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Clinical Aspects Of Respiratory Infections Notes

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Lecture 3 Clinical aspects of respiratory infections

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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