Faisal with Fever and Respiratory Distress

Faisal with Fever and Respiratory Distress

1. Anatomy of lung

2. Microbiology

   • URTI's
     • The Common Cold
       • Rhinorrhea and nasal obstruction
         • Rhinovirus
     • Pharyngitis
       • Sore throat, fever and acute pharyngeal inflammation
         • Adenovirus
     • Croup
       • acute viral infection of the URT presenting as stridor and a brassy cough
         • Parainfluenza, RSV
   • LRTI's causes
     • Pneumonia
       • inflammation of the lungs with consolidation due to an infectious agent.
       • Signs and Symptoms
         • Fever, rigors, Cough dry or productive, Chest pain, Dyspnea, Respiratory distress, tachypnea, hypoxemia, Bluish color to lips and fingernails, Crackles +/- evidence of consolidation, Abnormal X-ray, Heavy perspiring Confused mental state or delirium.
       • Epidemiology
         • Number 1 killer among infectious diseases
       • Types
         • Hospital-acquired
         • Ventilator-associated
         • of Immunocompromised
         • Community-acquired
         • Aspiration pneumonia
       • Risk factors
       • Pathogenesis
         • Congestion >> Red hepatization >> Gray hepatizaiton >> Resolution
         • Lobar pneumonia
           • Pleural involvements are common.
         • Bronchopneumonia
           • Pleural involvements are less common
     • Viruses
     • Bacteria
       • S. pneumoniae M. pneumonia K. pneumoniae C. pneumonia L. pneumophilla
     • Fungi
       • PCP - PjP

3. Physical examination

   • Palpitation (↑vibrations), Percussion (Dullness), Auscultations (bronchial sounds)

4. Investigations

   • Blood tests. Chest X-ray, Pulse oximetry, Sputum test, CT scan or Pleural fluid culture (for adults).

5. Management

   • Quinolones B-lactams Macrolides
   • Vaccination
     • Pneumococcal conjugate vaccine (PCV13 or Prevnar 13)
       • All babies and children younger than 2 years old. All adults 65 years or older. People 2 through 64 years old who are at increased risk for disease due to certain medical conditions.
     • Pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax23®)
       • All adults 65 years or older. People 2 through 64 years old who are at increased risk for disease due to certain medical conditions. Adults 19 through 64 years old who smoke cigarettes

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