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Clinical Aspects Of Respiratory Infections Notes

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Lecture 3 Clinical aspects of respiratory infections

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Intro o

Pneumonia causes 10Xxmore deaths than all other infectious diseases together (UK) o Cause usually bacterial, need antibiotics o Most infections of URT are viral, do not need antibiotics
? Inappropriate antibiotic treatment in patients=adverse effects o When patient first seen, rare for organism to be identified. Physician's determine:
? How ill patient is
? Likely site of infection in tract
? Most likely causative organism o Decision about antibiotics, hospital admission etc. Is antibiotic treatment indicated?
o Upper respiratory tract infections
? Cough, sore throat or runny nose (& systemic symptoms)
? Usually viral, self-limiting or minor
? Important rate exceptions

* Epiglottitis (Rapid progressive condition in children, Haemophilus influenza type b, Stridor, muffling of voice and drooling)

* Diphtheria (grey adherent membrane on pharynx)

* Suspicion of either condition=hospital admission o Acute bronchitis
? Cough, purulent sputum
? Viral or bacterial or atypical organism (mycoplasm or Chlamydia species)
? Antibiotics do not hasten resolution if previously fit
? Antibiotics recommended in patients with underlying lung diseases, have less pulmonary reserve
? Acute-on-chronic bronchitis most common organisms Haemophilius influenza, Streptococcus pneumonia and viruses o Pneumonia
? "Lower respiratory tract infection"= cough, dyspnoea, tachypnoea, pleuritic pain or physical signs in chest (crackles, consolidation, pleural rub/effusion)
? Pneumonia or incipient pneumonia
? Antibiotic treatment Which antibiotic?
o General
? Choice in pneumonia depends mainly on clinical circumstances it occurs in
? Additional info from clinical history, physical findings, radiology &
haematological changes, but no single clinical, radiological or haematological picture is pathognomonic of any individual organism
? Treatment based on clinical situations associated with different organisms o Community acquired pneumonia

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