Micp

• Hemoptysis


  Coughing up of blood from the respiratory tract
• Hypoxia


  Inadequate oxygen in the body
• Upper respiratory tract infections

  • Nasopharyngitis
  • Pharyngoconjunctival fever (fever, sore throat, coryza, conjunctivitis)
• Lower respiratory tract infections

  • Bronchitis
  • Atypical pneumonia
• Streptococcal pharyngitis


  Acute bacterial infection of the throat
• Symptoms of streptococcal pharyngitis include soreness, chills, fever, headache, beefy red throat, white patches of pus on the pharyngeal epithelium, enlarged tonsils, and enlarged and tender cervical lymph nodes
• Streptococcal pharyngitis has the potential to spread to the middle ear, sinuses, or hearing organs
• Scarlet fever


  Associated with strep throat or pharyngitis, manifested by a pinkish red rash on skin and strawberry appearance of tongue. As disease progresses, skin peels off like sunburned.
• Treatment for scarlet fever is Penicillin G
• Streptococcus pyogenes


  Beta-hemolytic, catalase-negative, Gram positive coccus in chains. Also known as group A streptococcus, GAS, or Strep A.
• Reservoirs and mode of transmission for streptococcal pharyngitis

  • Infected humans
  • Human-to-human transmission through direct contact, aerosol droplets, secretions from patients and nasal carriers, and contaminated dust, lint, or handkerchiefs
• Laboratory diagnosis for streptococcal pharyngitis


  • Routine throat culture
  • Rapid strep tests (antigen detection on throat swabs)
• If rapid strep test is negative, a throat culture and bacitracin susceptibility is performed
• Complications of streptococcal pharyngitis

  • Rheumatic fever
  • Glomerulonephritis
  • Toxic shock syndrome
  • Necrotizing fasciitis
• Otitis externa (swimmer's ear)


  • Inflammation of auditory canal, caused by Pseudomonas and Staphylococcus aureus. Prevention is to minimize swimming.
• Otitis media


  • Inflammation of middle ear, with cough and coryza prior to infection. Causative agents are Streptococcus pneumoniae, Haemophilus influenzae, adenovirus, rhinovirus, and respiratory syncytial virus. Most common symptoms are otalgia, otorrhea, and tinnitus.
• Diphtheria


  Acute, contagious, potentially serious upper respiratory tract disease affecting tonsils, pharynx, larynx, and nose
• Corynebacterium diphtheriae


  Gram positive, non-spore forming rods arranged in V or L shaped formations, producing toxin
• Humans are the only natural hosts for Corynebacterium diphtheriae
• Diphtheria is transmitted through airborne droplets and contact with susceptible individuals
• Clinical findings of diphtheria

  • Sore throat, fever
  • Thick, gray pseudomembrane over tonsils and throat
  • Extension of pseudomembrane to larynx and trachea causing airway obstruction and suffocation
  • Damage to heart (arrhythmia)
  • Nerve weakness or paralysis
  • Cervical lymphadenopathy giving "bull-neck" appearance
• Definitive diagnosis of diphtheria is by culture using Loeffler's medium
• Treatment for diphtheria is Penicillin G or erythromycin, along with antitoxin. Prevention is through immunization (DPT - diphtheria, pertussis, tetanus)
• Bacterial diseases of the lower respiratory tract
• Legionnaires' disease


  Acute bacterial pneumonia
• Symptoms of Legionnaires' disease

  • Anorexia, malaise, myalgia, headache, high fever, chills, dry cough, followed by productive cough, shortness of breath, diarrhea, and pleural and abdominal pain
• Pontiac fever, a less severe form of legionellosis, is not associated with pneumonia or death
• Groups more likely to be affected by Legionnaires' disease

  • Elderly persons
  • People with preexisting respiratory disease, diabetes mellitus, renal disease, or malignancy
  • Immunocompromised
  • Smokers
  • Heavy drinkers
• Legionella pneumophila


  Etiologic agent of Legionnaires' disease, a poorly staining, Gram-negative bacillus
• Reservoirs for Legionella


  • Environmental water sources (ponds, lakes, creeks)
  • Hot-water and air-conditioning systems, cooling towers, evaporative condensers
  • Whirlpool spas, hot tubs, shower heads, humidifiers, tap water, water distillation systems
  • Decorative fountains
  • Dust
• Transmission of Legionnaires' disease

  Inhalation of aerosolized water containing the bacteria. Most common sources are potable water, cooling towers, hot tubs, and decorative fountains. Can also occur through aspiration of contaminated water.
• Legionnaires' disease is not transmitted from person to person
• Laboratory diagnosis of Legionnaires' disease

  • Sputum and blood cultures
  • Legionella spp. require cysteine and other nutrients to grow, with buffered charcoal yeast extract agar as the recommended culture medium
  • Immunodiagnostic procedures such as antigen detection in urine
• Atypical pneumonia


  Gradual onset, with symptoms of headache, malaise, dry cough, sore throat, and less often, chest discomfort. Sputum increases as disease progresses. Most common in people 5–35 years of age.
• Mycoplasma pneumoniae


  Etiologic agent of atypical pneumonia, a tiny, Gram-negative bacterium lacking cell walls
• Reservoirs and mode of transmission for Mycoplasma pneumoniae

  • Infected humans
  • Transmission via droplet inhalation, direct contact with an infected person, articles contaminated with nasal secretions, and sputum from an ill, coughing patient
• Laboratory diagnosis of Mycoplasma pneumoniae infection

  • Demonstration of rise in antibody titer between acute and convalescent sera
  • Tiny "fried egg" colonies on artificial media
• Droplet precautions should be used for patients with Mycoplasma pneumoniae infection
• Tuberculosis (TB)


  Also known as Koch's Disease, caused by Mycobacterium tuberculosis, an acid-fast, obligately aerobic bacillus with a peculiar cell wall structure that provides an exceptionally strong, impermeable barrier
• Tuberculosis is transmitted person-to-person through respiratory aerosols generated by coughing of infected individuals. Rarely, primates, cattle and other infected mammals can serve as reservoirs.</b>