pulmonary infection Flashcards
what are the risks for developing chronic pulmonary infection?
- abnormal host response
- abnormal innate host defence
- repeated insult
what does an IgA deficiency do?
- increased risk of acute infections but not chronic infections
what is hypogammaglobulineaemia?
- rare, increased risk of acute and chronic infections
- poor host immune response
what is CVID?
- most common cause of immunodeficiency, recurrent infection
- specific polysaccharide antibody deficiency
give examples of immunosuppressants.
- steroids
- monoclonal antibodies
- chemotherapy
what suppresses the activity of cilia?
smoking
what are examples of defective innate host defences?
- damaged bronchial mucosa eg malignancy
- abnormal cilia
- abnormal secretions eg cystic fibrosis
give example of repeated insult?
- recurrent aspiration eg NG feeding, poor swallow = swallowing into the wrong hole
- indwelling material eg NG tube in the wrong place
what is an intrapulmonary abscess?
- indolent presentation
- weight loss common
- lethargy, weakness
- cough/sputum
- ## high mortality if not treated
how does pneumonia precede to an abscess?
- flu
- staph pneumonia
- caaviting pneumoina
- abscess
when will you see a pharyngeal pouch?
in aspiration pneumonia?
what is empyema?
pus in the pleural space
how does effusion (water) progress to empyema?
- simple parapneumoinc effusion
- complicated parapneumonic effusion
- empyema
what are the gram positive and negative bacteria of empyema?
positive = strep milleri, staph aureus negative = e.coli, pseudomonas, H. influenzae, kelbsiellae
how is empyema diagnosed?
- clinical suspicion
- CXR - look for a D
- USS - ultrasound
- CT
how is empyema treated?
- Iv antibiotics = broad spectrum, amoxicillin and metronidazole initially
what is bronchiectasis?
- localised, irreversible dilation of the bronchial tree
- involved bronchi are dilated, inflamed and easily collapsible
- airflow obstruction
- impaired clearance of secretion
how does bronchiectasis present?
- recurrent chest infections
- recurrent antibiotic prescriptions
- no response to antibiotics
- persistent sputum production
