. vancomycin
2.1.3.6.2. third G cephalocporins
2.1.3.7. dexamethasone
2.1.3.7.1. gd prognosis for the ear and hearing loss
2.1.3.7.2. so prevent hearing loss
2.1.3.7.3. to prevent complication
2.1.3.7.4. reduce mortality rate
2.1.3.7.5. in a study they said it is giving ??
2.1.3.7.6. some giudlines prefer dexamethasone and some refuse
2.1.3.8. IV fluid and fluid monitoring
2.1.3.9. liver , renal test and serum
2.1.3.10. duration
2.1.3.10.1. 10-14 days aith at least 5 afebrile days
2.1.3.11. reported to WHO
2.1.3.12. analgeseia
2.1.3.12.1. pain management
2.1.3.13. fever control
2.1.3.14. abscess location
2.1.3.14.1. should be determined
2.1.3.14.2. from the CT cerebellat abscess
2.1.3.15. penicillin has some resistance
2.1.4. on going
2.1.4.1. supportive care
2.1.4.2. moniter
2.1.4.2.1. heart
2.1.4.2.2. BP
2.1.4.2.3. RR
2.1.4.3. assessment of neurlogical function
2.1.4.4. check lens
2.1.4.5. consult an ENT for mastoditis
2.1.4.6. fluid monitring
2.1.4.7. immune system problem
2.1.4.8. monitring intracranial pressure
2.1.4.9. rifambin and sepro as prophylactice with people who had contact
2.1.5. prognosis
2.2. Prevention
2.2.1. treating early would prevent complication
2.2.2. vaccination
2.2.2.1. pneumococcal conjugate vaccine
2.2.3. vaccine before going to crowded area ((alhajj))
2.2.4. hygen
2.2.5. capmgain to increase awareness
2.2.6. educate about complince
2.2.7. prophylaxis
2.2.7.1. eradication from nasopharix