C05 P15 ARI CLI FEATURES Community Medicine.ppt

Community Medicine

1. Clinical Features of
Acute Respiratory
Infections

2. ACUTE RESPIRATORY TRACT
INFECTIONS
UPPER LOWER
 Common cold
 Pharyngitis
 Epiglottitis
 Laryngotracheitis
 Bronchitis

Bronchiolitis
 Pneumonia

3. Common Cold
Pathogenesis:
 Infected virus transported to the adenoid
area where they bind to ICAM-1.
 Replicate within Resp. epithelial cells &
activate inflammatory cascade.
 Infected cells signal production of
cytokines & chemokines that activate
inflammation and immunocompetent cells.
 Clinical symptoms occur within 10-12
hours after infection.

4. Common Cold
Symptoms:
Sore throat
Profuse and watery rhinorhoea.
Watering eyes.
Nasal congestion, sneezing & cough.
Complications:
Middle ear infections
Sinusitis

5. Pharyngitis
Pathogenesis:
In infectious pharyngitis, bacteria or viruses
may directly invade the pharyngial mucosa causing
a local inflammatory response.
Some viruses cause irritation of pharyngial
mucosa.
Symptoms:
Sore throat
Fever, headache, swollen lymph nodes in the neck.
Running nose, post nasal drip
Dysphagia & Dyspnoea

6. Epiglottitis
 Acute inflammation of Epiglottis, Vallecula,
Aryepiglottic fold & Arytenoids.
Symptoms:
Sore throat
Odynophagia / Dysphagia
Fever & Mild cough
Stridor & Muffled voice
Complications:
Otitis media, adenitis
Cervical necrotising fasciitis.

7. Laryngotracheitis
(croup)
Pathophysiology:
As the infection extends to the proximal trachea,
diffuse inflammation with exudate and edema of the
sub - glottic area causes narrowing of the airway.
Cricoid ring of the trachea is narrow in children.
A small amount of exudate in this region can cause
significant airway obstruction.
Airflow in this narrow sub-glottic area causes stridor.

8. Symptoms:
A brassy sealing, barking cough
Low grade fever
Stridor (typically b/w 6 pm & 6 am)
Complications:
Respiratory failure
Laryngotracheitis
(croup)

9. Bronchitis
Pathophysiology:
 Viruses or bacteria cause inflammation of the
resp. passages which results in irritation of the
resp. passages causing cough.
 There is an increased production of the mucus
(phlegm).
 The swelling of the mucus membrane of the
bronchi along with the production makes the
airways narrow leading to a wheeze.

10. Symptoms:
Persistent cough-sputum (thick & yellow-green)
Burning pain, wheezing &crackling in the chest.
Painful & difficult breathing
Malaise & low grade fever.
Insomnia
Complications:
Rt. sided heart failure
(Cor pulmonale)
Emphysema & Pneumonia
Pulmonary HTN
Bronchitis

11. Bronchiolitis
PATHOGENISIS
Invaded viruses causes necrosis of resp
epithelium, proliferation of goblet cells
and results in EXCESSIVE MUCOUS PRODUCTION
Lymphocytic infiltration --- SUBMUCOSAL EDEMA
Obstruction of bronchiole by
inflam., edema & debris ---HYPERINFLATION &
ATELECTASIS
SYMPTOMS
CORYZA, CONGESTION, low grade FEVER,
COUGH, DYSPNOEA, WHEEZING

12. PNEUMONIA
CLASSIFICATION
ANATOMICAL
Lobar,
Broncho,
Interstitial
MICROBIOLOGICAL
Bacterial, Viral,
Fungal, Parasitic
CLINICAL
COMMUNITY ACQUIRED
HOSPITAL ACQUIRED

16. GROSS LUNG SPECIMENS OF
PNEUMONIA
ATYPICAL LOBAR
BRONCHO

17. PNEUMONIA ACQUIRED DURING OR
AFTER HOSPITALISATION FOR
ANOTHER ILLNESS OR PROCEDURE

18. It is infectious pneumonia in a person
who has not recently been hospitalized
CLINICAL FEATURES
PRODUCTIVE COUGH
HIGH FEVER
PLEURITIC CHESTPAIN
MAJOR
MINOR
LOSS OF APPETITE
FATIGUE
VOMITING
JOINT PAINS
S.O.B
Community Acquired Pneumonia

19. GRADING OF ILLNESS
CHILD AGED 2 months up to 5 YEARS
1. VERY SEVERE PNEUMONIA
2. SEVERE PNEUMONIA
3. PNEUMONIA (not severe)
4. NO PNEUMONIA : Cough or Cold
Community Acquired Pneumonia

20. VERY SEVERE PNEUMONIA
NOT ABLE TO DRINK
CONVULSIONS, ABNORMALLY
SLEEPY
STRIDOR IN CALM CHILD
SEVERE MALNUTRITION

21. SEVERE PNEUMONIA
PNEUMONIA NOT SEVERE
NO PNEUMONIA : Cough or Cold
Chest in drawing
Fast breathing
Nasal flaring, Grunting, Cyanosis
Fast breathing ( Child 2-12 months R.R >50/min )
No chest in drawing
( Child 12months-5years R.R >40/min)

22. COMPLICATIONS OF PNEUMONIA
COMPLICATIONS OF PNEUMONIA
Resp & circulatory failure
Pleural effusion
Empyema
Abscess
Pneumo thorax