Giver of all gifts, we pray especially today for the mercy and love you give us. Open our hearts and minds to you. Give us the grace to accept your mercy. As we live each day, we pray for those less fortunate, especially those who are hurting, and whose wounds need to be healed. Help us become involved in ways that show them how deeply we care. Give us the personal courage to listen to their concerns and help them find the solutions to which they are entitled as your children and our brothers and sisters. Glory be ... Describe the anatomy of upper and lower respiratory tract. Describe the important opportunistic pathogens that commonly inhabits the respiratory system. Identify the causative agent, pathogenesis, symptoms, treatment and prevention of common respiratory infections.
Normal Flora Staphylococcus Corynebacterium Moraxella Haemophilus Bacteroides Streptococcus Strep Throat Streptococcus pyogenes Sore, red throat with pus, enlargement and tenderness of lymph nodes Sequelae: Rheumatic fever, glomerulonephritis Direct contact, droplet infection, ingestion of contaminated food P&T: Avoidance of crowding Ventilation 10 days of Penicillin or Erythromycin
Diphtheria Corynebacterium diphtheriae (toxin-producing) Sore throat, fever, fatigue Membrane forms on tonsils and throat may obstruct breathing Paralysis, heart and kidney failure Droplet transmission, direct contact, indirect contact via fomites P&T: Immunization (DPT) Antitoxin Erythromycin
Pseudo membrane BULL NECK APPEARANCE Common Cold Rhinovirus Scratchy throat, nasal discharge, malaise, headache, cough Droplet transmission, contaminated fingers, lack of care of nasal secretions P&T: Handwashing Avoid crowded places Antivirals: Pleconaril The United States Food and Drug Administration (FDA) recommends that over-the-counter cough and cold medications not be used in children younger than 2 years of age because serious and potentially life-threatening side effects can occur. Do not use aspirin or aspirin containing medications in children or teenagers because it has been associated with a rare potentially fatal condition called Reye's syndrome.
What is Reyes Syndrome? Reye's syndrome is a potentially fatal disease that causes numerous detrimental effects to many organs, especially the brain and liver, as well as causing hypoglycemia.
The disease causes fatty liver with minimal inflammation and severe encephalopathy (with swelling of the brain). The liver may become slightly enlarged and firm, and there is a change in the appearance of the kidneys. Early diagnosis is vital; while most children recover with supportive therapy, severe brain injury or death are potential complications.
Adenoviral Pharyngitis Adenoviruses Droplet transmission Fever, very sore throat, severe cough, swollen lymph nodes, pus on tonsils and throat P&T: Relief of symptoms Antibacterial meds PNEUMONIA Pneumococcal Klebsiella Mycoplasmal CA Streptococcus pneumoniae Klebsiella pneumoniae Mycoplasma pneumoniae Symptoms Cough, fever, rust- colored sputum, shortness of breath, chest pain Fever, chills, bloody mucoid sputum Gradual onset of cough, fever, sputum production, headache, muscle ache Transmission Droplet Droplet Droplet P&T Vaccine Penicillin Erythromycin No vaccine Cephalosporin No vaccine Erythromycin Avoid crowded places Pertussis Bordetella pertussis Runny nose followed by violent coughing (whooping cough), vomiting and convulsions Droplet transmission P&T: Vaccines Erythromycin
Tuberculosis Mycobacterium tuberculosis Chronic fever, weight loss, cough, sputum production Droplet transmission P&T: BCG vaccination Mantoux test Anti tubercular meds: INH, Rif Rifampicin Isoniazid Pyrazinamide Ethambutol Streptomycin TB-DOTS
