Atypical pneumonia is caused by certain bacteria including Mycoplasma pneumoniae, Chlamydia pneumoniae, Chlamydia psittaci, and Legionella pneumophila. It tends to cause milder symptoms than typical pneumonia and does not usually require hospitalization. Different antibiotics are required to treat atypical versus typical pneumonia. Common symptoms include a persistent cough, headache, and low-grade fever.
A detailed description of sarcoidosis, pulmonary in specific but also covering the other systems. a rare entity in india or a better way to say, often an overlooked disease.
A detailed description of sarcoidosis, pulmonary in specific but also covering the other systems. a rare entity in india or a better way to say, often an overlooked disease.
Bacterial Atypical pneumonia and its microbiological a[sectspptxDr. Nagendra Kumar
atypical pneumonia Infection occurring in the interstitial space of lungs. Cough is characteristically non-productive.
Respiratory viruses - influenza viruses, corona viruses, respiratory syncytial virus, Epstein–Barr virus and adenoviruses.
Bacterial agents:
Mycoplasma pneumoniae
Chlamydiae: Chlamydophila pneumoniae, C. psittaci, Chlamydia trachomatis serotypes D to K
Legionella species
Coxiella burnetii (Q fever), Francisella tularensis (pulmonary tularemia), and Orientia tsutsugamushi (scrub typhus).
Infections and salivary gland disease in pediatric age: how to manage - Slide...WAidid
The slideset by Professor Susanna Esposito aims at explaining how to manage the salivary gland infections in pediatric age, from pathogenesis, to transmission, treatments and vaccination coverage, that should be urgently increased in Italy as well as in EU Countries.
Legionellosis is a respiratory disease caused by Legionella bacteria.
The term“legionellosis” may be used to refer to either Legionnaires’ disease or Pontiac fever.
https://www.cdc.gov/legionella/index.html
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
2. WHAT IS ATYPICAL PNEUMONIA?
bacterial infection of lower respiratory
tract caused by Mycoplasma pneumoniae,
Chlamydia pneumoniae, Chlamydia psittaci, and
Legionella pneumophila.
The types of bacteria that cause it tend to create
less severe symptoms than those in typical
pneumonia.
Cases of atypical pneumonia do not usually
require hospitalization, and a person with it is
unlikely to be significantly ill. This is why it is
often called walking pneumonia.
3. WHAT IS ATYPICAL PNEUMONIA?
People with atypical pneumonia will also have certain
symptoms that others with typical pneumonia will often
not have. These might include a prominent headache, a
low-grade fever, an earache, and a sore throat.
Symptoms of atypical pneumonia tend to be milder and
more persistent than those of typical pneumonia, which
appear suddenly, and cause a more serious illness.
Atypical pneumonia requires different antibiotics than
typical pneumonia, which is commonly caused by the
bacteria Streptococcus pneumonia.
4. WHAT IS ATYPICAL PNEUMONIA?
quite common.
2 million cases of mycoplasma pneumonia occur in
the US each year.
8,000-18,000 patients are hospitalized for
Legionnaires’ disease in the US each year.
5. CHLAMYDIA PNEUMONIAE INFECTION
one cause of community-acquired pneumonia
The bacteria cause illness by damaging the lining of
the respiratory tract including the throat, windpipe,
and lungs.
Some people may become infected and have mild
or no symptoms.
spread by coughing or sneezing, which creates
small respiratory droplets
long incubation periods 3-4 weeks
6. CHLAMYDIA PNEUMONIAE INFECTION
C. pneumoniae growth consists of two alternating forms:
elementary and reticulate bodies.
Elementary bodies are metabolically inactive.
They infect the host when cells ingest the elementary bodies
through the process of receptor-mediated endocytosis.
Once inside the cell, the elementary bodies differentiate into
reticulate bodies, which are metabolically active but
noninfectious.
The reticulate bodies rely on the host cell for adenosine
triphosphate (ATP) synthesis.
The reticulate bodies divide by binary fission and induce a host
immune response.
After 48 to 72 hours, the reticulate bodies reorganize
themselves and condense to form new elementary bodies.
The elementary bodies then leave the host cell and start a new
infectious cycle.
