Respiratory System Infection

dr erly SpMK

1. Infections of the upper part of the
respiratory system
2. Infection of the lower respiratory
system


Focus point:
1. Anatomy and Physiology
- out line the function of the URT
- describe the mucociliary escalator
2. Normal Flora
The eyes and the nose are portals of
entry to the respiratory system.
More than entrances
Respiratory infections often first establish
themself there and then spread to other part
of the system
1. Bacterial infection of the Upper Respiratory
System
2. Viral Infection of the Upper Respiratory System
3. Bacterial infection of the Lower Respiratory
System
4. Viral Infection of the Lower Respiratory System
5. Fungal Infection of the Lower Respiratory
Syestem
SPECIMENS
1. Upper Respiratory Specimens
- collected : swab
- area : tonsillar-posterior pharynnx-exudate
and ulcerative area should be sampled
- contamination of specimen with saliva
avoided
- pseudomembrane(diphtheriae)dislodged
Submitted for culture or Gram stain
Group A Streptococcus and C diphtheriae
resistant to drying.
B.pertussis and N.gonorrhoeae bed side in
oculation or transport medium.
Chlamydia and Mycoplasma transport
medium.
Sinusitis
. Direct aspiration of the sinus
. Anaerobic transport
2. Lower Respiratory specimens
variety of techniques to collect specimens:
- expectoration
- induction with saline
- bronchoscopy
- bronchial lavage
Diagnostic Microbiology
Pharyngitis
- Mono spot test to rule out EBV infection
- Culture from swabs
- Antibody detection
- Antigen detection
- PCR
- Serology

Tonsilitis
- Mono spot test
- Rapid Antigen Detection Test(RADT)
- Culture
Pertussis
- Direct Fluoresence Testing for
nasopharyngeal specimens (DFA)
- Culture nasopharyngeal secretion
- PCR for nasopharyngeal secretion
Pneumonia
- Gram stain of sputum
- Culture of sputum
- Blood culturesBACTEC
- Serology for Mycoplasma and Chlamydia
pneumoniae
Influenzae (types A,B and C)
- Rapid antigen testing Direct Immuno-
fluorescense antibody of nasopharyngeal
swab or nasal aspirate
- Gram stain and culture sputum to rule out
bacterial pneumonia
- Serology
- PCR
TBC
- Skin test(Tuberculin)
- Acid fast stain (BTA)
- Culture of sputum ( sputum S-P-S )
- PCR
Fungi
1. Aspergillus
- Direct microscopy: BTA , Gram stain
- Fungal culture
- Serum antigen testing for Aspergillus
- Blood culture to rule out bacteremia

2. Histoplasma
- Serologic detects spesific antibody
- Culture
- Histopathological of infected tissue
3. Cryptococcus
- detection of antigen--. Latex agglutination
The clinician may consult with the microbiologist
Collecting specimens at the correct technique
without delay to the laboratoy critical
importance
The poor quality of the specimenthe result
of the test reported back to the clinician will be
unreliable.
Medical Microbiology



TERIMA KASIH