respiratory tract infections dr. muhammad atif qureshi mbbs, fcps associate professor medicine
TRANSCRIPT
Respiratory TractInfections
Dr. Muhammad Atif QureshiMBBS, FCPS
Associate Professor Medicine
Infections of Respiratory Tract
• Pharyngitis • Laryngitis• Tracheitis• Bronchitis• Alveolitis• Pneumonia• Tuberculosis• Aspergilosis
Laryngitis
• Clinical features– Weak or loss of voice– Hoarseness– Rawness in throat or tickling sensation– Dry cough– Dry throat– Sore throat
Laryngitis – Acute causes
• The majority of laryngitis cases is only temporary and gets better when the underlying illness improves.
• Vocal straining • Viral infections – common cold– mumps or measles
• Bacterial infections – Diphtheria
Laryngitis – Chronic causes
• Cases of laryngitis that last more than 3 weeks .• Vocal cord injuries or strain as well as vocal cord growths referred to as nodules
or polyps. • Irritants inhaled - chemical allergens, fumes or smoke• Chronic Sinusitis • GERD • Alcohol • Smoking• Habitual vocal overuse – such as cheerleaders or singers
• Fungal, bacterial infections
• The risk issues for laryngitis consist of:• Respiratory infection - bronchitis, a cold or sinusitis• Overuse of the voice • Exposure to irritants - alcohol, cigarette smoke, stomach acid, or workplace
chemicals
Laryngitis Treatment
• Acute viral Laryngitis usually becomes better on its own in 7 days.
• Treatments for chronic laryngitis – treat cause- smoking, excessive alcohol or heartburn.
Antibiotics• In viral laryngitis, antibiotics not very effective. • But bacterial infection usually need antibiotics.Corticosteroids• Corticosteroids may reduce inflammation of vocal
cords. But, only if very urgent need to treat laryngitis.
Treatment-Home Remedies • Breathing of moist air• Humidifier. • Rest the voice as much as conceivable• Avoid singing or talking too long or too loudly. • Drink lots of fluids• Avoid caffeine and alcohol• Keep the throat moist• Do this by sucking on a lozenge, chewing gum or gargling with salt
water.• Avoid using decongestants• These drugs dry the throat out.• Avoid whispering• This places more straining of the voice than speech that is normal
Laryngitis-Complications
• Laryngeal edema
Tracheitis
Tracheitis- causes
• Viral infections• Streptococcus pneumonia• Haemophilus influenza• Moraxella catarrhalis
Tracheitis- Clinical Features• Usually follow an upper respiratory infection, initial symptoms
such as cough, runny nose, or a low-grade fever may appear. • After two to five days, symptoms of infection and airway
obstruction may develop. These symptoms may include:• Deep, severe cough• Breathlessness• High fever• Wheezing• Cyanosis• Stridor - A high-pitched sound while breathing can be a sign of
serious infection and represents partial airway obstruction, a potentially fatal condition.
Tracheitis - Diagnosis
• Physical examination• Blood oxygen level• Nasopharyngeal culture• Tracheal culture • X-ray of the trachea
Acute Tracheitis: Complications
• Review possible medical complications related to Acute Tracheitis:
• Airway obstruction• Toxic shock syndrome• more complications
Acute Bronchitis
• Clinical Features
• Diagnosis
• Treatment
Chronic Bronchitis
• Clinical features
• Diagnosis
• Treatment
Pneumonia
• Bronchopneumonia
• Lobar pneumonia
Community-acquired pneumonia (CAP)
• Pneumonia in persons who have not recently been hospitalized.
• Can affect all ages. • CAP occurs throughout the world and is a
leading cause of illness and death. • Causes of CAP include bacteria, viruses, fungi
and parasites.
Causes of pneumonia
• H. influenza• S. pneumonae• Klebsiella Pneumonae
Symptoms of CAP
• Dyspnea • Cough with greenish or yellow sputum• High grade fever with sweating, chills, and rigors • Sharp or stabbing chest pain increased by breathing • Less commonly:• Hemoptysis • Headache • Anorexia • excessive fatigue• Cyanosis • Nausea and vomiting • Diarrhea • Arthralgias and muscle aches
Symptoms of CAP commonly include:
• In older people typical symptoms may not be present early in disease :
• New or worsening confusion• Hypothermia • Overly sleepy
Risk factors
• Some people have a high risk• Obstruction - foreign bodies especially in infants or
lung cancer in elders. • Underlying lung diseases - emphysema, smoking,
cystic fibrosis, pulmonary sequestration. • Immunocompromised people are more likely to get
CAP, like AIDS etc.
Diagnosis • Symptoms on history• Signs on physical examination• Laboratory investigations• Blood counts• Arterial blood gases• X-ray chest • VQ-scan• CT scan• Blood cultures
Chest auscultation
Ventilation perfusion scan
Treatment
General management• Rest• Antipyretics • Pain relief• Oxygen• Cough syrupsOral or intravenous antibiotics
Treatment
• Macrolides• Flouroquinolones• Doxycline first choice in UK for atypical
pneumonias
Complications
SEPSIS• Streptococcus pneumoniae is the most common cause. • Individuals with sepsis require hospitalization in an intensive
care unit, i.v. antibiotics. Sepsis can cause liver, kidney, and heart damage.
RESPIRATORY FAILURE• May need mechanical ventilationPLEURAL EFFUSION AND EMPYEMA • Thoracocentesis• Chest tube insertionLung Abscess
Pulse oxymetry
Prognosis • Mortality in CAP less than 1%. • Fever typically responds in the first two days
of therapy and other symptoms resolve in the first week.
• The x-ray, may remain abnormal for at least a month.
• Among individuals hospitalized, the mortality rate averages 12% overall, but is as much as 40% in people who have bacterimia and septicemia or require intensive care.
Thank You