Pulmonary Infections Flashcards
What are the usual causes of pulmonary infections?
- bacterial
- viral
What are some unusual causes of pulmonary infections?
- fungal
- mycoplamsal
When do pulmonary infections generally occur?
Generally occur when host defense mechanisms are impaired
What are some causes for the host defense mechanisms to be impaired?
- Impaired cough reflex
- Injury to mucociliary apparatus
- Immunodeficiency
- Pulmonary vascular congestion and edema
- Accumulation of secretions
occurs when bacteria enter bronchioles and alveoli and proliferate
bacterial pneumonia
What does bacterial pneumonia result in and where?
Results in purulent exudate collecting in alveoli, or in bronchioles and surrounding tissue
Is bacterial pneumonia bilateral or unilateral?
unilateral
Is bacterial pneumonia unilobar or bilobar?
unilobar
What is the most common cause of acute bacterial pneumonia?
streptococcus pneumoniae
What may bacterial pneumonia follow?
may follow a viral respiratory infection
What is something you should consider with someone who has bacterial pneumonia?
consider immunosuppression
What are the 2 patterns of bacterial pneumonia?
- bronchopneumonia
- lobar pneumonia
Infection within the walls of the bronchioles, may be associated with infection into alveoli
bronchopneumonia
What pattern of bacterial pneumonia has patchy consolidation and is unilateral or bilateral?
bronchopneumonia
Suppurative fluid fills alveoli
lobar pneumonia
What pattern of bacterial pneumonia results in consolidation of a large portion or all of a lob and is usually unilateral?
lobar pneumonia
What are some complications of bacterial pneumonia?
- abscess formation
- empyema
- organization of the exudate (becomes solid)
- bacteremia / sepsis
What are symptoms of bacterial pneumonia? (9)
- Typically develop quickly
- High fever and chills
- Productive cough with yellow or brown sputum
- Pleuritic chest pain
- Shortness of breath
- Altered mental status (especially in elderly)
- Loss of appetite
- Easy fatigue
- Fatigue
Viral proliferation within respiratory epithelial cells results in inflammation of tissues, transudate/exudate formation
viral pneumonia
With viral pneumonia, is there generally evidence of consolidation or not?
generally no evidence of consolidation
Is viral pneumonia usually bilateral or unilateral?
often bilateral
What are some organisms that cause viral pneumonia?
- Influenza virus A and B – children and elderly
- Respiratory syncytial viruses
- Adenovirus
- Parainfluenza
What is something you should consider with someone who has viral pneumonia?
consider immunosuppression
What are symptoms of viral pneumonia?
- Cough (usually nonproductive)
- Fever and chills, excessive sweating and clammy skin
- Shortness of breath
- Altered mental status (especially elderly)
- Headache
- Loss of appetite
- Easy fatigue
- Pleuritic chest pain
How to you evaluate pneumonia?
- history and PE
- CXR, CT
- endoscopic bronchoscopy
- CBC
- sputum assessment
- Legionella and pneumococcus urinary antigen tests
- PCR
What will a CBC for viral pneumonia show?
lymphocytes and monocytes are elevated
focal infection within a tissue, generally filled with pus
abscess
4 stages of abscess formation
- infection
- localization/acute inflammation
- enlargement
- rupture
What happens during the infection stage of abscess formation?
-Microbes enter tissue and become established
What are the sources of infection?
Sources include:
- direct implantation
- hematogenous spread
- lymphatic spread
What happens during the localization/acute inflammation stage of abscess formation?
- Microbial growth initiates inflammation, attracts neutrophils into area, focuses area of infection
- Tissue remodeling results in formation of a collagen-rich capsule around the area of inflammation
What happens during the enlargement stage of abscess formation?
- As more neutrophils accumulate the abscess enlarges
- Tissue remodeling and capsule formation continues
What happens during the rupture stage of abscess formation?
The purpose of abscess formation is to eventually cause the purulent fluid to be extruded from the body by rupturing out of the tissue
Microbes contained in the ______ may be released into blood or _____ to cause
_______ at another site.
Microbes contained in the abscess may be released into blood or lymph to cause infection at another site.
What are the causes of pulmonary abscesses?
- aspiration
- primary bacterial infection
- septic embolism
- neoplasia
What is the most common cause of pulmonary abscesses?
aspiration
What are signs and symptoms of pulmonary abscess?
-SOB
-hemoptysis
-fever
-pleuritic chest pain
-cough with sputum production
night sweats
anorexia
-weight loss
What is the evaluation for an pulmonary abscess?
- history and PE
- CXR, CT
- CBC
An infection within the pleural space and fluid resulting in accumulation of purulent pleural fluid
empyema
What is an empyema often caused by?
extension of a pulmonary infection
What are the stages of an empyema?
- exudative stage
- fibrinopurulent stage
- organizational stage
What happens in the exudative stage of an empyema?
pleural fluid accumulates in the pleural space secondary to inflammation
What happens in the fibrinopurulent stage of an empyema?
- bacterial invasion and growth with deposition of fibrin on visceral and parietal pleural membranes
- formation of fibrinous loculations, adhesions
What happens in the organizational stage of an empyema?
if the infection progresses, the empyema fluid solidifies into a thick, non-elastic pleural “peel” that inhibit lung expansion, causing a condition known as trapped lung
Which stage has a high mortality if it is reached?
organizational stage
What are signs and syptoms of empyema?
- SOB
- fever
- pleuritic chest pain
- other associated symptoms of pneumonia
