Clinical Aspects Of Respiratory Infections Notes
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Lecture 3 Clinical aspects of respiratory infections
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?
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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