 Inflammation of the lung

parenchyma with the production

of alveolar exudates resulting to
consolidation of the air sacs
 Streptococcus pneumoniae
 Haemophilus influenzae
 Staphylococcus aureus
 Klebsiella pneumoniae
(Friedlander’s bacilli)
 Mycoplasma pneumonia
 Droplettransmission – mouth
& nose of an infected person
via nasopharynx, through
intimate contact w/ carriers

 Indirect contact contaminated

objects
 Tuberculosis is considered as the
world’s deadliest disease and remains
as a major public health problem in
the Philippines

 Is a chronic bacterial infection

characterized by granuloma
formation, necrosis and calcification
of involved tissues
 Koch’s Disease
 Consumption
 Phthisis
 Class 0 – no exposure, no infection
 Class 1 – (+) exposure, (-) infection
 Class 2 – (+) infection, (-) disease
 Class 3 – (+) symptoms, PTB active
 Class 4 – disease, not clinically active
 Class 5 – diagnosis pending; suspect
 Mycobacterium tuberculosis-
most common
 Mycobacterium africanum
 Mycobacterium bovis
 2 – 10 weeks

 Airborne transmission through coughing and

sneezing
 Direct invasion through mucous membranes
or breaks in the skin may occur, but
extremely RARE
 Bovinetuberculosis results from
exposure to tuberculosis cattle:
Ingestion of unpasteurized milk
or dairy products
 Fever – low grade. Late afternoon or
early evening
 Chronic cough – more than 2 weeks
 Anorexia
 Weight loss
 Nocturnal sweating
 Fatigue
 Chest and back pains
 Dyspnea and hemoptysis
 Mantoux Test/ PPD/ Tuberculin Test
◦ Intradermal injection of PPD
◦ Results are read after 48-72 hours of
injection
◦ (+) for not immunocompromised is
10 mm or more induration
◦ (+) for immunocompromised is 5
mm or more induration
 Direct Sputum Smear
Microscopy- primary diagnostic
tool; requested after control of
hemoptysis.
 Chest X-Ray
 Sputum Culture- Confirmatory
test
 Rifampicin (RIF)
 Isoniazid (INH)
 Pyrazinamidel (PZA)
 Ethambutol (EMB)
 Streptomycin

 multipledrugs reduce
development of resistant to
strains of the bacteria
 Intensive Maintenance
Category Cases
phase phase
- New smear (+) PTB
- New smear (-) PTB
with extensive
parenchymal
lesions on CXR RIPE
I RI (4months)
- Extrapulmonary TB (2months)
- Severe concomitant
HIV disease

- Treatment failure
- TB relapses RIPES
(2months)/ RIE
II - Return after default
RIPE (5months)
- Others (1month)
 - New smear (-)
PTB with
minimal RI
RIPE
III parenchymal (2months)
(4month
s)
damage on
CXR

- Chronic (still
smear positive Referral to
specialized
IV
after facility or
supervised DOTS Plus
retreatment Center
 Provide patient with adequate rest
periods
 Promote adequate nutrition
 Advise to cover nose and mouth
when sneezing and coughing
 Provide frequent oral hygiene and
handwashing
 Monitor drug compliance
 AvoidMOT
 Immunization: BCG
 Modalities of Treatment
 Elements of DOTS
 An acute febrile infection of
the tonsil, throat, nose, larynx
or a wound marked by a patch
or patches of grayish
membrane from which
diphtheria bacillus is readily
cultured.
 Corynebacterium diptheriae
(Klebs-loeffler bacillus)
 Droplet transmission
 Indirect Contact with contaminated
objects

