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32 Cards in this Set
- Front
- Back
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Respiratory Tract Infections
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Many are spread by respiratory droplets and secretions
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Upper Respiratory Tract Infections: bacterial respiratory disease:
Pharyngitis and Tonsillitis |
Swollen tissues, white exudate, petechiae present
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Upper Respiratory Tract Infections: bacterial respiratory disease:
Otitis and Sinusitis |
ear infection/swelling and sinus infection/swelling
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Upper Respiratory Tract Infections: bacterial respiratory disease:
Streptococcal Disease |
Streptococcus pyogenes – *Gram+ Group A, beta-hemolytic,
*Causes strep throat *Symptoms include: sore, scratchy throat, difficulty swallowing, red and swollen tonsils, sometimes with white patches or streaks of pus, swollen, tender lymph glands (nodes) in your neck, fever, headache, rash *Produces many virulence factors *Must be treated with antibiotics in full to reduce complications |
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Post-streptococcal complications
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Production of a M adhesion proteins and/or anti-streptococcal antibodies resulting in immune-mediated etiology
A fever or pain or swelling in the joints, shortness of breath or a rash after a strep infection, even as long as three weeks after infection, can be indicate rheumatic fever Cola-colored urine more than a week after a strep infection may indicate kidney inflammation (post-streptococcal glomerulonephritis |
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Upper Respiratory Tract Infections: bacterial respiratory disease:
Diphtherial disease |
*Corynebacterium diptheriae, Gram-, non-motile bacillus
*Spread through aerosol droplets produced by an infected person; colonizes pharynx superficially *May posses a prophage-encoded exotoxin, diptheria, which destroys epithelial cells *Leads to formation of a pseudomembrane *Suffocation may occur if airway is blocked *DTaP toxoid vaccine offers lifelong immunity |
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viral respiratory disease: The ‘Common Cold’
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*Adeno- and Coronoviruses
Adenoviruses are unusually stable to chemical or physical agents and adverse pH conditions, allowing for prolonged survival outside of the body, 200 types Transmitted by direct contact, fecal-oral transmission, and occasionally waterborne transmission Cause acute symptoms in 2-4 day; sore throat, cough, head-ache, excessive mucus secretions (blood or pus may be present), lymph nodes swelling, general malaise Other diseases; epidemic conjunctivitis, pharyngitis, gastroenteritis, cystitis, rash illness, acute respiratory disease (ARD) Can also set-up chronic, asymptomatic infection of tissues No viral-specific therapy; vaccine for subtypes 4 and 7 (military only) |
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viral respiratory disease: Rhinovirus; common ‘head’ cold
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Naked, icosahedral RNA virus
113 known types Transmitted by aerosol or direct contact Attaches to respiratory epithelium in nasal cavity; does not replicate well at body temp Symptoms are nasal discharge and congestion, sneezing, and throat irritation, cough Resolves after 1-2 weeks; ear and sinus infection common complications, triggers asthma Antihistamines can be used for temporary relief of symptoms No vaccine; Anti-viral Kleenex |
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viral respiratory disease: Parainfluenza
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Enveloped RNA virus, has H and N spikes like influenza virus
Only 4 types Transmitted by respiratory drops, direct contact Symptoms and disease manifestation similar but more exaggerated than “head cold”; Cough and hoarseness, harsh breathing and red throat Progesses to (croup) barking cough, high-pitched, noisy respiration Humidity helps to manage the symptoms Can be inactivated with soap and water |
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lower respiratory infection:Pertussis - Whooping Cough
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Gram-negative, nonmotile bacilli - Bordetella pertussis
Highly contagious ‘whooping cough’ disease - up to 5000 cases/annually in US. Increasing incidence. Transmitted through respiratory drops Produces powerful exotoxins which paralyze the cilia of lung tissues resulting in severe, non-productive coughing ‘fits” Complication include CNS anoxia, secondary pneumonia Cough may take weeks to months to go away completely DTaP toxoid vaccine available and can be treated with antibiotics*. |
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Disease manifests in two locales:
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upper or lower respiratory tract
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lower respiratory infection: Pneumonia
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microbial disease of the bronchial tubes and the lungs
