ACUTE LOWER RESPIRATORY

INFECTIONS AND PNEUMONIA

ACUTE LOWER RESPIRATORY INFECTIONS

• Acute lower respiratory infections include pneumonia

(infection of the lung or alveoli), as well as infections
affecting the airways such as acute bronchitis and
bronchiolitis, influenza and whooping cough. They are
a leading cause of illness and death in children and
adults across the world. The importance of lower
respiratory infections may be underestimated.
 PNEUMONIA

•Pneumonia is caused by an infection in

the lungs. The infection affects the air sacs
in the lungs rather than the tubes that
carry air to and from the lungs. Infected
parts of the lung fill up with fluid, which
contains white blood cells that fight the
infection.
MODE OF TRANSMISSION
• Organisms enter the distal airway by
inhalation, aspiration or by hematogenous
seeding. The pathogen multiplies in or on
the epithelium, causing inflammation,
increased mucus secretion, and impaired
mucociliary function; other lung functions
may also be affected..
SIGN AND SYMPTOMS

ACUTE LOWER RESPIRATORY INFECTION

• The main symptom cough. However, it's usually more

severe and you may bring up phlegm and mucus.

Other possible symptoms are:

• Tight feeling in your chest,
• Increased rate of breathing,
• Breathlessness
• Wheezing.
 PNEUMONIA
Common symptoms include:

• Cough, sometimes with yellow, green or blood-flecked

phlegm
• Breathlessness
• Chest pain, which may get worse when you breathe in
• High temperature
• Shivery episodes
• Loss of appetite
• Weakness
 LAB AND DIAGNOSTIC TEST
• A patient should be suspected of having pneumonia:
pulse rate >100 or fever >4 days.

• In patients with a suspected pneumonia, a test for the

serum level of C-reactive protein (CRP) can be done.

• A level of CRP <20 mg/L at presentation, with symptoms

for >24 h, makes the presence of pneumonia highly
unlikely

• A level of >100 mg/L makes pneumonia likely.

• Chest X-ray should be considered to confirm or reject
the diagnosis.

Microbiological tests :
• Sputum specimens are cultured for bacteria, fungi and
viruses.
• Culture of nasal washings
• Fluorescent staining technic
• Blood cultures and/or serologic methods
• Enzyme-linked immunoassay methods can be used for
detections of microbial antigens as well as antibodies
• Bacteria: Streptococcus pneumoniae
NONPHARMACOLOGIC THERAPY

•OXYGEN THERAPY
•SMOKING CESSATION
•LIFE STYLE MODIFICATION
•AEROBICS EXERCISES
PHARMACOLOGIC THERAPY
ACUTE LOWER RESPIRATORY INFECTION
• Give Antibiotic
PNEUMONIA
• Low-severity community-acquired pneumonia - Offer
a 5-day course of antibiotic. Consider a macrolide or a
tetracycline for patients who are allergic to penicillin.
• Moderate- and high-severity community-acquired
pneumonia - 7- to 10-day course of dual antibiotic
therapy with amoxicillin and a macrolide
• High-severity community-acquired pneumonia - dual
antibiotic therapy with a beta-lactamase stable
beta-lactam and a macrolide.
 Hospital-acquired pneumonia

Antibiotic therapy:
• 5- to 10-day course of antibiotic therapy, beta-
lactamase stable beta-lactams include:
co-amoxiclav, cefotaxime, ceftaroline fosamil,
ceftriaxone, cefuroxime and piperacillin with
tazobactam.
 REFERENCES

• http://www.europeanlung.org/assets/files/en/publications/pneu
monia-en.pdf
• http://www.nhs.uk/conditions/Respiratory-tract-
infection/Pages/Introduction.aspx
• http://www2.keelpno.gr/blog/?p=3320&lang=en
• http://www.ncbi.nlm.nih.gov/books/NBK8142/
• https://www.nice.org.uk/guidance/cg191/chapter/1-
recommendations