 2 – 5 days, occasionally longer

 Usually
2 weeks and
seldom more than 4
weeks
Respiratory type of diptheria
1) Nasal – localized in the nares
◦ Excoriation of the upper lip and
alae nasi with serosanguinous
secretions which later becomes
bloody and foul smelling
2) Pharyngeal or faucial – pharynx (tonsilar,
uvular, palatar)
◦ Low grade fever
◦ Malaise
◦ Headache and sore throat
◦ Pseudomembrane very visible within 24 hrs.
 Pseudomembrane – false membrane, a grayish,
white color and leathery in consistency and
irregular in shape, usually inflamed which
decreases the opening of the nasopharynx.
◦ Bull neck appearance
3) Laryngotracheal
◦More common in infants
◦Laryngeal stridor
◦Hoarseness of voice
◦Signs of respiratory distress
 Nose and throat culture
 Schick’s test – determines
susceptibility and immunity to
diphtheria
 Moloney test – determines
hypersensitivity to diphtheria
toxoid
 Antibiotics
 Penicillin-
Drug of choice
 Erythromycin- alternative
 Diphtheria antitoxin
 Tracheostomy – laryngeal
 Isolate the patient
 Provide liquid and soft diet
 Maintain good oral hygiene and
proper airway
 Complete bed rest
 Ice collar
 Monitor for respiratory distress
Immunization – DPT
Proper disposal of
nasopharyngeal
secretions
 An acute contagious disease
characterized by intermittent
episodes of paroxysmal cough
followed by an explosive
expiration ending in an
inspiratory “whoop” and ending in
vomiting (5-10x in succession
repeated 20-40x in a day)
 ”Whooping cough”
 Entrance of air in

the epiglottis

 Bordetella
pertussis: Gram (-)
coccobacilli
 Droplet transmission
 Indirect Contact with contaminated
objects

 7 – 14 days
1) CATARRHAL STAGE– most
communicable stage
◦ Frequent sneezing
◦ Watery secretions
◦ Coryza
◦ Dry and hacking cough
increasing in intensity at night
2) PAROXYSMAL STAGE– most fatal
stage
◦ intermittent episodes of paroxysmal
cough followed by an explosive
expiration ending in an inspiratory
“whoop” and ending in vomiting (5-
10x in succession repeated 20-40x
in a day)
◦ Cough worsen
2) PAROXYSMAL STAGE
◦ Force of coughing may cause
involuntary micturation / defection,
intracerebral hemorrhage and
abdominal hernia
◦ Popping of eyeball
◦ Protrusion of tongue
◦ Vomiting signals end of attack
3) CONVALESCENT STAGE
◦frequency of attacks is
reduced

Incidence:
Infants is highly susceptible
Single attack usually
produces lifetime immunity
 Cough plate or agar plate

 Bordet – Gengou test

 Antibiotics– ampicillin,
erythromycin (DOC) – given for
5 to 7 days

 Antitussives:
sinecod – for
extremely dry cough
 Bed rest
 NPO in attacks (paroxysmal and catarrhal
stage – aspiration
 Positioning – prone for infants
 - upright for older persons
 Isolate the pt.
 Provide a quiet, non-stimulating
environment
 Keep patient warm and out of wind
 Small frequent feedings
 Adequate ventilation
Avoid MOT

Immunization: DPT
MUMPS
In 1934, Claud D. Johnson and Ernest W.
Goodpasture discovered that mumps is
caused by a virus they found in saliva samples.

On Mar. 30, 1967 the FDA licensed

Mumpsvax, a mumps vaccine developed by
Maurice Hilleman, MD, that was created
from the mumps virus that infected his five-
year-old daughter, Jeryl Lynn.
 ViralParotitis
 Epidemic Parotitis
 Infectious Parotitis
 Paramyxovirus
◦ (Saliva- source of infection)

Direct Contact with repiratory

secretions coming from infected
patients
 Indirect Contact with objects
contaminated with secretions
 14 – 25 days

 7 days before and 9days after the

onset of parotid swelling
 Low-grade fever
 Headache
 Earache
 Malaise
 Myalgia
 Anorexia
 Dysphagia
 Pain and swelling in front and below
the ear
 Viral Isolation
 Blood Exam
 Viral Serology
 Serum Amylase Determination
Test
 Orchitis- most dreaded
complication in males;
Oophoritis-in females
 Mastitis
 Pancreatitis
 Myocarditis
 Analgesic
 Antipyretic
 Moistheat and cold
application
 MMR
 Avoid MOT