Pulmonary Infections Flashcards
Risk factors
Immunodeficiency, Immunosuppression
Damaged bronchial mucosa, abnormal cilia
Repeated insult
Intrapulmonary abscess Presentation
Weight loss Lethargy Night sweats, rigors Cough + sputum Breathlessness Chest pain (pleuritic) Preceding illness - pneumonia
Intrapulmonary abscess Signs
Tachypnoea Tachycardia Finger clubbing Dull percussion note Bronchial breath sounds
Intrapulmonary abscess Investigations
CXR: round cavity which fills with pus and air, looks like a kinder egg
Intrapulmonary abscess Management
Oxygen Analgesia Rehydration Drain abscess Antibiotics
Empyema
Collection of pus in the pleural space
Empyema Presentation
Breathlessness Dry cough Fever Chest pain Headache Confusion Preceding illness - pneumonia, pleural effusion
Empyema Investigations
CXR: D sign as empyema sticks to lateral chest wall
US: simple bed side test
CT: banana shape, attaches to pleural wall
Empyema Management
Remove pus
Drain fluid
Treat infection - antibiotics
Bronchiectasis
Localised, irreversible dilation of the bronchi
Bronchi are thus easy to collapse which can cause airflow obstruction
Causes: CF, Kartanger’s syndrome, bronchial obstruction
Bronchiectasis Presentation
Recurrent chest infections - no response to antibiotics Persistent sputum production Chronic cough Haemoptysis Wheeze Breathlessness Chest pain Weight loss Fatigue
Bronchiectasis Investigations
Sputum cukture
CXR
HRCT - signet ring sign as bronchi are hugely dilated
Bronchiectasis Management
Flu vaccine, pneuomococcal vaccine
Reactive antibiotics
Chronic bronchial sepsis
All the hallmarks of bronchiectasis but no bronchi dilation on HRCT
Ususally in childcare workers
Cystic Fibrosis (CF)
Autosomal recessive disorder (need 2 faulty copies)
Congenital cause of bronchiectasis
CFTR - Cl channel found on every cell. In CF, this has a mutation
