This document discusses lung abscess, including definitions, classifications, causes, risk factors, clinical manifestations, investigations, and management. It begins with defining pneumonia and classifying it based on anatomy and pathogen. Common causes of pneumonia by age group and risk factors are discussed. Clinical manifestations of pneumonia include fever, cough, chest pain, and dyspnea. The document then defines a lung abscess and classifies it as acute or chronic based on duration and etiology. Causes include aspiration, bronchial obstruction, and spread from other sites of infection. Risk factors for gram-negative colonization are listed. Symptoms of a lung abscess include cough, foul sputum, hemoptysis, and chest pain. Invest
Pneumonia is characterized by the emergence of new lung infiltrates, accompanied by clinical signs such as fever, purulent sputum, leukocytosis, and decreased oxygenation and Nosocomial Pneumonia is a non-incubating lower respiratory infection that presents clinically two or more days after hospitalization. In this presentation "Nosocomial Pneumonias" has been described including their causes, therapy, Principles, diagnosis, symptoms, management, etc. For more information, please contact us: 9779030507.
Pneumonia is characterized by the emergence of new lung infiltrates, accompanied by clinical signs such as fever, purulent sputum, leukocytosis, and decreased oxygenation and Nosocomial Pneumonia is a non-incubating lower respiratory infection that presents clinically two or more days after hospitalization. In this presentation "Nosocomial Pneumonias" has been described including their causes, therapy, Principles, diagnosis, symptoms, management, etc. For more information, please contact us: 9779030507.
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Dental consideration in respiratory disorders/ dental crown & bridge coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
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Dental consideration in respiratory disorders/prosthodontic coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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Dental consideration in respiratory disorders/ dental crown & bridge coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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.
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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
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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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.
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.
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
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6. Definition
• Pneumonia is an acute
infectionofthe
parenchyma of the
lung, caused by bacteria,
fungi,virus,parasite etc.
• Pneumoniamayalsobe
causedby otherfactors
including X-ray,
chemical,allergen
9. Bacterialpneumonia
(1) Aerobic Gram-positive bacteria,such as streptococcus
pneumoniae, staphy- lococcus aureus, Group A hemolytic
streptococci
(2) Aerobic Gram-negative bacteria, such as klebsiella
pneumoniae, Hemophilus influenzae, Escherichia coli
(3) Anaerobicbacteria
10. Atypical pneumonia
Including Legionnaies pneumonia ,
Mycoplasmal pneumonia ,chlamydia pneumonia.
Fungal pneumonia
Fungal pneumonia is commonly caused by
candida and aspergilosis
11. Viral pneumonia
Viral pneumonia may be caused by adenoviruses, respiratory
syncytial virus , influenza, cytomegalovirus, herpes simplex
12. Ⅱ.Classification by anatomy
1. Lobar: Involvement of an entire lobe
2. Lobular: Involvement of parts of the lobe only, segmental
or of alveoli contiguous to bronchi (bronchopneumonia).
3. Interstitial
17. Overview
◆ Pneumonia can result from a variety of causes,
including infection with bacteria, viruses, fungi,
parasites, and chemical or physical injury to the
lungs
◆ Source of Infection
◆ Aerosol
◆ Aspiration of amniotic fluid
◆ Blood-borne infection across the placenta
20. Overview
◆ The risk factors for pneumonia include:
smoking, age>65, immuno-suppression,
exposure to chemicals, and underlying lung
disease.
