Chapter 21 – Respiratory Infections, causes, epidemiology – Flashcards
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pleura
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membrane that surrounds the lungs
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pharyngitis
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inflammation of the throat
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laryngitis
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inflammation of the vocal cords
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tonsilitis
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infection of the tonsils
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epiglottitis
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infection of the epiglottis
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Strep Throat: Signs and symptoms
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Sore, red throat, with pus and tiny hemorrhages, enlargement and tenderness of lymph nodes in the neck; less frequently, abscess formation involving tonsils; occasionally, rheumatic fever and glomerulonephritis as a sequelae
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Diptheria: Signs and Symptoms
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Sore throat, fever, fatigue and malaise; pseudomembrane forms on tonsils and throat or in nose; paralysis, heart and kidney failure
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Pertussis is also called:
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Whooping cough
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The Common Cold: Signs and symptoms
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scratchy throat, nasal discharge, malaise, headache and cough
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Influenza: Signs and symptoms
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Fever, muscle aches, lack of energy, headache, sore throat, nasal congestion and cough
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Strep Throat: Incubation period
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2 to 5 days
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Strep Throat: Causative agent
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Streptococcus pyogenes
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Strep Throat: Pathogenesis
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Virulence associated with hyaluronic acid capsule and M protein, both which inhibit phagocytosis; protein G binds Fc segment of IgG; protein F for mucosal attachment; multiple enzymes
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Strep Throat: Epidemiology
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Direct contact and droplet infection; ingestion of contaminated food
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Strep Throat: Treatment and prevention
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Treatment - Penicillin or erythromycin Prevention - avoiding crowds; adequate ventilation; daily penicillin for those with rheumatic heart disease
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Diptheria: Incubation period
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2 to 6 days
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Diptheria: Causative agent
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Corynebacterium diptheriae
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Diptheria: Pathogenesis
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Infection in upper respiratory tract; exotoxin is released and absorbed by bloodstream; toxin kills cells by interfering with protein synthesis; effect is on cells that have receptors for the toxin - mainly heart, kidney and nerve tissue
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Diptheria: Epidemiology
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Inhalation of infectious droplets; direct contact with patient or carrier; indirect contact with contaminated articles
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Diptheria: Treatment and prevention
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Treatment - antitoxin; erythromycin to prevent transmission Prevention - vaccine, diphtheria toxoid (DTaP vaccine, 5 doses)
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Pinkeye, Earache and Sinus Infection: Signs and Symptoms
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Pinkeye - increased tears, redness of the conjunctiva, swollen eyelids, sensitivity to bright lights and large amounts of pus Earache - severe earache, fever mild or absent Sinus Infection - facial pain and pressure, headache and severe malaise; Thick green nasal discharge.
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Pinkeye, Earache and Sinus Infection: Causative agent
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Haemophilus influenzae or Streptococcus pneumoniae
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Pinkeye, Earache and Sinus Infection: Pathogenesis
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Pinkeye - probably inoculated directly onto the conjunctiva from airborne respiratory droplets or rubbed in from contaminated hands.Resist destruction by lysozyme. Following attachment the bacteria release proteases, collagenases and coagulases combined with toxins in some cases that further damage the tissue and all the entry of organisms. Earache and Sinus Infection - preceded by infection of the nasal chamber and nasopharynx that probably spreads upward through the eustachian tube. Infection damages the ciliated cells, resulting in inflammation and swelling.
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Pinkeye, Earache and Sinus Infection: Epidemiology
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largely unknown
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Pinkeye, Earache and Sinus Infection: Treatment and prevention
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Treatment - antibiotic medication Prevention - Handwashing and proper hygiene; tubes in ears; Flu shot
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The Common Cold: Incubation period
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1 to 2 days
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The Common Cold: Causative agent
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rhinoviruses (more than 100 types)
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The Common Cold: Pathogenesis
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Viruses attach to respiratory epithelium, starting infection that spreads to adjacent cells; ciliary action ceases and cells slough; mucus secretion increases and inflammatory reaction occurs; infection stopped by interferon release, cell-mediated and humoral immunity
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The Common Cold: Epidemiology
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Inhalation of infected droplets; transfer of infectious mucus to nose or eye by contaminated fingers
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The Common Cold: Treatment and prevention
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No treatment, just medications to control symptoms Prevention - handwashing and avoiding touching face
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Adenoviral Pharyngitis: Signs and symptoms
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fever, very sore throat, severe cough, swollen lymph nodes of neck, pus on tonsils and throat, sometimes conjunctivitis; less frequently pneumonia
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Adenoviral Pharyngitis: Incubation period
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5 to 10 days
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Adenoviral Pharyngitis: Causative agent
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Adenoviruses (more than 45 types)
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Adenoviral Pharyngitis: Pathogenesis
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Virus multiplies in host cells; cell destruction and inflammation occur; different types produce different symptoms
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Adenoviral Pharyngitis: Epidemiology
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Inhalation of infected droplets; possible spread from gastrointestinal tract
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Adenoviral Pharyngitis: Treatment and prevention
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No treatment other than relief of symptoms Prevention - handwashing and avoiding people with symptoms.
