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bacterial pharyngitis group a beta strep, most common
bacterial pharyngitis symptoms fever, pain, swollen glands, exudate on tonsils/pharynx. diff swallowing, no cough
bacterial pharyngitis collection swab tonsillar area/posterior pharynx. avoid tongue + other surfaces. get exudate,
bacterial pharyngitis diagnosis culture: blood, sxt. non-culture: rapid enzyme immunoassays, if pos = group A(highly specific) fairly sensitve(follow neg with cultrue)
Trench mouth Vincent's angina. inflamed bleeding gums
Trench mouth gram stain spirochete + fusiforms
pharyngitis viral rhinovirus, adenovirus, RSV, influenza
barriers to infection nasal hair, ciliated mucosal cells, coughing, normal flora, phagocytes
uncommon pharyngitis cause Corynebacterium diptheriae-when no DPT vaccine
sinusitis bacteria S. pneumoniae, H. influenzae, S. pyo. Moraxella catarrhalis(children), S. aureus
sinusitis virus rhinovirus, parainfluenza, influenza
sinusitis diagnosis CT, MRI, culture aspirate of direct sinus puncture(rare), culture secretions(unreliable) treated empirically(symptoms)
otitis media pathogens Strep pneumoniae, Haemophilus influenza
otitis media complications damage to tympanic membrane, hearing loss, meningitis(spread to CNS-close proximity)
otitis media diagnosis empirical antibiotic treatment
otitis media culture not usually done, blood, chocolate(H.influenza)
Epiglottitis pathogen Haemophilus influenzae type b
epiglottitis rapid, edema causing airway obstruction
epiglottis diagnosis gram stain-"intracellular very small pleomorphic coccobacillus white cells"
epiglottis diagnosis chocolate agar, capnophile 5-10% CO2
pertussis Bordetella pertussis + parapertussis, "whooping cough"
bacterial bronchitis secondary infection following viral.
bacterial bronchitis most common pathogens Strep pneumoniae, H. influenzae
bacterial bronchitis uncommon causes mycoplasma, chlamydophila, bordetella
bronchitis diagnosis viral cultrues not in uncomplicated cases, 2ndary bact. pneumonia-culture sputum
CA pneumonia 1. RSV(children) 2. Parainfluenza 3. Bacterial
CA pneumonia bacteria adults S. pneumoniae(adults),mycoplasma pneumoniae(young adults) H.influenzae type b,
CA pneumonia bacteria neonates group B strep, Chlamydia trachomatis
CA pneumonia bacteria S aureus, Legionella pneumophila
bacterial pneumonia symptoms rapid onset, chills, fever, productive cough (purulent, blood tinged) high WBC
viral pneumonia symptoms slower onset, less sputum
HA pneumonia Pseudomonas aeruginosa, MRSA
HA pneumonia risks unconscious patients, intuvation of airway, immunosuppressed
pneumonia diagnosis gram stain (WBC + squamous) culture sputum - blood, chocolate, EMB/MacConkey
good gram stain more than 25 polys, less than 10 epis
poor gram stain more than 25 epis, don't culture
aspiration pneumonia - at risk elderly, immumosuppressed, periodontal disease, altered lung defense(smoke, lung disease)
Empyema thick fluid in plerual space, bacterial
Chronic pneumonia TB, NTM, fungal
Pneumocystis jiroveci carinii, LRT infection in immumosuppressed
sputum specimen most common, least relevant, normla flora
Thoracentesis aspirates pleural fluid, excellent=pneumonia
bronchial washing sterile saline instilled into bronchial tree
BAL Bronchoalveolar lavage deeper, diagnosis - pneumocystis, fungi, TB/ snip tissue
better specimens thoracentesis, bronchial washing, BAL - surgery needs to be done, not routine
Created by: sara.



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