Typical Pneumonia (Productive cough with purulent sputum)
Necrotizing bronchopneumonia (exotoxin A)
neutropenia patients following chemotherapy and in pateints with AIDS - shock may devleop
*****CHRONIC INFECTION OF Lower Respiratory Tract
prevalent among CF: present with chronic productive cough, anorexia (loss of appetite), wheezing, rales and tachypnea (rapid breathing).
Can also see leukocytosis
Fever, chills, severe dyspnea, cyanosis, retractions, productive cough with purulent sputum, lung abscesses, confusion - may be rapidly fatal
largest group of medically important gram - bacilli
Associated with aspiration/typical pneumonia in elderly and those with underlying disease, alcoholism, diabetes
1)Klebsiella (Thick Capsule, Lac +, mucoid colonies, Indole -)
2) E Coli (Lac +, Indole +, Citrate -, Simmon's Citrate Agar)
3) Proteus (Lac -, Urease +, Swarmer (rings))
4) Serratia (lipase _, Gelatinase +, produces red pigment
Klebsiella (Thick Capsule, Lac +, mucoid colonies, Indole -)
E Coli (Lac +, Indole +, Citrate -, Simmon's Citrate Agar)
Proteus (Lac -, Urease +, Swarmer (rings))
Serratia (lipase _, Gelatinase +, produces red pigment
Positive result indicates TB infection (past or present)
A. 5 mm or more is positive in (imunocompromised)
HIV-positive person, recent contacts of TB case, persons with changes on CXR consistent with old healed TB, patients with organ transplants and other immunosuppressed patients
B. 10 mm or more is positive in (positive exposure) THIS IS FOR MOST PPL
Recent arrivals (<5 yrs) from high-prevalent countries, injection drug users, residents and employees of high-risk congregate settings (e.g., prisons, nursing homes, hospitals, homeless shelters, etc.), persons with clinical conditions that place them at high risk (e.g., diabetes, leukemia, etc), children <4 yrs, or children exposed to adults in high-risk categories.
C. 15 mm or more is positive in
Persons with no known risk factors for TB
HANTAVIRUS PULMONARY SYNDROME (HPS) (potentially deadly) OR
HEMORRHAGIC FEVER WITH RENAL SYNDROME (Hantaan Virus)
Rapid breathing, tachycardia, hypotension, crackles or rales on lung examination
No extreme swelling of lymph nodes (as seen w/ Bubonic plague)
EARLY = fever, headaches, muscle aches, stomach problems, dizziness, chills
LATE= 4-10 later lungs fill with fluid, sob
INTERSTITAL PULMONARY EDEMA; RESPIRATORY FAILURE, DEATH WITHIN DAYS
LEGIONNAIRES DISEASE (In Red)
(5% of those exposed, oppoortunistic with risk factors)
2-10 day incubation
Fever, chills, early in infection can have initial non-productive cough, myalgia, malaise, fatigue, anorexia, headache, chest pain, watery diarrhea, abdominal pain, nausea and vomiting.
Chest examination can show rales.
Can develop mild cough which is moderately productive and streaked with blood.
Can develop pneumonia, difficulty breathing, and pleural effusion (some lung abscess); renal failure
Somnolence (drowyness), delirium, confusion
(95% of those exposed, milder, self limiting)
1-2 day incubation...similar to influenza
NO GI TRACT MANIFESTATIONS
NO CNS manifestations
Upper Airways : mucociliary apparatus,
anatomy/turbinates bone in nose that maximizes flow of air over cilia,
Oropharynx: saliva, sloughing of epithelial cells, normal flora, complement
Conducting Airways (trachea, bronchi)
Lower Respiratory Tract (terminal airways, alveoli)
cough, epiglottic reflexes,
sharp-angled branching of airways,
IgG, IgM, IgA,
Airway surface liquid (lysozyme, lactoferrin (acts against infection), secretory leukocyte proteinase inhibitor (elastase inhibitor prevents destruction of epithelial cells)
Aspiration pneumonia: follows aspiration of oral or gastric contents into lungs
Occurs when you accidentally inhale food, drink, vomit, or saliva from your mouth into your lungs. This usually happens when something disturbs your normal gag reflex, such as a brain injury, swallowing problem, or excessive use of alcohol or drugs.
Aspiration pneumonias cause changes in the chest x-ray that can be seen six to 24 hours after inhalation. Symptoms include respiratory distress indicated by grunting, cough, and fever after the aspiration of hydrocarbons, foreign substances, or bodily fluids. Symptoms may develop in minutes or hours depending on the volume and nature of the aspirated substance.
Aspiration pneumonia can cause pus to form in a cavity in the lung. This is called a lung abscess.