21. Risk Factors
◆ AirwayObstruction
◆ When part of the airway (bronchi)leading to the alveoli is obstructed, lead to
infection of the fluid resulting in community-acquired pneumonia (CAP)
◆ Another cause of obstruction is lungcancer
◆ LungDisease
◆ Smoking, and diseases such as emphysema, result in more frequent and severe
bouts of CAP
◆ ImmuneCompromise
◆ more likely to get CAP
◆ active malignancy,immuno-suppression, neurological disease, congestive
heart failure, coronaryartery disease, and diabetes mellitus
23. Clinicalmanifestations(1)
• Many patients have had an upperrespiratoryinfectionfor
several days before the onset of pneumonia
• Onset usually is sudden, half caseswith a shaking
chill
• The temperature rises during the first few hours to 39-
40℃
24. Clinicalmanifestations(2)
• Typically, patients have the symptoms of high
fever , shaking chill, sharp chest pain, cough,
dyspnea and blood-flecked sputum.
• But in some cases, especially those at age
extremes symptoms may be more insidious.
25. • The pulse accelerates
• Sharp pain in the involved hemi thorax
• The cough is initially dry with pinkish or
blood-flecked sputum
• Gastrointestinal symptoms such as,
anorexia, nausea, vomiting abdominal
pain, diarrhea may be mistaken as acute
abdominal inflammation
Clinicalmanifestations(3)
29. • A lung abscess is a localized
area of destruction of lung
parenchyma (usually >2 cm in
diameter)
• Infection by pyogenic
organisms results in tissue
necrosis
• Manifested radiologically as
a cavity with air fluid level
Definition
30. Classification
Lung abscess may be single or multiple and they
frequently containair-fluid levels
Lung abscesses can be classified based on the
duration & the likely etiology
Acute abscess
Chronic abscess
31. Acute
patient presents with symptoms of <2weeks
duration
more likely to have an infection caused by a
virulent aerobic bacterial agent (e.g. S. aureus)
32. Acute Lung Abscess
CXR of a patient who had foul-smelling & bad tasting sputum, an almost
diagnostic feature of anaerobic lung abscess
33. Classification…
Clinically useful during initial evaluation
Chronic:
A chronic lung abscess is defined by symptoms lasting for > 4 to 6 weeks.
Patients more like to have an underlying neoplasm or infection with a less
virulentanaerobicagent
34. Primary abscess
caused by aspirationor pneumonia in the healthy
host
Mostly result from necrosis in an existing
parenchymal process, usually untreated or
aspiration pneumonia
35. Classification…
Secondary abscess is caused by
Pre-existing condition eg bronchiectasis
Bronchial obstruction (eg- aspirated foreign body)
An immuno-compromised state
Spread from an extra-pulmonary site
Abscess that complicates either a septic vascular
embolus (eg- right sided endocarditis)
37. Causes of Lung abscess (A) Aspiration
A) Aspiration of infected material containing
oropharyngeal flora (commonest cause)
Organisms are anaerobic and
aerobic May be due to
Dental/ periodontal sepsis esp following tooth
extraction, tonsillectomy and nasal operation
Paranasal sinus infection
44. Symptoms …
Patients present with
Severe cough with
Profuse foul smelling sputum, may be foetid
There may be large amounts of purulent sputum once a
bronchial communication has been established
Putrid sputum is a highly specific symptoms
pathognomonic for anaerobic infection
although present in only 50-60% of patients
that is
Haemoptysis (25% of patients) – not uncommon and may be life-
threatening
45. Symptoms …
Chest pain (pleuritic or deep-seated aching discomfort) – 60% of patients
Fever – usually high with chill & rigor, profuse night sweating
Constitutional upset like- malaise, weakness
Weight loss (60% of patients) – with an average loss of between 15 & 20
lbs
Anorexia
Symptoms of associated disease process eg-
Bronchial obstruction due to lung cancer
Oesophageal obstruction due to achalasia
Right-sided endocarditis
Dyspnoea
46. Symptoms …
In most patients, presentation is insidious with symptoms lasting at
least 2 weeks before presentation
History
Includes risk factors for aspiration, eg-
Alcoholism
Drug overdose
Seizures
Head injury
Stroke
