TOP

Lung Infection

A lung infection is also known as bronchial pneumonia, pneumonia or lobar pneumonia. Oxygen is needed by our body in order for the cells to survive. When the air is inhaled, it travels through the mouth or nose into the lungs via the air canal systems called as bronchi. The left and right lungs are located below the ribcage on both sides of the chest cavity. The lungs are spongy organs. In pneumonia, inflammation or infection of the lungs causes the pus or fluid to fill a particular section (Lobar pneumonia) or patches are formed on the lungs (bronchial pneumonia). These two interferes oxygen uptake.

Symptoms

· Bacterial Pneumonia

Lung InfectionSymptoms include fever more than 38.3 degrees Celsius, sudden onset of chills, dry cough, productive cough with rusty sputum with blood stains, sharp chest pain especially during inhalation, rapid shallow breathing, and shortness of breath with activity, nausea and vomiting, headache, diarrhea, weakness, abdominal pain and fatigue.

· Viral Pneumonia

Viral pneumonia starts with symptoms involving the upper respiratory tract such as low grade fever and dry cough, nasal congestion, headache, sore throat with muscle and joint pains, dry cough with or without sputum, chest pain upon inhalation, chills, shortness of breath during activity, nausea and vomiting and diarrhea.

Causes

Pneumonia is a common cause of lung infection. Bacteria such as streptococcus pneumonia, Haemophilus influenza, Staphylococcus aureus, Chlamydia, Klebsiella, Moraxella catarrhalis, Legionella, and Pseudomonas aeruginosa are all causative agents of lung infection.

Another cause of lung infection is aspiration when the stomach contents goes up to the lungs. Aspiration happens when the normal swallowing mechanism is impaired or because of vomiting and acid reflux.

Pneumocystis carinii is a fungus that causes pneumonia in AIDS patients and decreases the body’s defences.

Tuberculosis with Mycobacterium tuberculosis as the causative agent infects the lungs and other organs such as kidney, brain and spine.

Parasites like ascaris or round worms may invade the lungs especially if they have multiplied successfully in the body.

Diagnosis

Different tests are done depending on the type of lung infection but clinical history and physical exam are routine measures done by doctors in assessing a patient.

Tests:

· Sputum analysis and culture are sent to the laboratory to identify the bacteria and to determine the type of antibiotic to be used. Sputum culture takes 48 hours and weeks for diagnosing Tuberculosis.

· Viral Cultures

· Blood specimen to be screened for bacteria, oxygen levels, sodium levels, proteins and other studies needed in the blood.

· Bronchoscopy for taking samples in the lung and sent to lab for biopsy.

· Thoracentesis is done to remove the fluid in the lungs for analysis and for therapeutic purposes.

Treatment

Treatment depends on the type of lung infection. General antibiotics such as erythromycin may be given first until culture results are not released. Antiviral medications such as Amantadine, Ribavirin and Ganciclovir are given to patients whose causative agents are identified. Oxygen levels are given in low concentrations. Antibiotics are given intravenously if admitted in the hospital. Respiratory support such as mechanical ventilation is provided if a patient is unable to breath.

Read More
TOP

Lower Respiratory Tract Infection

The lower respiratory tract is located beneath the vocal cords. Lower respiratory tract infection is always referred to pneumonia but it can also refer to other illnesses like acute bronchitis and lung abscess. Symptoms include weakness, shortness of breath, coughing, high fever and fatigue.

Infection in the lower respiratory tract is far more serious than upper respiratory tract infection. There are different diseases associated with lower respiratory tract. The first line treatment for this infection is antibiotics but these are not prescribed for viral infections. It is important to have the right kind of medication based on the bacteria involved to ensure treatment success and to avoid bacterial resistance. M. catarrhalis and haemophilus influenzae are thought to be common in both chronic bronchitis exacerbation and community-acquired pneumonia.

Classification

· Bronchitis

Lower Respiratory Tract InfectionBronchitis is classified as either acute or chronic. Acute bronchitis is an acute viral or bacterial infection of the large airways in people who are healthy without recurrent disease history. Viral infection is mostly the cause therefore, antibiotic use is not indicated. Some use antibiotics as treatment for viral bronchitis but its effects are not that beneficial compared to the side effects it may exhibit such as increased resistance, nausea and vomiting, and cost of treatment. Beta 2 agonist is sometimes used to relieve cough in acute bronchitis.

