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InfDis of Respiratory Tract
Infectious Diseases of the Respiratory Tract
55
Microbiology
Undergraduate 2
11/27/2013

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Term
nasal congestion, pressure above the nose or in the forehead, feeling of headache or toothache, facial swelling/ tenderness common
-Discharge appears opaque with a white, brown, green, or yellow color

CC: viral, bacterial, or fungal
Definition
sinusitis
Term
2 common causes of acute otitis media?
Definition
Strep Pneumoniae, H. influenzae
Term
How is acute otitis media treated?
Definition
"watchful waiting" for 72 hours,
Beta Lactams/ vaccination (Prevnar, Pneumovax, HiB)
Term
Fusobacterium Necroforum that causes pharyngitis is treated with?

what can it lead to?
Definition
Penicillin, Cefuroxime

can lead to Lemierre's syndrome
Term
Pharyngitis caused by Strep Pyogenes (GAS) is treated with?
Definition
Penicillin plus Augmintin (anti Beta Lactamase)
Term
rare condition in which bacteria spreads from the throat to the tinterior jugular vein in the neck. clumps of bacteria then travel through the bloodstream to the lungs, joints, and bones. Can be treated with antibiotics but fatal if now diagnosed correctly and quickly.
Definition
Lemierre's syndrome
Term
erythrogenic toxin production
-sandpaper-like rash and high fever, common in school-age children
Definition
scarlet fever (aka scarlatina)
Term
-damage to heart valves and circulatory system, arthritis in multiple joints
-X-rxn between streptococcal M protein and heart muscle
-occurs ~3 weeks after pharyngitis has subsided
Definition
Rheumatic fever
Term
-characterized by nephritis and kidney function/failure
-formation of antigen-antibody complexes in the glomeruli (T3HS)
Definition
glomerulonephritis
Term
-has a gram stain of "chinese character" or XY pattern
-forms black colonies on Tinsdale Agar
Definition
corynebacterium diphtheriae (gram + rod)
Term
-URT with sore throat, lack of appetite, low-grade fever
-pseudomembrain forms on tonsils or pharynx
Definition
diphtheria
Term
symptoms of systemic diphtheria?
Definition
extreme fatigue, dementia, and eventual deal that looks very much like a myocardial infarction
Term
treatment of diphtheria?
Definition
PEN or ERY plus anti-toxin and vaccine (DPT)
Term
-name of disease comes from sound patient makes as he or she tries to grab a breath between uncontrollable bouts of coughing (paroxysms)
-violent coughing spasms can result in burst blood vessels in the eyes, vomiting, cracked ribs
Definition
Pertussis (Whooping cough)
Term
-stage of pertussis in which the bacteria present in resp tract cause what appear to be cold symptoms, most notably a runny nose

-last 1-2 weeks
Definition
catarrhal stage
Term
the stage in which numbers of bacteria are decreasing and no longer cause ongoing symptoms (recovery period), but the patient is particularly susceptible to other respiratory infections
Definition
convalescent
Term
treatment of pertussis?
Definition
erythromycin, DPT vaccine
Term
how is pertussis transmissible?
Definition
aerosol
Term
-symptoms mimic common cold but as inf progresses. inflam of URT voicebox and windpipe can spread to affect bronchi

-leads to barking sound or hoarseness

-when very swollen, "stridor" squeaking noise upon inhalation

-may be worse at night or when upset/crying
Definition
croup
Term
CC of croup?
Definition
parainfluenza virus
Term
steeple sign (narrowing or trachea) is sign of?
Definition
Croup
Term
treat croup by?
Definition
treat symptoms and monitor airflow/breathing, cool mist humidifiers and outdoors
Term
symtoms: fever lasting ~3 days, rhinitis, pharyngitis, otitis
-may see "blueing" from airway inflammation
-serious inf give rise to symptoms of croup like coughing, wheezing, dyspnea, rales
Definition
Respiratory syncytial virus
Term
treatment of RSV?
Definition
mild inf are self limiting but severe inf may need admission for O2, IV fluids, ventilation, and antivirals (Ribavirin)
Term
Dx RSV?
Definition
bronchial/nasal wash to find syncytial cells (giant multinucleated cells)
Term
symptoms: rapid onset, headache, chills, dry cough, body aches, fever, stuffy nose, and sore throat from draining
-extreme fatigue can last a few days/weeks
Definition
Influenza
Term
what is responsible for the systemic symptoms of the flu?
Definition
cell breakdown products 'cytokine storm'
-also sloughing of cells into airway and inflammation
Term
this vaccine is:
-3-5 dif viruses resembling variants predicted in the coming flu season, 70-90% effective against those strains
-for anyone over the age of six months
-standard side effects & risks
Definition
inactivated seasonal vaccine ("the injection")
Term
flu vaccine:
-stimulates secretory immunity
-for persons between ages of 5 and 49
Definition
live attenuated seasonal vaccine (FluMist)
Term
flu vaccine:
2-3 viruses, efficacy is protective, but % is unknown
-ages 5-60
-higher side effects, same risks, less antigen
-thimersal (Hg) free
Definition
intradermal version vaccine (Fluzone ID)
Term
Symptoms similar to influenza: rapid onset headache, chills, dry cough, body aches, fever, stuffy nose, and sore throat

