S/Sx

  • fever

  • sputum

  • cough

 

Because its an infection, sputum gets released. Nerve irritation causes the cough. IL1,6 are responsbile for the fever.

 

Bronchitis: infection of the upper airways themselves

  • Streptococcus 40%

  • Haemophilus Influenza 30%

  • Moraxella 20%

  • unknown 10%

 

- acute bronchitis: anyone can get

- chronic bronchitis: smokers often have exacerbation. Part of COPD. 

  • Diagnosis

    • CXR will be normal (you are ruling out pneumonia)

  • Treatment

    • Amoxicillin

    • Macrolide (2nd line)

    • Amoxicillin / clavulanate: if had recent abx in last few weeks

    • respiratroy FQ

    • 2nd/3rd generation Cephalosporin

 

Pneumonia: infection of the lung tissue

  • streptococcus pneumonia: most common

  • viral

  • mycoplasma pneumonia: youn adults

  • chlamydia pneumoniae

  • haemophilus influenza

  • moraxella pneumoniae

  • legionella pneumophilia

  • pseudomonas aeruginosa

  • staph auerus

  • P. jiroveci

  • klebsiella

  • fungus

 

Pulmonary abscess: focal infection of pulmonary tissue

  • anaerobes - 90% (+/- aerobes)

  • Risk Factors

    • alcoholics

    • aspiration 

    • poor dentition (anaerobes)

    • intubation

  • Diagnosis

    • CXR 

      • wall of abscess with air / fluid level

  • Treatment

    • Clindamycin (above the diaphragm abscess)

    • drainage rarely needed

 

 

 

 

... but I would more especially commend the clinician who, in acute diseases, by which the bulk of mankind are cutoff, conducts the treatment better than others.
 
Hippocrates, 400 BC