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Lower Respiratory Tract Infection

Lower Respiratory Tract Infection. Pneumonia. Common with high morbidity and mortality rates. Acute respiratory infection with focal chest signs and radiographic changes. Classification; 1. Community-acquired pneumonia. 2. Hospital-acquired pneumonia (nosocomial).

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Lower Respiratory Tract Infection

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  1. Lower Respiratory Tract Infection

  2. Pneumonia • Common with high morbidity and mortality rates. • Acute respiratory infection with focal chest signs and radiographic changes. • Classification; 1. Community-acquired pneumonia. 2. Hospital-acquired pneumonia (nosocomial). 3. Pneumonia in the immunocompromised.

  3. Community-acquired Pneumonia • Epidemiology; Worldwide disease, common in the winter months. • Clinical features; 1. Symptoms; malaise, fever, and shortness in breath; productive cough, pleuritic chest pain, tachycardia. 2. Chest X-ray; lobar, patchy consolidation, or diffuse shadowing. . Complications. Septicaemia and empyaema

  4. . Laboratory diagnosis; • Sputum specimens for microscopy (Gram stain) and culture. • Bronchial-alveolar lavage specimens. • Blood cultures. • Serology (viruses, mycoplasma, chlamydia, coxiella, Legionella).

  5. Causes of Community-acquired Pneumonia

  6. S. pneumonia • 30-50% of community-acquired pneumonia. • Occurs in all age groups. • Risk group; patients with chronic lung disease, splenectomized patients and immunocompromised patients. • X-rays; shows lobar consolidation. • Laboratory diagnosis; by sputum and blood cultures. • Treatment; penicillin or erythromycin.

  7. Mycoplasma pneumoniae • 1-20% • Occur primarily in young adults. • X-ray shows diffuse changes. • Laboratory diagnosis is by serology. • Treatment; erythromycin.

  8. Haemophilus influenzae • <10% of all community acquired cases. • Common in infants <5 years. • Diagnosis by sputum culture.

  9. Staphylococcus aureus Very rare Post-influenza pneumonia Laboratory diagnosis; sputum culture.

  10. Legionella pneumophila • L. pneumophila is transmitted via aerosols particularly from contaminated air-conditioning systems. • <5% • Elderly and immunocompromised are in particular risk. • Specimen; culture, serology, direct immunofluorescence.

  11. C. pneumoniae • 10% • Young adults have high incidence. • Diagnosis by serology.

  12. C. psittaci • Contact with birds • Serology

  13. Hospital-acquired (nosocomial) pneumonia

  14. Symptoms appears >2 days after admission. • Common nosocomial infection • Risk factors include assisted respiration, immunocompromised and pre-existed pulmonary disease. • Aetiology; S. pneumoniae, H. influnzae, Gram negative organisms like E. coli, Klebsiella.

  15. Pneumonia in the immunocompromised

  16. Infected with classical chest pathogen like S. pneumoniae M. pneumoniae…etc • Or with opportunistic pathogens; • Actinomyceteae • Atypical mycobacteria • Legionella pneumophila.

  17. Whooping cough (pertussis)

  18. Tuberculosis

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