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  1. Unless there is a clear contraindication, vaccinations provide a measure of protection which can prevent the onset of an infection or reduce its severity and duration.  Mitochondrial patients are especially good candidates for seasonal vaccinations (e.g. against influenza).
  2. Enforce meticulous care of central lines or port-a-caths when present.
  3. When gut dysmotility is present and when a patient has an indwelling central venous catheter, promote enteral feeding and the use of the gut to reduce the chance of microbial translocation.
  4. When urinary retention is a concern, ensure adequate urinary bladder emptying (see RENAL/BLADDER).
  5. Monitor infection risk carefully in the setting of diabetes mellitus.
  6. When a patient develops recurrent infections, an immune work-up or referral to an immunologist is indicated.  For those patients who have recurring or consecutive infections, the negative impact on their health or ability to attend school or work can be very significant.  When indicated, intravenous immunoglobulin may offer a striking improvement in their quality of life.


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