Bacterial Disease (Respiratory, Nervous, GenitoUrinary)

• Diseases of the Upper Respiratory Tract

  • Common Cold
  • Tonsillopharyngitis
  • Croup
  • Influenza
  • Diphtheria

  
• Diseases of the Lower Respiratory Tract

  • Chronic Bronchitis
  • Pneumonia
  • Pertussis
  • Tuberculosis

  
• Tonsillopharyngitis


  Inflammation of the pharynx and tonsils
• Tonsillopharyngitis


  • Seasonal occurrence
  • Children: 5-10 years
  • Adults: 18-20 years
• Causative agent of Tonsillopharyngitis

  Streptococcus pyogenes
• Mode of transmission for Tonsillopharyngitis


  Direct contact with large droplets or respiratory secretions

  
• Clinical manifestations of Tonsillopharyngitis

  • Sudden onset of fever
  • Sore throat
  • Headache
  • Nausea
  • Malaise
  • Pain
  • Tonsillopharyngeal erythema
• Laboratory diagnosis of Tonsillopharyngitis


  Culture of specimen obtained by swab of the posterior pharyngeal-tonsillar regions
• Treatment and prevention of Tonsillopharyngitis

  • Penicillin
  • Erythromycin
  • Clindamycin

  
• Diphtheria


  Serious infection caused by a bacteria that make toxin (poison)
• Diphtheria


  • Can lead to difficulty breathing, heart failure, paralysis, and even death
• Causative agent of Diphtheria

  Corynebacterium diphtheria
• Incubation period of Diphtheria

  2 - 5 days
• Period of communicability for Diphtheria

  Up to 3 weeks following onset of manifestations
• Clinical findings of Diphtheria

  • Inflammation of respiratory tract
  • Sore throat
  • Fever
  • Thick, gray, adherent pseudomembrane over the tonsils & throat
  • Extension of the membrane into the larynx and trachea causing airway obstruction

  
• Clinical findings of Diphtheria (continued)

  • Obstruction may cause suffocation relieved by intubation or tracheostomy
  • Do not attempt to remove the membrane because it is tightly adherent to the underlying tissue à massive bleeding
  • Arrhythmia
  • Nerve weakness or paralysis
  • "Bull neck" appearance = massive enlargement of cervical lymph nodes
• Laboratory diagnosis of Diphtheria

  1. Swab from the nose, throat or other suspected lesions

  2. Gram stain

  3. Culture = definitive diagnosis
• Treatment for Diphtheria


  • Penicillin G
  • Erythromycin
  • Diphtheria antitoxin = to neutralize the exotoxin
• Prevention of Diphtheria


  • Vaccine
  • Diphtheria-Pertussis-Tetanus (DPT)
  • Given: 2 - 4 - 6 months
  • Isolate infected patients

  
• Chronic Bronchitis


  • A chronic inflammatory condition involving the bronchi
  • A recurrent bacterial infection
• Causative agent of Chronic Bronchitis

  Streptococcus pneumonia = most common
• Mode of transmission for Chronic Bronchitis

  • Droplets
  • Direct contact
• Pneumonia


  Infection involving the lung parenchyma

  
• Types of Pneumonia


  • Typical pneumonia: Lobar pneumonia, Interstitial pneumonia, Bronchopneumonia
  • Atypical pneumonia: "walking pneumonia"
• Causative agents of Pneumonia

  • Streptococcus pneumoniae
  • Staphyloccocus aureus
  • Klebsiella pneumoniae
  • Escherichia coli

  
• Mode of transmission for Pneumonia

  • Droplet
  • Nasopharyngeal secretions
• Clinical findings of Acute Bacterial Pneumonia

  • Abrupt onset of fever, chills, productive purulent sputum, pleuritic chest pain
  • Sputum is red or brown ("rusty") in color
  • Organism may reach other sites

  
• Laboratory diagnosis of Pneumonia

  1. Gram stain & microscopic examination of sputum

  2. Culture of blood or sputum = gold standard

  3. Capsular swelling test (Quellung reaction)

  4. Optochin sensitivity

  
• Treatment for Pneumonia


  • Penicillin G
  • Ceftizoxime
  • Vancomycin

  
• Prevention of Pneumonia


  • Vaccine especially to high-risk individuals elderly, no spleen
  • PPSV 23 (Pneumo 23 / Pneumovax) given every 5 years
  • PCV 13 (Pneumo 13) lifetime
  • Avoidance of risk factors: URTI, alcohol & drug intoxication, malnutrition
  • Establishment of early diagnosis
  • Early administration of antimicrobial agents

  
• Pertussis (Whooping Cough)


  A highly contagious disease occurring primarily in infants and young children
• Causative agent of Pertussis

  Bordetella pertussis
• Mode of transmission for Pertussis

  Airborne droplets during severe coughing episodes
• Clinical findings of Pertussis

  • Catarrhal stage: most contagious stage lasting 1-2 weeks, manifests a mild URTI with non-specific symptoms, greatest number of microorganism produced
  • Paroxysmal stage: series of 5-20 forceful, hacking, coughs accompanied by production of copious amounts of mucus ending in high-pitched indrawn breath making the "whooping cough", may turn cyanotic, tongue protruding, eyes bulging and neck veins engorge, lasts 2-10 weeks
  • Convalescent stage: reduction in symptoms leading to recovery, non-contagious

  
• Laboratory diagnosis of Pertussis

  Culture of nasopharyngeal swabs taken during the paroxysmal stage

  
• Complications of Pertussis


  • Can unmask underlying PTB
  • Convulsions due to anoxia during coughing spells
  • Blindness resulting from hemorrhages into conjunctiva during paroxysms
  • Pneumonia, deafness and hernia
• Treatment for Pertussis


  • Macrolides = drug of choice to patient and exposed individuals
  • Supportive: O2, suctioning of mucus during paroxysmal stage, increase oral fluid intake
• Prevention of Pertussis


  Vaccine: Diphtheria-Pertussis-Tetanus (DPT)

  
• Tuberculosis


  A contagious infectious disease that mainly affects the lungs but may spread to other parts of the body
• Causative agent of Tuberculosis

  Mycobacterium tuberculosis = an acid-fast, obligately aerobic bacillus with a cell wall containing mycolic acid contributing to the acid-fastness of organism