7. CHLAMYDIA PNEUMONIAE INFECTION
all ages can get infection
People at increased risk include those who live or work
in crowded places where outbreaks most commonly
occur8, such as:
Schools
College residence halls
Military barracks
Nursing homes
Hospitals
Prisons
Older adults are at increased risk for severe disease
8. CHLAMYDIA PNEUMONIAE INFECTION
SIGNS AND SYMPTOMS
chlamydia pneumoniae infection is a mild illness that
most commonly causes an upper respiratory tract
infection. :
Runny or stuffy nose
Fatigue (feeling tired)
Low-grade fever
Hoarseness or loss of voice
Sore throat
Slowly worsening cough that can last for weeks or months
Headache
C. pneumoniae can also cause lower respiratory tract
infections like bronchitis and pneumonia.
Symptoms can continue for several weeks
11. CHLAMYDIA PNEUMONIAE INFECTION
DIAGNOSIS
1- Molecular real-time PCR (preferred method for the
diagnosis of an acute infection
o available , high sensitivity and specificity, expensive
2- Serology enzyme immunoassay
o available , lacks specificity, not standardized, ,not optimal
for treatment decisions
3- Culture
genotyping and antimicrobial susceptibilities testing, Time-
consuming , low sensitivity and specificity, Positive results
should be confirmed by PCR
12. CHLAMYDIA PNEUMONIAE INFECTION
DIAGNOSIS IMAGING
unilateral pattern of alveolar infiltrates or
bronchopneumonia predominates then progress bilateral
Findings are usually confined to a single lobe with lower
lobe involvement more frequent than middle or upper
lobe involvement Up to a quarter of patients may
demonstrate a
small to moderate-size pleural effusion.
Hilar or mediastinal lymphadenopathy is an uncommon.
13.
14. CHLAMYDIA PNEUMONIAE INFECTION
TREATMENT
Illness caused by Chlamydia pneumoniae is usually
self-limiting and patients may not seek care.
Because C pneumoniae is an obligate intracellular
microbe, antibiotics must achieve intracellular
penetration to achieve efficacy
Macrolides (azithromycin) — first-line therapy
Tetracyclines (tetracycline and doxycycline)
Fluoroquionolones
15. LEGIONELLOSIS (LEGIONNAIRES' DISEASE
AND PONTIAC FEVER)
60 different species of Legionella; most are considered
pathogenic,
but most disease is caused by Legionella pneumophila,
particularly serogroup 1.
Legionella is transmitted via inhalation of aerosolized water
containing the bacteria.
Legionnaires’ disease is likely underdiagnosed, More than
6,000 cases were reported in US 2015.
Legionnaires’ disease is hard to distinguish from
pneumonia caused by other pathogens because it
presents similar clinical symptoms; however, presence of
diarrhea and elevated creatinine kinase levels can be
indicators
16. LEGIONELLOSIS
RISK FACTORS
Age ≥50 years
Smoking (current or historical)
Chronic lung disease (such as emphysema or COPD)
Immune system disorders due to disease or medication
Systemic malignancy
Underlying illness such as diabetes, renal failure, or
hepatic failure
Recent travel
Exposure to hot tubs
17. LEGIONELLOSIS
PATHOGENESIS
In water, Legionella grows and multiplies within
amoebae and ciliated protozoa (providing nutrients for
replicating and growing Legionella, & shelter that
protects Legionella from adverse environmental
conditions, such as extreme temperatures and
chemicals like chlorine).
Human alveolar macrophages look very similar to
protozoa. When in human lungs, Legionella invades
and grows within alveolar macrophages, mistaking
them for their natural host and causing disease.
18. LEGIONELLOSIS
CLINICAL FEATURES
Legionella infections are manifested mainly in 2
forms:
1. Legionnaires’ disease, which is a severe form of
pneumonia due to infection with Legionella. Legionnaires’
disease can manifest as a multisystem disease most
commonly involving the
lungs and gastrointestinal tract and is associated
with significant mortality.
2. Pontiac fever, which is a mild and self-resolving
flu-like disease.