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Pneumococcal Pneumonia: Signs and symptoms
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Cough, fever, single shaking chill, rust-colored sputum from degraded blood, shortness of breath, chest pain
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Pneumococcal Pneumonia: Incubation Period
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1 to 3 days
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Pneumococcal Pneumonia: Causative agent
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Streptococcus pneumoniae
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Pneumococcal Pneumonia: Pathogenesis,
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Inhalation of encapsulated pneumococci; colonization of the alveoli incites inflammatory response; plasma blood, and inflammatory cells fill the alveoli; pain results from involvement of nerve endings
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Pneumococcal Pneumonia: Epidemiology
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High carrier rates for S. pneumoniae. Risk of pneumonia increased with conditions such as alcoholism, narcotic use, chronic lung disease, and viral infections that impair the mucociliary escalator. Other predisposing factors are chronic heart disease, diabetes and cancer.
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Pneumococcal Pneumonia: Treatment and Prevention
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Treatment with Penicillin, erythromycin, and others. Capsular and conjugate vaccines available
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Klebsiella Pneumonia: Signs and symptoms
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Chills, fever, cough, chest pain, and grossly bloody, mucoid sputum.
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Klebsiella Pneumonia: Incubation period
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1 to 3 days
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Klebsiella Pneumonia: Causative agent
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Klebsiella pneumoniae
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Klebsiella Pneumonia: Pathogenesis
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Aspiration of colonized mucus droplets from the throat. Destruction of lung tissue and abscess formation common; infection spreads via blood to other body tissues
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Klebsiella Pneumonia: Epidemiology
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Often resistant to antibiotics and colonize individuals who are taking them. Klebsiella species and other gram negative rods are common causes of fatal healthcare associated pneumonias
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Klebsiella Pneumonia: Treatment and prevention
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Treated with cephalosporin with aminoglycoside. No vaccine.
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Mycoplasmal Pneumonia: Signs and symptoms
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Gradual onset of cough, fever, sputum production, headache, fatigue and muscle aches
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Mycoplasmal Pneumonia: Incubation period
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2 to 3 weeks
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Mycoplasmal Pneumonia: Causative agent
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Mycoplasma pneumoniae
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Mycoplasmal Pneumonia: Pathogenesis
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Cells attach to specific receptors on the respiratory epithelium; inhibition of ciliary motion and destruction of cells follow
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Mycoplasmal Pneumonia: Epidemiology
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Inhalation of infected droplets; mild infections common and foster spread of the disease
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Mycoplasmal Pneumonia: Treatment and prevention
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Treated with tetracycline or erythromycin. No vaccine.
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Pertussis: Signs and symptoms
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Runny nose followed after a number of days by spasms of violent coughing; vomiting and possible convulsions
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Pertussis: Incubation period
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7 to 21 days
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Pertussis: Causative agent
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Bordetella pertussis
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Pertussis: Pathogenesis
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Colonization of the surfaces of the upper respiratory tract and tracheobronchial system; ciliary action slowed; toxins released by B. pertussis cause death of epithelial cells and increased cAMP; fever, excessive mucus output and a rise in the number of lymphocytes in the bloodstream result.
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Pertussis: Epidemiology
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Inhalatation of infected droplets; older children and adults have mild symptoms
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Pertussis: Treatment and prevention
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Erythromycin, if given before spasms start. Acellular vaccine (DTaP) available.
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Tuberculosis: Signs and symptoms
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Chronic fever, weight loss, cough, sputum production
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Tuberculosis: Incubation period
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2 to 10 weeks
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Tuberculosis: Causative agent
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Mycobacterium tuberculosis
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Tuberculosis: Pathogenesis
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Colonization of the alveoli incites inflammatory response, ingestion by macrophages follows; organisms survive ingestin and are carried to lymph nodes, lungs, and other body tissues; tubercle bacilli mutliply; granulomas form
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Tuberculosis: Epidemiology
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Inhalation of airborne organisms; latent infections can reactivate
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Tuberculosis: Treatment and prevention
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two or more antitubercular medications given simultaneously long term, such as isoniazid and rifampin. BCG vaccination available but not in US.
