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pneumonia chronic epi lecture

lecture notes for pm494, april 22 2010

James Dolan

on 23 April 2010

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Transcript of pneumonia chronic epi lecture

Pneumonias, tuberculosis, and diffuse interstitial lung diseases Pneumonia Epidemiology With influenza 6th leading cause of death in US

Steady increase in hospitalizations since 1980 Community acquired vs hospital acquired Community acquired
Leading cause of M&M in pts over 65
Mortality rates up to 40%

Comorbid conditions neoplastic disease
neurologic disease
history of hospitalization for pneumonia leading cause of mortality from
hospital acquired infections Risk factors
other chronic illnesses
thoracic or upper abd surgery
Icu stay
mechanical ventilation polymicrobial hospital flora Exposure + infection airborne particles micro-aspiration blood borne spread Pulmonary defenses
upper resp tract flora & aerodynamics
gag, ough, other protective reflexes
mucus carpet
ciliary action
antibacerial substances in mucus
free drainage, tracheo-bronchial tree
blood supply
alveolar macrophages
immune system
gastric acid Cough, pleuritic chest pain, fever,
chills, dyspnea, hypoxia Treatments
supportive therapy
antibiotics Tuberculosis airborne droplets Mycoplasma tuberculosis primary infection, possible reactivation Rx: multiple drugs, 6 - 12 months 2nd leading cause of infectious
deaths worldwide 2 billion people may be
infected, at risk of
reactivation US risk factors
immigant from endemic country
low ses
HIV Prevention
prevent transmission
screening, RX newly infected people
?? BCG Chronic diffuse interstitial lung diseases > 100 Affect alveoli & interstitium; airways spared Drugs pneumoconioses hypersensitivity pneumonitis malignancies Known cause unknown cause sarcoidosis idiopathic pulmonary
fibrosis Other primary lung diseases
desquamative interstitial fibrosis
acute interstitial pneumonia
lymphocytic interstitial pneumonia
BOOP Collagen vascular diseases
Full transcript