Refers to disease caused by a diverse group of organisms 95% of all pneumonia cases are caused by Streptococcus pneumoniae High fever, chill, cough, sputum; chest x-ray required to diagnose |
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Pneumonia Conditions
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Lobular - exudate forms and clots in aveoli rendering them solid (consolidation)
Bronchopneumonia - patchy, more diffuse consolidation Lung abcess - cavity formation and tissue destruction Respiratory distress results from all conditions |
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Other lung conditions
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Pleural effusion - fluid
Empyema - pus (puralent exudate) |
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lower respiratory infection: Pneumococcal pneumonia
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Caused by Gram-positive, encapsulated diplococci, Streptococcus pneumoniae
Can not infect a healthy host, defenses must be weakened Transplant patients, malnutrition, smoking, viral infection, elderly Symptoms include high fever, sharp chest pain, difficulty breathing, cough with rust colored sputum Grouped into capsular types; over 90 Vaccine available that can protect against 23; antibiotic resistant strains emerging 500,000 infected; 40,000 deaths annually |
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lower respiratory disease-
Primary Atypical Pneumonia |
Caused by Mycoplasm pneumoniae
Spread quickly in crowded conditions Smallest of the bacteria, have no cell wall, no distinct shape, no Gram reaction Obligate human pathogen but rarely fatal Can attach to and destroy cilia cells Known as ‘walking pneumonia’; symptoms include fever, cough headache, and myalgia Antibiotic treatment is available but no vaccine |
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lower respiratory disease-
Legionellosis: Legionnaire’s disease |
Gram-, motile bacilli, Legionella pneumophila
Often found in warm water and soil, sometimes within a protozoan populations Does not transmit person to person; inhalation of contaminated water droplets; live inside white blood cells Symptoms include fever, painful chest and abdomen, cough, diarrhea and vomiting Severe, (sometimes necrotizing) pneumonia may occur Can be treated with antibiotics |
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lower respiratory disease-
Tuberculosis |
Non-motile bacilli, Mycobacterium tuberculosis
Transmitted be repeated exposure to respiratory drops of an infected individual Does not produce toxins, but can maintain persistent growth and an acute imflammatory response, which can spread to other organs ie. liver, kidney, spine, CNS Possess a thick, waxy coat that offers protection against the external environment acid fast test required to screen |
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The Progress of Tuberculosis
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1. Latent or primary (a)
2. Active 3. Miliary or consumption (b) |
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TB cont
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Early detection is key to survival - we use the Matoux test
Injection of PPD under skin and site scored for reaction Therapy requires 9 months of treatment - if not completed, organisms will come back stronger and often resistant to antibiotics There is a vaccine using attenuated M. bovis; but not administered in the United States. New technologies are being researched to come up with a recombinant vaccine. |
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lower respiratory infection: Q fever
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A Rickettsiae, small bacterium Coxiella burnetii
No flagella, pili or capsule Derived from livestock (reservoir) and transmitted by occupational exposure, can also be present in unpasteurized milk or in ticks Symptoms similar to ‘walking pneumonia”; can result in lung tissue lesion but rarely fatal Can become chronic, lasting more than 6 mo. Infection of heart and heart valves can be fatal Effective antibiotic treatment available Recovered patients can have lifelong immunity Vaccine is available for humans and livestock but not in US |
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lower respiratory disease-
Chlamydial respiratory diseases: organism 1 |
Chlamydia pneumoniae:
Identifiers: Small bacterium, obligate intracellular pathogen Risk group Infants and young adults Mode of transmission Person to person inhalation of respiratory secretions Distinguishing symptoms Range of lung diseases, both upper and lower, ‘walking pneumonia’ Treatment Antibiotics Incidence Hard to separate from the 500,000 pneumonia-related cases each year |
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lower respiratory disease-
Chlamydial respiratory diseases: organism 2 |
Chlamydia psittaci
identifiers: Small bacterium, obligate intracellular pathogen, derived from birds risk group: Bird owners, pet shop employees, veterinarians mode of transmission: Inhalation of dried secretions of infected birds distinguishing symptoms: Severe pneumonia, scattered patches on lung surfaces treatment: Antibiotics; repeated infection most likely occurs incidence: Diagnosis is difficult; only 50 cases rpt. since 1996 |
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viral respiratory disease: Influenza "the flu"
