Chronic Pulmonary Infection Flashcards Preview

Respiratory > Chronic Pulmonary Infection > Flashcards

Flashcards in Chronic Pulmonary Infection Deck (25):
1

Immunoglobulin deficiency

IgA Deficiency
Hypogammaglobulinaemia
CVID
Specific Polysaccharide Antibody Deficiency

2

Other immunodeficiencies

Hypo-splenism
Immune paresis (Myeloma, lymphoma etc)
HIV

3

Therapies causing immuosuppression

Steroids
Azathioprine
Methotrexate
Cyclophosphamide
Monoclonal antibodies
Infliximab, etanercept, rituximab, leflunamide
Chemotherapy

4

Defective innate host defences

Damaged bronchial mucosa
Abnormal cilia
Abnormal secretions

5

Causes of damaged bronchial mucosa

Smoking
Recent pneumonia, or viral infection
Malignancy

6

Causes of abnormal cilia

Kartenager’s Syndrome
Youngs Syndrome

7

Causes of abnormal secretions

Cystic Fibrosis
Channelopathies

8

Risk factors for developing chronic pulmonary infection

Immunodeficiency
Immunosuppression
Abnormal host defences
Repeated insult

9

Forms of chronic infection

Intrapulmonary abscess
Empyema
Chronic bronchial sepsis
Bronchiectasis
Cystic fibrosis

10

Features of intrapulmonary abscess

Indolent presentation
Weight loss
Lethargy
Cough
High mortality if untreated
Usually a preceding illness

11

Pathogens that cause abscesses (from pneumonia)

Streptococcus
Staphylococcus
E-coli
Gram negatives
Aspergillus

12

Septic emboli in injecting drug users

Inject into groin
DVT
Infection
PE + abscesses

13

Empyema

Pus in the pleural space

14

Simple parapneumonic effusion

Clear fluid
pH>7.2
LDH < 1000
Glucose >2.2

15

Complicated parapneumonic effusion

pH <7.2
LDH > 1000
Glucose <2.2
Requires chest tube drainage or becomes empyema

16

Bacteriology of empyema

Aerobic organisms most frequently
Gram Positive (Strep Milleri, Staph Aureus)
Gram Negatives (E-Coli, Pseudomonas, Haemophilus Influenzae, Kelbsiellae)

17

Bronchiectasis

Localised, irreversible dilation of the bronchial tree
Involved bronchi are dilated, inflamed and easily collapsible
Airflow obstruction
Impaired clearance of secretions

18

Presentation of bronchiectasis

Recurrent "chest infections"
Recurrent antibiotics
No response/ short lived response to antibiotics
Persistent sputum production

19

Clinical bronchiectasis

Cough with sputum production
Chest pain
Recurrent LRTIs

20

Radiological bronchiectasis

High resolution CT scan

21

Pathophysiology of bronchiectasis

Bronchial obstruction
Cystic fibrosis
Young's syndrome
Kartanager's syndrom
ABPA
Immunodeficiency
Rheumatoid arthritis
Bronchopulmonary sequestration
Mounier-Khun Syndrome
Yellow nail syndrome
Traction bronchiectasis associated with pulmonary fibrosis
Idiopathic >50%

22

Chronic bronchial sepsis

All the hallmarks of bronchiectasis but none on the HRCT
Positive sputum results

23

Treatment of bronchiectasis

Stop smoking
Flu vaccine
Pneumococcal vaccine
Reactive antibiotics
Prophylactic antibiotics
Nebulised gentamicin, colomycin, pulsed IV abx,
alternating antibiotics
Low dose macrolide antibiotics
Clarithromycin, azithromycin

24

Mortality rate from abscess

10%

25

Mortality rate from empyema

20%