Community acquired infections

Community acquired infections - What it is

As the name suggests, community acquired infections are infections which are acquired in the community, outside of healthcare facilities. They are commonly caused by viruses or bacteria and can affect both healthy individuals or individuals with suppressed immunity.

Most community acquired infections are usually mild and are managed by general practitioners. Occasionally, the infections may not resolve, develop complications and certain individuals may need to be hospitalized for further investigation and therapy (e.g. receipt of intravenous antibiotics, drainage of abscesses).

Community acquired infections - Symptoms

Usually fever is the most common symptom. Non-specific symptoms like lethargy, malaise, loss of appetite, and general sense of “feeling poorly” may also be present. Other symptoms may point to the site of infection. For example:

For upper respiratory tract infections, sore throat, cough, runny nose, facial pain / sinus congestions are not uncommon.
For chest infections (pneumonia), one may complain of cough, sputum productive, breathlessness or pain with inspiration.
Pain or burning sensation when passing urine, passage of blood in the urine, pain above the pubic bone, flank pain are signs and symptoms of urinary tract infections.
Redness, pain and swelling over the skin suggest skin and soft tissue infections. If an abscess has developed, there may be pus discharge. Dark, discoloured blistering skin lesions may be associated with severe and fulminant infections which require immediate medical attention.
Head and neck infections are associated with breathing difficulties, difficulty or pain on swallowing.
Joint infections are associated redness over the overlying skin, swelling and pain with limited range of movement.
Central nervous system infections are characterized by headaches, altered mental state, behavioural changes, neck stiffness or photophobia (being irritated by bright lights). It may also be associated with focal or generalised weakness or sensory disturbances. Seizures may develop.
With gastroenteritis, one may experience nausea, vomiting, diarrhoea, bloody stools or abdominal pain. Appetite is often reduced.

Signs and symptoms due bloodstream infections may be non-specific (e.g. fever, chills, malaise and myalgia; which can also occur with viral infections) or associated with signs and symptoms at another site (e.g. pain on urination, suggesting that the infection may be coming from the urinary tract). Bloodstream infections require urgent evaluation. If left untreated, they can progress rapidly to fulminant infections.

Warning signs associated with severe infection include low blood pressure and altered mental status, and this group of patients require prompt medical evaluation. Other medical emergencies which require prompt medical attention include:
Necrotizing skin and soft tissue infections (e.g. necrotizing fasciitis)
Joint infections
Meningoencephalitis (central nervous system infection)
Head and neck infections (e.g. neck abscesses, tonsillar abscesses)

Community acquired infections - How to prevent?

Infections develop when microbes are transferred from other persons / environment to you. They enter through our body surfaces (e.g. skin or mucosal surfaces) or they can be inhaled or ingested. We can catch infections through the activities we take part in and also acquire them when we travel. The best ways to prevent infections is to block them from entering the body and to strengthen our immunity.

Good hygiene prevents infection

Wash your hands after using the bathroom, before preparing and eating your food, after gardening or other tasks which could contaminate your hands (e.g. changing the diapers of toddlers, coughing, sneezing, caring for the sick).
Cover a cough. Cover your mouth / nose with a tissue when you sneeze or cough.
Wash and bandage your cuts

Practice safe food handling techniques.

Infections can spread through the food we consume.
Rinse your raw food under clean running water before cooking or serving them
Wash your hands before and after handling raw food.
Separate raw and cooked food.
Cook your food thoroughly.

Travel precautions

Consume clean food and water.
Obtain necessary travel vaccinations prior to travel.
When travelling through regions where insect-borne disease are prevalent, use DEET-containing insect repellent and wear appropriate attire (long-sleaved, light coloured clothing).

Vaccinate

Many serious infections can be prevented with immunization. Contact your health care provider regarding your immunization status, and the routine / travel-related vaccinations which you may require.

Community acquired infections - Diagnosis

The diagnoses of mild community acquired infections are often made clinically, based on history and physical examination.

If the infections do not resolve or are serious in nature, blood / body fluid tests or imaging may be performed to determine the severity of the infection as well as to pin point the exact cause.

Community acquired infections - Treatments

Treatment is dependent on cause.

In general, individuals with viral infections are symptomatically managed. Bacteria infections are treated with antibiotics, choice of which is guided by type of infection and type of bacteria causing the infection. If an abscess has developed, drainage of the abscess is often recommended.