Cleveland Browns

It's an effective antibiotic.

It wipes out bifidobacteria, lactobacilli, the most... important microbes and you've got but there are many more we've got about anywhere for about seven eight hundred different families of microbes in our tummies but let me share this with you something you may not know it also wipes up wipes out an organism called bacteroides fragilis be fragilis Who cares? Like, so what? Oh, here's why.

I'm glad you asked, Steve.

Because there is something that you need to prevent autoimmune disease, and that's called vitamin D.

Our goal with empiric therapy is to target the organisms actually destroying the tissue in the deep bone, right?

Yes, which are typically group A and B streptococcus, staphylococcus aureus, and Bacteroides fragilis.

But when you inevitably swab that ulcer, because everyone wants to swab over 95% of the time, the lab culture comes back positive for Pseudomonas aeruginosa.

Right.

This raises both the intraluminal as well as the intramural pressure.

The normal bacterial flora of the appendix begins to rapidly multiply in this stagnant segment, examples of which include E. coli and Bacteroides fragilis.

As the pressure exceeds venous pressure, the small venules and capillaries become thrombosed, while the arterioles remain open, causing engorgement and congestion.

Eventually, the small arterioles thrombose too, and the antimesenteric border becomes ischemic, which can lead to infarction and necrosis.