Use of MYCIN's Rules for Tutoring

Performance Level D-RULE578 IF: 1) The infection which requires therapy is meningitis, and 2) Organisms were not seen on the stain of the culture, and 3) The type of the infection is bacterial, and 4) The patient has been seriously burned THEN: There is suggestiv evidence (.5) that pseudomonas-aeruginosa is one of the organisms (other than those seen on cultures or smears) which might be causing the infection UPDATES: COVERFOR USES: (TREATINF ORGSEEN TYPE BURNED) Support Level MECHANISM-FRAME: BODY-INFRACTION.WOUNDS JUSTIFICATION: "For a very brief period of time after a severe burn the surface of the wound is sterile. Shortly thereafter, the area becomes colonized by a mixed flora in which gram-positive organisms predominate. By the 3rd post-burn day this bacterial population becomes dominated by gram-negative organisms. By the 5th day these organisms have invaded tissue well beneath the surface of the burn. The organisms most commonly isolated from burn patients are Pseudomonas, Klebsiella-Enterobacter, Staph., etc. Infection with Pseudomonas is frequently fatal." LITERATURE: MacMillan BG: Ecology of Bacteria Colonizing the Burned Patient Given Topical and System Gentamicin Therapy: a five-year study, J Infect Dis 124:278-286, 1971.