Misconception Correct concept 1 TB is infectious.Hence, TB patients should not return to work or school, and should be isolated. () The great majority of TB patients can be rendered non-infectious soon after commencement of treatment. Hence, they can return to work or school soon after commencement of treatment. ( ) 2 All TB patients should be admitted to hospital for isolation.() The great majority of patients can be treated as an outpatient. ( ) 3 After taking anti-TB treatment for a few weeks, the drugs can be stopped if the symptoms have disappeared. () The whole course of anti-TB treatment last for at least 6 months. The treatment course should be completed even if the symptoms have disappeared. Otherwise, the disease may not be cured and relapse may occur. ( ) 4 BCG vaccination can offer 100% protection for the children. () The protection offered by BCG vaccination is only partial. Maintenance of good bodily health and leading a healthy lifestyle are essential preventive measures. ( ) 5 After completion of anti-TB treatment for the disease, the patient can have life-long immunity against the disease. () After completion of anti-TB treatment, the chance for relapse of TB should be low. However, the patient should still maintain good bodily health and lead a healthy lifestyle to prevent relapse of the disease.( ) 6 TB patients should be separated from household members during meals. () TB is transmitted by breathing in small air droplets containing the germs. It is not generally transmitted through the mouth. ( )
TB-DOT (Directly Observed Treatment) DOT is the process, during which the TB patient takes every dose of the medication under the direct observation of health-care staff. DOT is strongly recommended by authoritative bodies like the World Health Organization (WHO) and the International Union Against Tuberculosis And Lung Diseases (IUATLD) as a most effective measure in the control of tuberculosis. By using DOT, TB patients can be provided the necessary support to complete the whole course of treatment, so that treatment failure, emergence of drug resistance and spread of the disease can be avoided. Mantoux Test Tuberculin Skin Testing Purified Protein Derivative
This is the x- ray of a 40 year old woman previously treated for tuberculosis. Her left lung is fibrotic and there is radiologic evidence of bullae and cavitations. Legionnaires Disease Legionella pneumophila Muscle ache, headache, fever, cough, shortness of breath, chest & abdominal pain, diarrhea Ingestion of warm water contaminated with other microorganisms Air-conditioning systems P&T: Avoid contaminated water with aerosols Regular cleaning and disinfection of humidifying devices Erythromycin & Rifampicin
A milder infection caused by the same type of Legionella bacteria is called Pontiac Fever . The symptoms of Pontiac Fever usually last for 2 to 5 days and may also include fever, headaches, and muscle aches; however, there is no pneumonia. Symptoms go away on their own without treatment and without causing further problems. The Legionella bacteria are found naturally in the environment, usually in water. The bacteria grow best in warm water, like the kind found in hot tubs, cooling towers, hot water tanks, large plumbing systems, or parts of the air-conditioning systems of large buildings. Influenza Influenza virus Fever, muscle aches, lack of energy, headache, sore throat, nasal congestion, cough Droplet transmission P&T: Vaccine Amantidine, Rimantidine for prevention of type A virus
Respiratory Syncytial Virus (RSV) Infection RSV Runny nose, cough, fever, wheezing, difficulty of breathing, dusky color Epidemics during cool months Droplet transmission Injections of immune response No satisfactory antiviral treatment Hantavirus Pulmonary Syndrome Sin Nombre and related hantavirus Fever, muscle ache, vomiting, diarrhea, cough, shortness of breath, shock Inhalation of air containing dust contaminated with urine, feces, saliva of infected rodents Zoonosis P&T: Avoid contact with rodents Seal access to food supplies Good ventilation Avoid dust Use disinfectants Coccidioidomycosis (Valley Fever) Cocciodioides immitis Fever, cough, chest pain, loss of appetite, loss of weight Painful nodules on extremities, pain in joints; skin, mucous membranes, brain and internal organs Droplet transmission P&T: Dust control methods Amphothericin B Fluconazole Histoplasmosis Histoplasma capsulatum Mild respiratory symptoms, fever, chest pain, cough, chronic sores Inhalation of contaminated bat and bird droppings P&T: Avoidance of soils contaminated with chicken, bat or bird droppings Amphothericin B Itraconazole