Absence of such risk factors should prompt a search for a diagnosis
other than primary lung abscess
47. Signs
There is no signs specific for lung abscess
Patient is toxic with high temperature & Halitosis
Clubbing may develop within few weeks if treatment is
inadequate
usually in 10% cases after 3 weeks
48. Signs…
On chest exam
Evidence of consolidation
Dullness to percussion and diminished breath sounds, if the abscess
is large and situated near the surface of the lung
The ‘amorphic’ or ‘cavernous’ breath sound traditionally associated
with lung cavities are rarely elicited in modern practice
49. Features Of Severe Aspiration Pneumonia
Chest radiographic findings
50% increase in the infiltrate in
48 hours
Respiratory rate >30 breaths/min SIRS (systemic inflammatory
Presence of shock
Urine output <<20 mL/h
Bilateral multilobar involvement Severe lung injury (PaO2/FIO2
response syndrome) or need for
vasopressors to support blood
pressure
ratio <<250 mm Hg)
Acute renal failure requiring
dialysis
56. Imaging Studies…
X-ray chest
Radiographic abnormality may start with
a pneumonic infiltrate
followed by the development of one or
more spherical areas of more
homogeneous density in which air-fluid
levels often arise
indicating the formation of a bronchial
communication
59. Treatment
Principles:
Sputum is sent for C/S
& broad-spectrum antibiotic should be started
Postural drainage & chest physiotherapy
Surgery
Treatment of the cause if any
60. Treatment…
Antimicrobials
Currently the mainstay of therapy is antimicrobial therapy
Antibiotics should be given according to the culture & sensitivity
for prolonged period
Commonly sputum is sent for C/S and a broad-spectrum antibiotic
should be started
61. Treatment…
The majority of patients are treated empirically
Most lung abscess pathogens are sensitive to conventional
antimicrobial therapy
Majority of lung abscesses are related to aspiration and are caused by
anaerobes
About 90% of patients with anaerobic lung abscess responds to
medical treatment
62. Treatment…
Clindamycin associated with fewer treatment failure & a shorter
time to symptom resolution than penicillin
May be preferable to other agents. Dose is 600 mg IV every 6-8
hourly
Switching to oral therapy at a dose of 300 mg every 6-8 hourly
when the patient improves
66. Differential diagnosis/Clinically
Consolidation (during resolution stage), usually no clubbing
Bronchiectasis
Bronchial carcinoma, usually Squamous cell carcinoma
Pulmonary tuberculosis (without causing abscess)
Rare infections, including – Actinomycosis, Nocardiasis, Fungal
pneumonia
67. Differential diagnosis (Contd)
In Lung abscess
Fever, systemic complaints
purulent sputum
and WBC count >11x109/L more likely to be
found
Response to antibiotic therapy
68. Differential diagnosis…/Radiologically
Necrosis in a lung tumour
Age more than 50 years
No history
suggestive of
aspiration
Lesions need not be situated
in a typically dependent
segment of the lung
In CXR: an eccentric cavity
with thick irregular walls
69. Lung abscess Empyema
Fever, systemic complaints Purulent infection ,confined to pleural space
Purulent sputum Can developed as a complication, or be a cause, of a
lung abscess
WBC count >11x109/L If an empyema contains an air-fluid level,
then a broncho-pleural fistula is likely to be
present
Response to
antibiotic therapy
Often difficult to distinguish radiographically between
a localized empyema with a bronchopleural fistula and
a lung abscess.
In CT - wall is of varying
thickness with an
irregular itraluminal
margin and exterior
surface.
Seen on the lateral Chest X-ray as a D- shaped
opacity with the convexity projecting Anteriorly
from the Posterior Chest wall.
Differential diagnosis…/Radiologically
71. Prevention
Prevention of aspiration is important to minimize the risk of lung abscess
Vomiting patients should be placed on their sides
Improving oral hygiene and dental care in elderly and debilitated patients
Positioning the supine patient at a 30° reclined angle minimizes the risk of
aspiration
Early intubation in patients who have diminished ability to protect the airway
from massive aspiration (cough, gag reflexes), should be considered