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*Enveloped, Helical RNA virus
*Has additional structural proteins called matrix proteins and spikes *2 types of antigenic spikes: hemmagglutin (H) and neuraminidase (N) *3 types of influenza virus: A, B, C *Antigenic variation of H and N lead to new strains (drift or shift) Ex. Avian bird flu virus, H5N1, Swine flu H1N1 *Transmitted by coughing and sneezing; contaminated objects Incubation period is 24 hours; fever and chills, extreme fatigue, headache, severe cough, body aches and pain, nasal congestion, dry throat, tight chest Disease is self-limiting and resolves in 7-10 days vaccine info: Complications from secondary infections (ie. Haemophilus influenzae), Guillain-Barré syndrome, Reye’s syndrome Vaccine takes 2 weeks to mount immunity; Anti-virals - amantadine, rimantadine, zanamivir, and oseltamivir 200,000 hospitalizations; 36,000 deaths annually in US |
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viral respiratory disease: Severe acute respiratory syndrome (SARS)
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*Encapsulated, helical RNA virus- coronavirus
*Transmission through close person to person contact, contaminated objects, may be airbourne *High fever (> 100.4°F), headache, overall feeling of discomfort, body aches, sometimes diarrhea; dry cough progresses to pneumonia and poor oxygenation; severe respiratory distress *10% mortality rate *As of May 3, 2005; there have been no known transmission of SARS world-wide; last outbreak was in 2004 (laboratory-acquired) |
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viral respiratory disease: Respiratory syncytial disease (RSV)
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*Enveloped, helical RNA virus
*Most common cause of bronchiolitis and pneumonia of infants under 1 yr old *Spread from respiratory secretions, contaminated surfaces or object *Moderate to severe ‘cold-like’ symptoms, hyperinflation cyanosis due to hyperventilation, fluid on the lungs, otitis media *Disease last 8-15 days; reoccurring *No vaccine Therapy for severe disease or immunocompromised individuals is anti-viral medications and/or immunoglobin (human antibodies) therapy Effectively killed with soap and water |
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fungal respiratory disease Coccidioidomycosis
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*Coccidioides immitis - asexual spore-former
*Transmission by inhalation of fungal spores in contaminated soils *Endemic to southwest US, Mexico *Symptoms - flu-like with high fever, rash *40% of people develop transient chest infection that resolves on its own *Some fail to respond and develop chronic pulmonary disease and or disseminated disease *High-risk for agricultural workers in endemic areas, pregnant women in the third trimester, Af. Am. and Asians, AIDS patients |
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fungal respiratory disease: Histoplasmosis
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*Histoplasma capsulatum - dimorphic yeast
*Transmission by inhalation of spores in dry, dusty soils, bat and pigeon droppings *Can infect healthy individuals but immuno-compromised at higher risk *Healthy individuals experience ‘flu-like’ symptoms *Recovery with no treatment *AIDS patient may have serious tuberculosis-like lung disease and/or systemic fungal infection *Treatment with IV antifungal medication |
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fungal respiratory disease: Cryptococcosis
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*Cryptococcus (Filobasidiella) neoformans - encapsulated yeast
*37 species, 4 capsular serogroups *Soil contaminant associated with pigeon droppings; inhalation of airbourne yeast particles *Causes meningitis which can lead to neurological damage; disseminated disease can affect other tissues *Often occurs in immuno-deficient people: 2-7cases/1000 AIDS patients *Intravenous anti-fungal drug |
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fungal respiratory disease: Pneumocystis pneumonia
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*Pneumocystis jiroveci (carnii) - fungus
*Life cycle complexities - takes place entirely within lung aveoli *Transmission by respiratory droplets; unknown reservoir *Most carriers are healthy asymptomatic individuals; most deadly for immuno-compromised (AIDS) patients, transplant recipients, cancer patients, infants and elderly *Patients develop high-fever, non-productive cough with deteriorating lung capacity, eventual death *Preventative anti-PCP medication administered once patient develops AIDS *85% of AIDS patients will develop PCP without treatment |
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fungal respiratory disease: aspergillosis
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*unique mold species can grow as a mycelium within the body
*may cause blockages requiring surgical removal *can disrupt gas exchange and cause death by asphyxiation |
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Parasitic infections in a nutshell
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*Ingestion of eggs
*Lifecycle or lifestyle may involve temporary or accidental localization of parasites in the lungs *Triggers an inflammation of the lungs (pneumonitis) or eosinophilia *Some may form cysts in the lung tissue |
