L8 - acute bacterial respiratory infections Flashcards
Sinusitis
infection of sinus
Tonsillitis
Infection of tonsils
Pharyngitis
sore throat, pharynx infection
Laryngitis
larynx infection
Tracheitis
trachea infection
Bronchiolitis
bronchiole infection
Pleurisy
inflammation of pleura often caused by infections
Bronchitis
Bronchi infection
Pneumonia
infection of alveoli and surrounding lung
Skin
keeps everything out, waterproof, keeps everything in except sweat
Skin surface area
1.5-2 metres squared
Urinary system
sterile and flow is outwards
Vagina
acidic pH, commensal bacteria, thick mucosal barrier, mucosal immune system
intestine and stomach
acidic, enzymes, commensal bacteria and thick mucosal bacteria
Pharyngitis symptoms
tender neck glands, fever, large tonsils with pus, throat swan grows Fram positive cocci
Pharyngitis viral
70-80%
rhinovirus, adenovirus, etc
Pharyngitis bacterial
10-30% due to streptococcus progenies, GABHs
GABHs-associated siease
scarlet fever, PSGN, rheumatic fever
Mycoplasma pneumoniae
3-14%, nasty cold with associated headache/congestyion
Lemiere’s disease
can cause infection of jugular vein leading to infection of heart, chest, lungs
Diptheria symptoms
Sore throat, low fever, pseudomembrane on tonsils, pharynx or nasal cavity
Diptheria swab
grows irregular gram-positive rods
Diptheria treatment
anti-toxin as it has a different pathogenesis
Antibiotics to eradicate carriage of organism and so prevent transfer to other susceptible subjects but does not cure disease
Sinusitis symptoms
usually viral, fever, discharge, unilateral pain
Sinusitis complications
brain abscess, sinus vein thrombosis and orbital cellulitis
Epiglottis
soft tissue that covers oesophagus when breathing
Acute epiglottitis
formerly an illness of children 2-4 years old presented with fever, dysphagia, drooling and strider
encaspulted, results in epiglottis swelling and affects rare immunocompromised patients
Bronchitis infection
haemophilus influenza type B now rare due to vaccine
Acute epiglottis swab
gram negative cocobacilli
Bronchitis definition
self-limited inflammation of the epithelia of the bronchi due to upper airway infection
Bronchitis symptoms
generally results in cough with phlegm and breathlessness, mostly viral, bacterial is rare
can be chronic or acute
Whooping cough bacteria
bordatella pertussis
whooping cough swav
gram negtaive bacillus
Adenylate cyclase toxin
inhibits phagocyte chemotaxis and T cell activation
Pertussis toxin
inhibits alveolar macrophage defence
Tracheal cytotoxin/dermonecrotic toxin
epithelial necrosis
Whooping cough virulence factors contribute…
to a chronic cough, paraxysms of coughing and 50% post-pertussive coughing
Whooping cough incubation phase
7-10 days
Whooping cough catarrhal phase
1-2 weeks, rhinorrhea, conjunctivitis, low-grade fever and lymphocytosis
Whooping cough paroxysmal phase
1-6 weeks, coughing spasms, inspiratory whoop, post-ptussive vomiting, cough lasting 2 weeks
Whooping cough complications
pneumonia, encephalopathy and subconjuval haemorrhage
whooping cough acellular vaccine
as part of TaP at 2, 3, 4 months and booster at 3-4 years
but may not give life-long immunity and may have reduced effects from natural infections
Pneumonia infection
general term for lung parenchyma inflammation specifically
Pneumonia alveoli
pus-filled so harder for gas exchange
Pneumonia pathogenesis
bacteria translocates to normal sterile distal airway, overwhelms neutrophil defence, develops an inflammatory response causing neutrophils and inflammatory exudate to fill the alveolar space
Pneumonia resolution phase
bacteria is cleared, inflammatory cells removed by apoptosis leading to complete recovery
Pneumonia severe disease
occurs if there is excessive inflammation, lung injury, failure to resolve or blood stream invasion by pathogen
Pneumonia symptoms
fever, sweats, riggers, weakness and malaise
fast heart rate, shortness of breath with low O2 levels, cough and sputum, pleuritic chest pain
signs of lung consolidations
Pneumonia microbiological tests
sputum culture and sensitivities, positive gram stain, blood culture, serology, urinary antigen, PCR< viruses
S. Pneumoniae
40%, gram positive cocci, alpha hemolytic, optocochin sensitive, over 90 serotypes
Staphylococcus aureus
may complicate recent influenza, ventilator-associated pneumonia
Klebsiella oneumonia
gram-negative bacilli, enterobacteriacae
Legionella pneumonia
lives in warm water, i.e. showers not used for a while and bad AC
hospital-acquired pneumonia
acquired at least 48 hours followingg admission, seen in elderly, ventilator-associated and post-operative patients
hospital-acquired pneumonia diagnosis
new fever, purulent secretions, radiological infiltrates, white cells rise, plus increasing oxygen requirements
earl onset under 5 days in HAP
organisms similar to CAP and also anaerobes
late onset over 5 days in HAP
Steph, Aureus, pseudomonas aeroginosa, acinetobacter baccmanii and klebsiella pneumonia
Lung abscess
seen in aspiration, alcoholics and those with poor dentition
Lung abscess organisms
Streptococcus Miller, anaerobes, klebsiella pneumoniae
Lung abscess metastatic
from right heart/intravenous system
Lung abscess treatment
prolonged antibiotics up to 6 weeks, may need surgical drainage
