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Resp Lecture 15 - Microbio of the Resp System

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darodri6's version from 2016-09-22 23:50

Primary vs Secondary Invaders

Question Answer
TopicInfo
Respiratory Tract-Most common site of infections.

-Exposure to many Airborne Pathogens:
Breathing
Hand to nose/mouth contact

-Organisms include:
Viruses
Bacteria
Airborne fungi
Each may localize to different areas of the respiratory tract
Produce different clinical syndromes
Profressional Invaders-can infect HEALTHY respiratory tract:
*Adhesion to normal mucosa
*Ability to interfere with cilia
*Resist destruction by alveolar Macrophages
*Ability to damage local tissues
-->Mucosal or sub mucosal
Secondary InvadersCause infection when host defenses are IMPAIRED

-2° infection after damage by respiratory virus
*Influenzae virus

-Local defenses impaired
*Cystic fibrosis

-Depressed immune function
*HIV

-Depressed resistance
*Age
*Alcoholism
*Renal or hepatic disease
memorize

Various Clinical Syndromes

Clinical SyndromeAssociation w/ Etiologic AgentsGeneral DescriptionSymptoms/OtherManagement
Otitis Media-Most common causes:
Streptococcus pneumoniae – Haemophilus influenza
*Manifest suddenly with high fever and Otalgia (ear pain)
*Not likely to spontaneously resolve
Moraxella catarrhalis – milder disease with spontaneous resolution

Common causes:
< 3 months of age = Streptococcus pneumoniae – (35-40% of cases)

>3 months of age = ADD in Haemophilus influenza – non typable
*What does non-typable tell you?
*Vaccine?
-May be primary infection, but more likely 2° bacterial infection

-Most common reason for pediatric antibiotics
<5 years may have several per year
>5 years incidence drops
-Patient present with:
Fever
Ear pain
*Toddler “ear tugging”
Headache
Otoscopic examination will reveal bulging tympanic membrane and poor mobility
Young children/ infants only sign may be irritability
Usually spontaneously resolves
*Treatment lessens duration
-Empirical antibiotic treatment
-Careful follow-up to ensure infection has resolved
-Extreme pressure/ severe pain
*Drainage of exudates may be required
*Incision of tympanic membrane
Acute Otitis Mediaalmost always bacterial complication of viral UTI:
Chronic Otitis Media-Due to an unresolved acute
*Prolonged by inadequate treatment
*Host factors – Eustachian tube dysfunction, allergy, immunodeficiency
*Progressive middle ear destruction may occur
-->Significant permanent hearing loss
:
Serous (secretory) Otitis Media-may be chronic or allergy related inflammation
*Associated with hearing loss
*Thick non-purulent secretions in the middle ear
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