ASTHMA

DEFINITION

• It is chronic inflammatory disease, characterized by

obstruction, airway inflammation and an increased
responsiveness of trachea and bronchi due to
bronchospasm, airway inflammation and an increased
responsiveness of trachea to various stimuli.
• It manifests by outs of dyspnoea resulting from
temporary narrowing of bronchi due to bronchospasm,
mucosal oedema and thick secretions.
Incidence and etiology

• Most cases have origin in first 2 year of life. Peal

incidence is seen in 5-10 years age.
• Boys suffer twice as much as girls.
Etiology
PATHOPHYSIOLOGY
EXPOSURE TO ALLERGEN OR TRIGGERS

INFLAMMTORY RESPONSE

BRONCHOCONSTRICTION

AIRWAY EDEMA AND INCREASED MUCOUS

PRODUCTON

AIRWAY ONSTRUCTION
HYPOXIA, WHEEZING, DYSPNEA

HYPERVENTILATION

HYPOVENTILATION

APNEA AND DEATH

CLINICAL MANIFESTATION
DIAGNOSTIC EVALUATION
LUNGS ABSCESS
DEFINITION

• IT IS A SEVERE, LOCALIZED SUPPORTIVE

INFECTION IN THE LUNG, ASSOCIATED WITH
NECROTIC CAVITY FORMATION.
• THE CAVITY IS SURROUNDED BY FIBROUS
REACTION, FORMING THE ABSCESS WALL.
MULTIPLE SMALL ABSCESS FORMATION MAY OCCUR
AND IS SOMETIMES REFERRED TO AS ‘NECROTIZING
PNEUMONIA’
ETIOLOGY AND RISK FACTORS

• The most frequent cause of lung

abscess is aspiration of anaerobic
organism from the mouth, in those
predisposed to pulmonary aspiration
and having impaired immune defence
and cough reflex.
• Inhalation of foreign body
• Bacterial colonization in the lungs
• Extension of hepatic abscess
• Bronchial asthma
• Pneumonia
• Diabetes mellitus
• Choking
• Severe periodontal disease
• Congenital heart disease
• Stroke
• Chronic lungs disease
Types

1.Primary abscess: occurs in

previously normal lungs and may
follow aspiration
2.Secondary abscess: occurs in
patients with an underlying lung
abnormality
Clinical features

• Spiking temperature
• Cough and phlegm production
• Pleuritic chest pain
• Breathlessness
• Tachypnea
• Tachycardia
• Finger clubbing in chronic cases
• Dehydration
• High temperature
• Crepitation's
Diagnostic evaluation

• Blood sputum cultures

• ESR and C-reaction protein, which are usually elevated
• Chest x-ray shows walled cavity, usually with a fluid level. There
may also be prescence of empyema or effusion .
• Microbiological and cytological study of pleural fluid or empyema.
• CT scan of thorax may detect multiple small abscesses.
• Trans-thorasic biopsy/aspiration or trans-tracheal biopsy.
MANAGEMENT

• Intravenous antibiotics are given usually for about 2-3 weeks,

followed by oral antibiotics for further 4-8 wks.
• Recommended first line therapy includes beta lactamase inhibitor
or cephalosporin's plus clindamycin.
• Is the condition fails to resolve, broncoscopy/trans-thorasic
drainage/cardiothorasic surgical intervention may be conssdered.
• Surgery may be necessary when reinfection of a large cavitary
lesion occurs or there iss evidancce of underlying neoplasm.
• The usual procedure done is lobectomy or pneumectomy. Surgery
is associated with a number of complications, such as empyema
and Broncho alveolar air leak-especially in children.
Complication

• Bronchial abscess
• Empyema
• Pneumatocele
• Bronchopleural fistula
• Bronchiectasis
Pneumonia
Definition

• It is defined as acute inflammation and

consolidation of lung parenchyma.
Incidence

• It is children is a major concern in developing

countries, because 1/3rd of all hospital out
patients comprise of acute respiratory infections
of which nearly 30% have pneumonia.
• It is the leading cause of death in children under-
five years of age.
Classification

a) Classification on anatomic basis

A. lobar or lobular pneumonia: one or more lobes of lungs are
involved.
B. Interstitial pneumonia: Interstitial tissues of lungs are
affected.
C. Bronchopneumonia: patchy consolidation of lungs is known as
bronchopneumonia
B. Classifications on etiological basis
Bacterial pneumonia: it may be caused by pneumococcus,
streptococcus, staphylococcus, haemophilus influenza and H. Pertusis.
Viral pneumonia: it is caused by viruses like influenza, measles,
adenovirus and respiratory syncytia virus.
Fungal pneumonia: it may be caused by histoplasmosis and
coccidiomycosis
Protozoal pneumonia: it is caused by pneumocystis carnii, toxoplasma
gondii and entamoeba histolytica.
• C. miscellaneous types:
Aspiration pneumonia
Loffler’s pneumonia : it is Dz which eosinopills accumulates in lungs,
in response to parasitic infection.
Hypersensitivity
Hypostatic pneumonia: it results from collection of fluid in dorsal
region of lungs and occurs especially in those confined to bed for
long time
Clinical features
• Poor feeding with irritability
• Tachypnea
• Retractions
• Grunting
• Hypoxemia
• Cough
• Congestion
• Fever
• Headache
• Chest pain
• Otitis media
(WHO) respiratory rate thresholds for identifying children with
pneumonia are as follows:
• Children younger than 2 months: Greater than or equal to 60
breaths/min
• Children aged 2-11 months: Greater than or equal to 50
breaths/min
• Children aged 12-59 months: Greater than or equal to 40
breaths/min
Diagnosis

• Pulse oximeter
• Auscultation
• Culture
• Serology
• CBC
• Chest radiography
• USG
Management

• Respiratory support
• Intubation
• External ventilation (CPAP)
• Antibiotics (amoxicillin, ampicillin, penicillin)
• Vaccination
(Aside from avoiding infectious contacts (difficult for many families who use day
care facilities), vaccination is the primary mode of prevention. Influenza vaccine is
recommended for children aged 6 months and older. The pneumococcal conjugate
vaccine (PCV13) is recommended for all children younger than 59 months old. The
23-valent polysaccharide vaccine (PPV23) is recommended for children 24 months or
older who are at high risk of pneumococcal disease.)
Tuerculosis
Definition

• Tuberculosis (TB) is a disease caused by bacteria

called Mycobacterium tuberculosis. The bacteria
usually attack the lungs, but they can also
damage other parts of the body. TB spreads
through the air when a person with TB of the
lungs or throat coughs, sneezes, or talks.
H
R
Z
E
THANK YOU