Respiratory Tract Infections Flashcards
Inflammation of Lung alveoili
Pts are sick
Can be lobar/broncho
Pneumonia
Inflammation of medium sized airway
Mainly in smokers
Cough with sputum for most days for 3 months for 2 or more consecutive years
Bronchitis
Fever, cough, pleuritic chest pain, SOB
Pneumonia
Cough, fever, increased sputum production, increased SOB
CXR: Normal
Bronchitis
Localising signs, abnormal CXR
Pneumonia
Normal CXR
Bronchitis
Score for CAP
CURB 65 Used to guide treatment New onset confusion Urea >7 mmol/L Resp rate >30 BP
Treatment for Pneumonia
Supportive
Abx
Treatment for Bronchitis
Bronchodilation
Physiotherapy
Abx
Rusty coloured sputum. Lobar on CXR usually, Vacciante at risk groups
S Pneumonia
Gram +ve Diplococci
S Pneumonia
Assoc with smoking and COPD
H Influenza
Gram -ve cocco-bacilli
H Influenza
Assoc with smoking
M catarrhalis
Gram -ve Coccus
M catarrhalis
Associated with recent viral infection
(EMQ post Influenza infection)
Cavitation on CXR
S aureus
Gram +ve cocci in grape bunch clusters
S aureus
Alcoholism, elderly, haemoptysis
K pneumonia
Gram -ve rod, enterobacter
Klebsiella
Diagnosis of CAP
Urine antigen test in severe CAP for S pneumoniae, Legionella
Antibody tests - paired serum samples (presentation + 10-14 days) Rise in Ab over time. Useful for difficult to culture (chlamydia, legionella)
Immunofluorescence - Ab labeled with due in virology
PCP also by silver stain - boat shaped
Diagnosis of HAP
BAL to differentiate URT + LRT microbes
URTI: sinusitis, tonsillitis
LRTI - Bronchitis, Pneumonia, Empyema, Bronchiectasis, Lung Abscess