· Pneumonia

Pneumonia occurs in different situations and the treatment depends on the severity. It is classified as community-acquired or hospital-acquired depending on where the patient has acquired the infection. Pneumonia is life-threatening especially to immunocompromised and elderly patients. It is treated with antibiotics. Pneumococcal bacteria like Streptococcus pneumoniae are the common cause of pneumonia which accounts to 2/3 of the cases. It is a dangerous type of infection with over 25% of mortality rate. Treatment and management include causative-agent identification, pain relievers for chest pain, oxygen, physiotherapy, bronchodilators, and hydration. The patient should be assessed for complications like lung abscess and emphysema.

Antibiotic of Choice

It is important to base the antibiotic of choice on the sensitivity test and isolated bacteria because of increasing bacteria resistant to antibiotics and traditional treatments are now becoming less effective.

In children, procaine penicillin and amoxicillin are found to have greater effect compared to cotrimoxazole for community-acquired pneumonia. In hospitals, penicillin and gentamicin are found to be effective than chloramphenicol. Oral amoxicillin has similar results with penicillins that are injectable. In children with severe pneumonia, oral antibiotics are as effective with injectible once without the need to experience injection pain, high cost and risk for infection. Amoxicillin is the first line drug for community acquired pneumonia while intravenous azithromycin is the first line drug if there is a risk of death. Ticarcillin and gentamicin with clavunalic acid is given intravenously in severe cases of hospital acquired pneumonia.

Non-Pharmalogical Treatment

Increased fluid intake is usually advised by doctors to patients having lower respiratory tract infection. Also, rest will allow conservation of energy, for the body to fight infection. In some types of pneumonia, physiotherapy is indicated if appropriate.

Read More
TOP

Upper Respiratory Tract Infection

Upper respiratory tract infection (URTI) is an illness caused by acute infections involving the upper respiratory tract which includes the nose, pharynx, larynx and sinuses. URTI are pharyngitis, laryngitis, tonsillitis, sinusitis, common colds and otitis media.

Common upper respiratory tract infections and their definitions:

· Rhinitis – nasal mucosa inflammation

· Sinusitis – paranasal sinuses inflammation including the frontal, maxillary, ethmoid and sphenoid areas of the sinuses

· Nasophayrngitis – pharynx, hypopharynx, nares, tonsils and uvula inflammation

· Pharyngitis – pharynx, hypopharynx, tonsils and uvula inflammation

· Epiglottitis – supraglottic area and larynx superior portion inflammation

· Tracheitis – subglottic area and trachea inflammation

· Laryngitis – larynx inflammation

· Laryngotrachetis – subglottic area, trachea and larynx inflammation

Signs and Symptoms

Upper Respiratory Tract InfectionAcute upper respiratory infection includes tonsillitis, rhinitis, pharyngitis and laryngitis sometimes referred as common cold. Complications include sore throat, cough, nasal congestion, runny nose, headache, facial pressure, low grade fever and sneezing. Usually, beginning of symptoms is in one to three days after microbial pathogen exposure. It usually last for seven to ten days.

Beta haemolytic group A streptococcal tonsillitis and pharyngitis presents sudden pain upon swallowing, sore throat and fever. Strep throat don’t cause, voice changes, runny nose or cough.

Pain and pressure on the ear caused by otitis media and reddening of eyes or conjunctivitis are usually associated with URTI.

Causes

In the case of upper respiratory tract infection over 200 viruses were already isolated. Rhinovirus is the most common virus. Other viruses are parainfluenza virus, corona virus, enterovirus, adenovirus and respiratory syncitial virus.

Streptococcal pharyngitis and group A streptococcus account 15% of cases of pharyngitis. The flu or influenza is a more severe type of upper respiratory infection.

Treatment

Treatment depends on the causative agent. There are no herbal remedies or medications discovered to shorten the disease duration. Treatment is usually symptomatic support, meaning the symptoms are being treated and not the disease itself. This can include analgesics for sore throat, headache and muscle aches.

Health authorities are now encouraging physicians to lessen the prescription of antibiotics for treating upper respiratory tract infections. Some have advocated delaying use of antibiotic for treating URTI to prevent drug resistance. Studies show that there is no so much difference with treating immediately with antibiotics with delayed prescriptions. However in severe cases like in COPD and bronchitis, antibiotics are used to shorten the illness.

Using vitamin C as treatment and prevention has been widely used since it was introduced. Some studies have shown that taking rest and doing exercises while having upper respiratory disease doesn’t contribute to the duration of illness. So people who have adapted a lifestyle where in exercise is a part of their daily routine, it is fine to continue exercising while in this condition.

Transmission

Transmission is through direct contact from virus-contaminated hands and through droplets. The upper respiratory tract including the nose, sinuses and throat inflammation usually causes secretions resulting to coughing or sneezing. This is how URTI can be transmitted.

URTI has been the leading reason for people to be absent in offices and schools.

Read More