-common in children and older adults

-acute resp. tract inf that is found commonly as influenza neg. and rsv neg
Definition
Metapneumovirus
Term
begins with mild cough/resp/cold like symptoms to swift respiratory collapse
-eventual progression to LRT and pneumonia or pneumonia like symptoms
-can be accompanied by diarrhea
Definition
SARS (15% mortality rate)
MERS (50% mortality rate)
Term
Sudden Acute Respiratory Syndrome and Middle East Respiratory Syndrome are both what kinda viruses?
Definition
Coronaviruses
Term
this type of TB is seen in lower, central areas of lungs as granulomas
Definition
primary TB
Term
this type of TB reveals extensive infiltration in the upper lungs/bronchi and marked tubercules
Definition
secondary TB
Term
Cytokine release from T cells results in __________ and spread out of lungs to other places. (Talking about TV=B)
Definition
Caseous (liquifying) necr
Term
TB
-flulike w/ mild fever
-tests positive for PPD, negative for CXR
-not highly contagious
-initial infection that is controlled and goes dormant
Definition
primary TB
Term
TB
-Fever, coughing with blood-tinged sputum, night sweats, weight loss
-"consumption"
-Positive for PPD and CXR
-active infection, contagious, reactivations
Definition
Secondary TB
Term
spread of M. TB out of lungs to other tissues, destrucitve lesions in spine or other bone structures, humps, etc
Definition
Miliary (disseminated) TB
Term
How is TB treated?
Definition
long term treatment:
Rifampin, Isoniazid, Pyrazinamide, Ethambutol, Streptomycin, Aminoglycosides
Term
Begins with upper resp tract symptoms (runny nose, congestion, often fever), onset of lung symptoms follows: chest pain, fever, cough, discolored sputum
-inflammatory condition of the lung in which fluid fills the alveoli
Definition
pneumonia
Term
T/F?
Alost any bacteria can be a cause of pneumonia
Definition
true
Term
-Most common cause of community acquired pneumonia
-Gram (+) lancet shaped diplococci
-small mucoid colonies with a-hemolysis

what is it?
treatment?
Definition
streptococcus pneumoniae, treatment: cephalosporins
Term
Common causes of community acquired pneumonia?
Definition
strep pneumo, H influenzae, Neisseria spp, E. coli, S. aureus
Term
causes pneumonia, bloodstream infections, wound or surgical site infections via ventilators or IV catheters
-has been associated with high rates of morbidity and mortality, particularly among persons with prolonged hospitalization
-healthy people usually do not get infections from it
Definition
Klebsiella pneumoniae (CRKP)
Term
what is different about CRKP? (appearance /characteristics of the organism itself)
Definition
it's from normal flora of gut and feces and it is sticky and stretches like "pizza cheese"
Term
How is CRKP treated typically if the bacteria are resistant to other antibiotics?
Definition
Carbapenem
Term
cause of walking pneumonia.. symptoms may range from asymptomatic to mild cough and malaise to fever, muscle ache, severe fatigue, etc.
-gram not applicable
-VFs OBLIGATE INTRAcellular

what is it?
treatment?
Definition
chlamydia pneumoniae, treat with macrolides or tetracyclines
Term
causes walking pneumonia
-no cell wall
-smallest free-living bacterium
-OBLIGATE EXTRAcellular, TIP adhesion structure
-colonies are very sow growing and resemble "fried eggs"
what is it?
treatment?
Definition
Mycoplasma pneumoniae, treat with macrolides or tetracyclines
Term
Common fungal pneumonia
-"the black mold" can be normal flora or opportunistic pathogen
-most common in AIDS patients
-causes pneumonia, lung infection
-appearance of black lesions
-appearance "septate branching hyphae" or "lightning and broccoli"
Definition
aspergillus fumigatus
Term
common cause of fungal pneumonia
-most cases begin cold-like but progress to uncontrolled
-often has lower sputum than other pneumonias
-recent large increase in AIDS patients
-appearance "crushed ping pong balls" aka flat on one side... hollow looking.. dark outline jelly lookin
Definition
Pneumocystis Jirovecii (pneumocystis pneumonia PCP)
Term
common cause of fungal pneumonia acquired from bird droppings, bat caves, some soil locations
-endemic
-cayses lung mycosis with progression to pneumonia disease
-many cases are asymptomatic cold-like
-appears as small oval budding yeasts inside macrophages
-lung disease can apear as "snowstorm" CXR
-suspect disseminated histoplasmosis in HIV cases (unexplained fever, hepatosplenomegaly, generalized lymoadenopathy, abmnormal liver functions, yadayada)
Definition
Histoplasma capsulatum
Term
headache, fever, chills, non-roductive cough- multifocal necrotizing pneumonia [productive cough, chest pain, vominting, confusion/delerium, diarrhea] -- shock, MOF, death.. mortality rate ~50%
-gram (-)
what is it/treatment?
Definition
Legionnnaires Disease caused by legionella pneumophila, treat with immediate antibiotics and environmental control/sourcing
Term
this CC of deadly pneumonia (~50% MR) lives in water, A/C cooling towers, water storage, sprinkler systems--- chlorine resistant
transmission= water aerosol.. no person to person
Definition
legionella pneumophila
Term
causes flu-like symptoms and vomiting, other GI symptoms.. short febrile prodrome lasting 3-5 days.. some patients report back pain and abdominal pain, typical findings on initial presentation inclyde fever, tachypnea, tachycardia
-brief recovery period, then rapid respiratory failure as hemorrhagic disease
-cytokine storm, large edema formation due to masive immune response, swamps lungs
-even with aggressive treatment, ~40% MR
-Spread by rodent droppings, but person to person eventually reported
Definition
hantavirus
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