19. LEGIONELLOSIS
CLINICAL FEATURES
Pontiac feverLegionnaires’ disease
A flu-like illness, often with
fever, chills, headache,
myalgia, fatigue, malaise;
less often with symptoms
such as cough or nausea
Fever, myalgia, and cough
shortness of breath,
headache, confusion,
nausea, diarrhea)
Clinical features
noyesPneumonia (clinical
or radiographic)
inflammatory response to
endotoxin
Replication of organismPathogenesis
24 to 72 hours2 to 10 daysIncubation period
20. LEGIONELLOSIS
CLINICAL FEATURES
Pontiac feverLegionnaires’ disease
Never demonstratedPossibleIsolation of the
organism
Supportive careAntibioticsTreatment
Greater than 90%Less than 5%percent of people
who become ill,
when exposed to
the source
of Legionella
Hospitalization uncommon
Case fatality rate: extremely
low
Hospitalization common
Case-fatality rate: 10%
Outcome
21. LEGIONELLOSIS
DIAGNOSIS
The preferred diagnostic tests for Legionnaires’
disease are culture of lower respiratory secretions
(e.g., sputum, bronchoalveolar lavage) on selective
media
Serological assays can be nonspecific and are not
recommended
Legionella urinary antigen test most commonly
used, remain positive for a few weeks after
infection, even with antibiotic treatment.
22. LEGIONELLOSIS
DIAGNOSIS
Indications that warrant testing include:
Patients who have failed outpatient antibiotic therapy for
community-acquired pneumonia
Patients with severe pneumonia, in particular those
requiring intensive care
Immunocompromised patients with pneumonia*
Patients with a travel history (patients who have traveled
away from their home within 10 days before the onset of
illness)
All patients with pneumonia in the setting of a
Legionnaires’ disease outbreak
Patients at risk for Legionnaires’ disease with
healthcare-associated pneumonia
23. LEGIONELLOSIS
TREATMENT
Antibiotics are the first-line therapy for Legionella
pneumonia. choice of antibiotic depends not only on its in
vitro bactericidal or bacteriostatic activity but
also on its ability to penetrate the cell membrane of host
tissues
Fluoroquinolone,
azithromycin
Clarithromycin
Doxycyline
The usual duration of therapy for most of the antibiotics
is 5 to 10 days, up to 3 weeks may be considered in
immunocompromised patients
24. LEGIONELLOSIS
PREVENTION
The key to preventing Legionnaires’ disease is
maintenance of the water systems in which
Legionella may grow.
maintaining water temperature outside the optimal
temperature for Legionella growth, preventing
stagnation, superheat-and-flush or point-of-use
filters, UV irradiation, and chemical disinfection
25. MYCOPLASMA PNEUMONIAE INFECTIONS
MICROBIOLOGY
The cell volume of M. pneumoniae is less than 5% of the cell
volume of a typical bacillus.
t can pass through filters typically used to remove bacteria.
Light microscopy cannot detect it.
It does not produce visible turbidity in liquid growth media. In
order to get a visual confirmation of growth, M.
pneumoniae cultures use specialized media.
M. pneumoniae lacks a rigid cell wall, allowing it to alter its size
and shape to suit its surrounding conditions.
It is also intrinsically resistant to antimicrobials, like beta-
lactams, that work by targeting the cell wall.
Due to its lack of a cell wall, M. pneumoniae is extremely
susceptible to desiccation. Thus bacterial transmission from
person to person by airborne droplets only occurs through
close contact.
26. MYCOPLASMA PNEUMONIAE INFECTIONS
PATHOGENESIS
spread through airborne droplets from person to person and is
exclusively a human pathogen.
primarily an extracellular pathogen that has evolved a
specialized attachment organelle for close association with
host cells.
This attachment is critical to the bacteria’s survival and ability
to infect. The close association between M. pneumoniae and
the host cells prevents the host’s mucociliary clearance
mechanisms from removing the bacterium.
The bacterium attaches to and damages the respiratory
epithelial cells at the base of cilia. This activates the innate
immune response and produces local cytotoxic effects.
27. MYCOPLASMA PNEUMONIAE INFECTIONS
PATHOGENESIS
produces a unique virulence factor known as Community
Acquired Respiratory Distress Syndrome (CARDS) toxin.
The CARDS toxin most likely aids in the colonization and
pathogenic pathways of M. pneumoniae, leading to
inflammation and airway dysfunction.
M. pneumoniae primarily lives on the surface of the respiratory
epithelial cells, but can invade tissues and replicate
intracellularly.
The endocytosis of M. pneumoniae by the host cells could:
Aid in the establishment of a latent or chronic disease state
Facilitate the bacterium in evading an immune response
Interfere with the efficacy of certain drug therapies
28. MYCOPLASMA PNEUMONIAE INFECTIONS
CLINICAL FEATURES
Mycoplasma pneumoniae infections can occur in the
upper or lower respiratory tract.
