Lower Respiratory Tract

Infections
Dr Ishrat Parveen
Introduction

 Lower respiratory tract infections comprise an

array of diseases ranging from bronchitis to
Pneumonia.
 It comprises of
Bronchitis
Pneumonia
Tuberculosis
Bronchitis

 Bronchitis is inflammation of bronchial tubes, te

airway that carry air into Lungs.
 Two types of bronchitis
Acute Bronchitis
Chronic Bronchitis
Definition

 Acute bronchitis is acute inflammation of the

bronch.
 Chronic bronchitis is defined as a productive
cough for atleast 3 months for 2 consecutive years.
Causes

 Viruses
 Bacterias
 Chemical irritants for example tobacco
smoke, gastric acid (GERD).
Clinical features

 Productive cough
 Fever with chills
 Chest pain or discomfort
 Shortness of breath
 wheezing
Management

 Cough suppressants
 Pain relief
ibuprofen, paracetamol
 Nasal decongestants like naphazoline,
phenylephrine.
 Antibiotics
 Antiviral
Pneumonia

 Pneumonia is acute inflammation of lung parenchyma

cause by certain microorganisms.
 Causes
Bacterial
Viral
Fungal
Nosocomial
Risk factors

 Smoking
 Alchohal abuse
 Other respiratory conditions such as COPD,
emphysema, Asthma.
 Extremes of ages i.e too young or too old.
 Immunocompromised or malnourished.
Sign and symptoms

 Cough, productive or non-productive

 Fever
 Shortness of breath
 Tachypnea
 Chest pain that worsen with taking a deep breath.
Investigations

 Cbc
 Chest x-ray
 ABG’s
 Sputum studies
Management

 O2 inhalation if sao2 is <92 %

 Pain relief
 Cough suppressants
 Antibiotics
 Steroids if severe.
Complications

 Abscesses
 Respiratory failure
 Pleural effusion
 Pneumothorax
Tuberculosis
 Chronic inflammation of lungs
caused by mycobacterium
tuberculosis.
Risk factors

 Alchohal
 Crowded living conditions
 Poverty
 Low body weight
 Immunocompromised states
Sign and symptoms

 Fever i.e low grade, evening rise, night sweats.

 Cough, produvtive or non-productive
 Hemptysis
 Weight loss
 Fatigue
 Can also present as
Pneumothorax
Pleural effusion
Pneumonia
Diagnosis

 Cbc
 Chest xray
 Sputum for gene expert, AFB smear, sputum CS
 CT chest
 Tuberculin skin test
Management
1st line drugs ( ATT )

 Isoniazid 300 mg/day

 Rifampicin 600 mg/day
 Pyrazinamide 1500 mg/day
 Ethambutol 1200mg /day
 Course of 6 months, 2months all 4 drugs next 4 months
isoniazid and rifampicin.
2nd line drugs

 Streptomycin
 Amikacin
 Capreomycin
 Ciprofloxacin
 Cycloserine
Adverse effects of ATT

 Rifampicin causes cholestatic jaundice

 Pyrazinamide hepatotoxicity and gout
 Ethambutol causes optic neuritis leading to
blindness.
 Isoniazid causes peripheral neuropathy
THANK YOU…