Chronic Lung Infections Flashcards
Risk factors for developing chronic lung infection
Immunodeficiency
Immunosuppressive
Damaged mucosa/cilia
Repeated insults
How does chronic lung sepsis present?
Weight loss Persistent sputum Chest pain Increased SoB Shadow on CXR
What immunodeficiencies can lead to chronic lung infections?
Ig deficiencies
- IgA deficiency is common
- Hypogammaglobulinaemia is rare
- Common Variable Immunodeficiency is the commonest
- Specific Polysaccharide Antibody Deficiency
Hyposlenism
Malignancy
HIV
What do Kartagener syndrome and Youngs syndrome cause?
Abnormal cilia and hence defective defence
What can result in recurrent aspiration?
NG feeding
Poor swallow (MND)
Pharyngeal pouch
What forms of chronic infection are there?
Intrapulmonary abscess Empyema Chronic bronchial sepsis Bronchiectasis CF
What infections typically precedes an Intrapulmonary abscess?
Staph aureus -> cavitating pneumonia -> abscess Other - Strep - E. coli - Gram negatives - Aspergillus
What is empyema?
Pus in the pleural space
How do we diagnose chronic pulmonary infections?
Clinical suspicion - Slow to resolve pneumonia CXR - Persisting effusion - D sign USS CT
What is the broad treatment of infection?
Amoxicillin + Metronidazole + Gentamicin
What is bronchiectasis?
Localised, irreversible bronchial tree dilation
How can exacerbations of infections be reduced?
Clarithromycin (250mg OD)
Azithromycin (250mg 3 times weekly)