The bacterium can also cause a wide array of
extrapulmonary manifestations without obvious
respiratory disease.
The incubation period is generally between 1 to 4 weeks
Infection most commonly results in:
Tracheobronchitis
Pharyngitis
Malaise
Fever
Cough
Headache
29. MYCOPLASMA PNEUMONIAE INFECTIONS
CLINICAL FEATURES
Illness onset can be gradual and subacute, slowly
progressing to a higher fever and a persistent cough.
While the disease can persist for weeks or months, it is
frequently mild and self-resolving.
The organism may persist for several weeks in the
oropharynx despite completion of recommended
antimicrobial therapy and resolution of clinical
symptoms.
30. MYCOPLASMA PNEUMONIAE INFECTIONS
CLINICAL COMPLICATIONS
Severe complications are uncommon, but can result
in hospitalization and sometimes death.
Severe pneumonia
Exacerbation of asthma
Encephalitis
Hemolytic anemia
Renal dysfunction
Gastrointestinal complaints
Erythema multiforme, Stevens-Johnson syndrome,
or toxic epidermal necrolysis
31. MYCOPLASMA PNEUMONIAE INFECTIONS
DIAGNOSTIC METHODS
Specimen : NP, OP, sputum or sera
Molecular real-time PCR :available ,High sensitivity and
specificity, Rapid, expensive, not standardized
Serology: available, low specificity
Culture genotyping and antimicrobial susceptibilities
testing, 100% specificity , Time-consuming
32. MYCOPLASMA PNEUMONIAE INFECTIONS
TREATMENT
All mycoplasmas lack a cell wall and, therefore, all
are inherently resistant to beta-lactam antibiotics
(e.g., penicillin).
Macrolides (e.g., azithromycin): Children and adults
Fluoroquinolones: Adults
Tetracyclines (e.g., doxycycline): Older children and
adults
33. PSITTACOSIS
Chlamydia psittaci is a type of bacteria that often
infects birds, Less commonly humans
cause a disease called psittacosis with a wide
range of symptoms, including fever, headache,
and a dry cough. This illness can also
cause pneumonia
34. PSITTACOSIS
Chlamydia psittaci, an intracellular gram-negative
bacterium
C. psittaci infects humans who inhale dust containing
dried droppings or respiratory secretions from infected
birds.
35. PSITTACOSIS
CLINICAL FEATURES
vary widely from no evidence of infection to severe systemic disease
accompanied by pneumonia.
The predominant presentation is upper respiratory tract infection with
constitutional symptoms.
Abrupt onset of fever and chills
Headache
Muscle aches
Nonproductive cough
Patients may present with pulse-temperature dissociation (fever
without increased pulse rate), splenomegaly, and rash, though less
frequently.
The incubation period is typically 5 to 14 days.
Pneumonia is evident often on chest x-ray. Radiographic findings may
include lobar or interstitial infiltrates
36. PSITTACOSIS
CLINICAL COMPLICATIONS
Severe pneumonia requiring intensive-care support
Respiratory failure
Endocarditis
Myocarditis
Hepatitis
Arthritis
Encephalitis
Sepsis
Death occurs in less than 1%
37. PSITTACOSIS
DIAGNOSIS
sputum specimens or swabs of the nasopharynx and
oropharynx or serum
• Real-time polymerase chain reaction (PCR), Rapid
,Sensitive and specific
• Serologic test (e.g., complement fixation,
microimmunofluorescent antibody test): available, Cross-
reactivity
• Culture: genotyping, antimicrobial susceptibility testing,
Time-consuming, Technically difficult
38. PSITTACOSIS
TREATMENT
Chlamydia psittaci are sensitive to both macrolides
and tetracyclines. However, tetracyclines are the
drugs of choice, unless contraindicated as they are
in children, due to reported macrolide failures.
39. TAKE HOME MESSAGE
CAP due to Legionella, Chlamydophyla, or Mycoplasma
continues to be a diagnostic challenge due to the
nonspecific clinical and radiographic presentations.
The vague clinical presentations of atypical CAP
contribute to its underdiagnosis and under-reporting.
Advancements in diagnostic techniques bring hope to
rapid and accurate diagnosis of atypical CAP.
Macrolides and respiratory fluoroquinolones are
currently the antibiotics of choice