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Legionnaires Disease: Signs and symptoms
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Muscle aches, headache, fever, cough, shortness of breath, chest and abdominal pain, diarrhea
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Legionnaires Disease: Incubation period
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2 to 10 days
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Legionnaires Disease: Causative agent
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Legionella pneumonphila
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Legionnaires Disease: Pathogenesis
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Organism multiplies within phagocytes; release with death of the cell; necrosis of cells lining the alveoli; inflammation and formation of microabscesses
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Legionnaires Disease: Epidemiology
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Originates mainly from warm water contaminated with other microorganisms, such as found in air conditioning systems
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Legionnaires Disease: Treatment and prevention
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Treatment - erythromycin and rifampin Prevention - avoid contaminated water aerosols
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Influenza: Incubation period
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1 to 2 days
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Influenza: Causative agent
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Influenza virus
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Influenza: Pathogenesis
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Infection of respiratory epithelium; cells destroyed and virus released to infect other cells. Secondary bacterial infection results from damaged mucociliary escalator
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Influenza: Epidemiology
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Antigenic drift and antigenic shift prevent immunity
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Influenza: Treatment and prevention
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Amantadine and rimantadine are sometimes effective for preventing type A but not type B. Neurominidase inhibitors
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Respiratory Syncytial Virus (RSV): Signs and symptoms
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Runny nose, cough, fever, wheezing, difficulty breathing, dusky color
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Respiratory Syncytial Virus (RSV): Incubation period
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1 to 4 days
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Respiratory Syncytial Virus (RSV): Causative agent
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RSV
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Respiratory Syncytial Virus (RSV): Pathogenesis
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Sloughing of respiratory epithelium and inflammatory response plug bronchioles cause bronchiolitis; pneumonia results from bronchiolar and alveolar inflammation, or secondary infection
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Respiratory Syncytial Virus (RSV): Epidemiology
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Yearly epidemics during cool months; readily spread by otherwise healthy older children and adults who often have milder symptoms; no lasting immunity
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Respiratory Syncytial Virus (RSV): Treatment and prevention
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No antiviral treatment. No vaccine.
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Hantavirus Pulmonary Syndrome: Signs and symptoms
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Fever, muscle aches, vomiting, diarrhea, cough, shortness of breath, shock
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Hantavirus Pulmonary Syndrome: Incubation period
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3 days to 6 weeks
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Hantavirus Pulmonary Syndrome: Causative agent
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Sin Nombre
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Hantavirus Pulmonary Syndrome: Pathogenesis
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Viral antigen localizes in capillary walls in the lungs; inflammation
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Hantavirus Pulmonary Syndrome: Epidemiology
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Zoonosis likely to invlove humans in proximity to increasing mouse populations; generally no person to person spread
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Hantavirus Pulmonary Syndrome: Treatment and prevention
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Avoid contact with rodents; seal access to houses, food supplies; good ventilation, avoid dust, use disinfectants. No proven anitviral treatment.
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coccidiodomycosis (Valley Fever) - signs and symptoms
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flue like signs and symptoms, typically recover in a month some develop chronic disease
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coccidiodomycosis (Valley Fever) - Causative agent
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Coccidiodes immititis a dimorphic fungus that grows in soil as mold. hyphae give way to arthroconidia highly infectious. airborne and can be inhaled. arthrocoidia develop thick walled spherules that can contain fungal endospores.
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coccidiodomycosis (Valley Fever) - Pathogensis
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enter lung, develop into spherules, rupture and release the endospores found within, cycle occurs and release, causing inflammatory response. tissue injury by hosts immune system. joint pain and painful nodules
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coccidiodomycosis (Valley Fever) - caseous necrosis
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dead tissue in a small percentage of people results in lung cavities, easily transmitted in bodily fluids and affects people with AIDS and other autoimmune diseases. fatal with out treatmetn
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coccidiodomycosis (Valley Fever) - incubation period
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2 days to 3 weeks
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coccidiodomycosis (Valley Fever) - epidemiology
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inhalation of airborne C. immitis spores with dust from soil growing the organism. occurs in certain semiarid regions of western hemisphere. farmworkers
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coccidiodomycosis (Valley Fever) - treatment and prevention
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amphotericin B and fluconazole or itraconazole. prevent dust by spraying water or grass planting
