Kategorier: Alle - bacteria - infections

av R G 15 år siden

427

Bacterial Infections of Lung

Lung infections caused by bacteria can arise due to various predisposing factors including dysfunction of the mucociliary apparatus, hypogammaglobulinemia, and loss or suppression of cough reflex.

Bacterial Infections of Lung

Bacterial Infections of Lung

PCP

Honeycomb appearance
Silver methenamine stain
Perihilar shadow
T cell count < 200

Mycoplasma Pneumonia

"Walking Pneumonia" = Asymptomatic pneumonia, but CXR looks bad

"Primary atypical pneumonia"

Cold agglutinins (50%)

Serum agglutinates group O blood at freezing point (0 deg C)

Community-acquired pneumonia

How Infections Develop

Bacteria
S. aureus
P. aeruginosa
Nosocomial
I.V. Lines
Intubation
Routes
Hematogenous spread
Inhalation

Predisposing Factors

Hypogammaglobulinemia
Distrubance of the phagocytic actions
Mucociliary apparatus dysfunction
Loss or suppression of cough reflex

"Atypical" Pneumonias

DNA
CMV

Neonates

Immunocomp

VZV

Pregnant women

Mortality Rate = 42%

HSV

Ground glass nuclei

Intranuclear inclusion surrounded by halo

Forms of Infxn

Hemorrhagic parenchymal nodules

Ulcerative tracheobronchitis

Adenovirus

Smudge cells

Military recruits

RNA
SARS-CoV
Influenza A

Neuraminidase

Ameliorate future infection

Hemagglutinin

Prevent future infection

Headache

Muscle pain

Human metapneumovirus
RSV

MGCs

Less than 1 year old

Lung Abscess

Localized suppurative process with necrosis of lung tissue

young adults

60% anaerobic organisms

Copious foul-smelling sputum

chest pain

Morphology
Micro

Neutrophil destruction w/ necrosis

Suppurative process (neutrophil destruction) w/ cavitation (necrosis)

Gross

Necrotic, cavitary mass

CXR
Cavitary mass w/ Air-fluid level
Sx
Chest pain
Copious foul-smelling sputum
Fever
Cough

Bacterial Pneumonia

Foamy macrophages
Lipoid pneumonia

Obstruction

Endogenous

Mineral Oil (Laxative)

Exogenous

Gram negative enterics, anaerobes, gag reflex
Aspiration pneumonia

Location depends on patient's position:

Lying on back --> apical segment of Right lower lobe

Variable

Oropharyngeal

Onset: < 24 h (Others are relatively immediate)

Low mortality

Isotonic fluids

High mortality

Large particulate matter

Hyper/Hypotonic fluids

Gastric acid

Elderly smoker, Cl- resistant, Cooling system
Legionnaire's Disease
Strep Pneumo (90-95%)
Lobar pneumonia
Patchy exudative consolidation
Bronchopneumonoia