Respiratory Tract Infections Flashcards
What would a CRB65 score be used for?
To decide which treatment should be administered for pneumonia :
Confusion
Resp Rate 30/min
Blood pressure < 90 SBP < 60 DBP
Age > 65
What investigations are used for Resp Infection?
CXR
Observations: RR, HR, Temp, BP
Sputum Sample
BAL
Throat Swab
Urine Dipstick
Rule out Cardiac Cause: BNP
Bloods: FBC, U&E, ABG, Lactic Acid
MALDI-TOF
PCR - viruses
What can a sputum sample show?
Where must it be taken from?
What is a useless sample?
What can it NOT grow
Sputum Sample: BACTERIA : staph aureus, strep pneumoniae, TB, coliforms (normal flora)
Useless: Salivary/Mucoid
CANNOT grow viruses : chlamydia, COVID
What is a quick diagnostic test for pneumococcus?
Urinary Antigen Test
Not affected by antibiotics
Better than a culture
Limitations: no bug = no sensitivity
Causative organisms of RESPIRATORY TRACT INFECTIONS
Bacteria:
Strep pneumonia
Haemophilus influenza
Mycobacterium Tuberculosis
Staph Aureus
Legionella
Mycoplasma Pneumonia
Chlamydia Pneumonia
Chlamydia Psittcci
Viruses:
Influenza
Parainfluenza
RSV
Coronavirus
HMP
Rhinovirus
Fungi
Aspergillus
Histoplasma
Crytococcus
What is community Acquired Pneumonia
Organisms that cause?
SVHiM
No hospitalisation within a MONTH prior to presentation
- Strep pneumonia
- Viruses
- H, influenzae (bacteria)
- mycoplasma (bacteria)
What is hospital Acquired pneumonia
Acquired after 2 days of hospitalisation
Every Kid Enters Ventilatedareas
- E.Coli
- Klebsiella
- Enterobacter
- Viruses
Ventilator associated pneumonia
after > 48 hours of intubation
Ventilator SSPA (spa inside tubing)
- Staph Aureus
- Pseudomonas
- Strenotrophomonas
- Acinetobacter
Aspiration pneumonia
Result of inhalation of stomach contents
- Chemical Pneumonitis,
- oral anaerobes
- alpha haem strep
what causes pneumonia in immunocompromised?
TB
Bacteria
Fungi
- Pneumocystis jirovecii
- Aspergillus
- Cryptococcus
- Histoplasma
URTI - : Colds
Common features
Time it takes to resolve
Treatment
Causative Organism
Runny nose- clear/green
Sore throat
Cough
?temperature
no smell
3-5 days
Rx: traditional remedies
Viruses:
Rhino
Corona
RSV
Adeno
parainfluenza
When would you suspect sinusitis?
What would be treatment?
Time Frame?
Runny nose - green discharge
> 10 days symptoms
?headache
Rx: ANTIBIOTICS
Tonsilitis
When would you suspect?
Common features
Common treatment
Causative organism
No Runny nose, no cough
VERY UNWELL
temperature - tonsils swollen with pus (white spots)
Rx: 10 days penicllin Abx
Causative organism: strep pyogenes
How would a child with scarlet fever present
What age would they be
What would be on their tongue
What would be on their face?
Organism?
Age: < 10 years
Organism: strep pyogenes
Swollen tonsils with pus (white spots)
High temperature
Sore throat
Face: red rash with circumoral pallor
Tongue: strawberry tongue
Body: sandpaper rash
Glandular Fever
- Symptoms
- Cause
- Treatment
- What should you NOT give
- Diagnosis
MASSIVE TONSILS - over long course of time
Cause: EBV (ebstein barr virus)
Treatment: NONE - resolves 1-2 weeks
DO NOT GIVE ANTIBIOTICS
Diagnosis
- monospot
- serology EBV
- throat swab
- LFT
EXCLUDE - strep pyogenes (tonsilitis)
Acute laryngitis
Cause
Symptoms
Virus
loss of voice - for a few weeks
no treatment
rest voice
Croup
symptoms
treatment if ACUTE
Pathology: inflammation of larynx and trachea
infants - more prone to collapse due to airways being compliant
Subglottic region - OBSTRUCTION
Barking Cough
3 months - 3 years
Acute resp distress - may require admission and ventilation
VIRUS: parainfluenza
Rx : 1 dose of steroids
no antibiotics as viral cause
Epiglottis
Age
Cause
Symptoms
Treatment
6 month - 6 years
Cause: HiB
Symptoms:
- will not lie down
- cannot breath - resp distress
- drooling - lack of swallow
- silent chest
DO NOT LOOK IN THROAT - might obstruct throat
Rx: intubation and ventilation
antibiotics
How is COPD exacerbated by resp infections?
Mainly Viruses:
Change in sputum
MORE
GREEN/YELLOW from clear
COUGH
BREATHLESS
WHEEZE
Immediate Rx: Amoxicillin and oral steroids 5 days and increased inhalers
<92% - ADMISSION - OXYGEN SUPPLEMENTATION and NEBULISED INHALERS
