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Lower Respiratory Tract Infections

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by

Gareth Hynes

on 12 September 2013

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Transcript of Lower Respiratory Tract Infections

Epidemiology

Mortality

Risk factors
Treatments
Lower Respiratory Tract Infections
Pneumonia
Inflammation of the lung tissue with filling of the alveolar air space with inflammatory cells and fluid

Aetiology and Classification
Community-acquired
Hospital-acquired
Signs and Symptoms
Investigations
Chest x-ray
Bloods (FBC, U&Es, CRP, Coag)
Blood cultures
ABG
Sputum for MC&S
Urinary pneumococcal and legionella antigen

Temp, RR, HR, BP, mental status, sats at least 2/d
Antibiotics
Analgesia and antipyretics
Chest physiotherapy
Intravenous fluids +/- catheter
Oxygen, sats > 94%
Repositioning
Nutrition
Mobilisation

Oral antibiotics, discharge and follow up
Gareth Hynes
Acute and Respiratory Medicine SpR

CURB-65 Score
C onfusion
U rea > 7.0mmol/l
R espiratory Rate > 30/min
B lood pressure < 90/60 mmHg
65 years or older

Cause more disease and death than any other infection

Greater burden of disease worldwide than HIV, malaria, cancer or heart attacks

A child dies every 20 seconds from pneumonia
Age
Respiratory disease
Other comorbidities
Impaired swallow
Smoking
Alcohol
Drug use
Neutropaenia
'Flu
Streptococcus pneumoniae (pneumococcus)
Staphyloccocus aureus
Gram-negatives (Pseudomonas, Haemophilus)
Anaerobes (Klebsiella)
Atypicals (Legionella, Mycoplasma)
CURB-65 Mortality
0 0%
1 3%
2 12%
3 33%
4 66%

Systemic
Fever
Rigors
Tachycardia
Hypotension
Confusion
Myalgia
Joint ache
Fatigue

Sepsis
Respiratory
Cough
Sputum
Chest pain
Shortness of breath
Low saturations
Cyanosis
Full transcript