Respiratory System Infections

Dear Loving and Compassionate God,

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

Thank you so much!