3. Description
Gram-positive diplococci (in pairs)
Encapsulated ovoid or lanceolate coccus
Non-motile
Fastidious (enriched media)
Blood or chocolate agar
5-10 % CO2
Alpha haemolysis + draughtsman appearance
Some strains are mucoid
Soluble in bile
Optochin sensitive
4. Pathogenesis
Virulence factors
Capsular polysaccharide
The major factor
84 serotypes
Both antigenic and type specific
Antiphagocytic
Serotype 3 , 7 are most virulent
90% of cases of bacteraemic pneumococcal pneumonia and meningitis are
caused by 23 serotypes
Quellung reaction , india ink
Pneumolysin
Membrane damaging toxin
6. Predisposing factors
Aspiration of upper airway secretions ( endogenous )
No person-person spread
Disturbed consciousness , general anaesthesia , convulsions ,
CVA , epilepsy , head trauma
Prior LRT. VIRAL infection
Preexisting respiratory diseases , smoking
Chronic bronchitis , bronchogenic malignancy
Chronic heart disease
Chronic renal disease ( nephrotic syndrome )
Chronic liver disease ( cirrhosis)
Diabetes mellitus
Old age , (extreme of age )
Malnutrition , alcoholism
7. Specific deficiencies in host defence
Hypogamaglobulinaemia
Asplenia , hypospenism ( tuftsin )
Homozygous sickle cell disease
Coeliac disease
Multiple myeloma , leukaemia , lymphomas
Neutropenia
HIV
Relative or absolute deficiency of opsonic antibody or inadequate manufacture
of type specific antibody
8. Diseases
Respiratory tract infections
Lobar pneumonia ( commonest cause of CAP )
Empyema
Otitis media (6 months – 3 yrs )
Mastoiditis
Sinusitis
Acute exacerbation of chronic bronchitis
Meningitis
Conjunctivitis
Peritonitis ( primary )
Bacteraemia ( 15 % of pneumonia )
septicaemia
10. Meningitis
The most virulent pathogen of meningitis
Mortality ( 20% )
Primary
Complicate infections at other site ( lung )
Bacteraemia usually coexists
Bimodal incidence ( < 3 yr - > 45 yr )
21. DESCRIPTION
• Is commonly known as common cold.
• Nasopharyngitis refers to the swelling of the nasal passages and
the back of the throat.
• Usually last about 7 days or less
• It can cause a blocked nose followed by a runny nose, sneezing, a
sore throat and a cough
• Can be contagious
22. The etiology:
•
• Rhinovirus is the most common cold-causing virus and
it’s highly contagious.
A virus or bacteria can cause nasopharyngitis. It can
spread through tiny air droplets that are expelled when a
person infected with the virus: sneezes, coughs, blows
their nose, talks.
23. PATHOPHYSIOLOGY
• The mechanism of this immune response is virus specific. For
example, the rhinovirus is typically acquired by direct contact it
binds to human ICAM-1 receptors(Inter-Cellular Adhesion
Molecule 2)
• This receptors present on respiratory epithelial cells. As the
virus replicates and spreads, infected cells release distress
signals known as chemokines and cytokines(which in turn
activate inflammatory mediators).
• These inflammatory mediators then produce the symptoms.
24. A cold can be spread through:
• direct contact – sneeze or cough, tiny droplets
of fluid containing the cold virus are launched
into the air and can be breathed in by others.
• indirect contact – sneeze onto a door handle
and someone else touches the handle a few
minutes later, they may catch the cold virus if
they can touch their mouth or nose
25. Signs and symptoms
• Dry or sore throat.
• Runny nose .
• Sneezing.
• Headache .
• Earaches, also brought on by the
congestion (especially in children).
• Slight fever and chills .
• Coughing.
• Feeling tired.
• Watery or itchy eyes
• Body aches
• Post nasal drip
26. DIAGNOSIS
• Symptoms and a physical examination are all
the doctor needs to diagnose the common cold.
• Usually, no blood tests or X-ray are necessary.
• During the physical examination, the doctor
will pay careful attention to the head, neck, and
chest.
• Examine the eyes, ears, throat, and chest to
help determine if a bacterial source is causing
the illness.
27. MEDICAL MANAGEMENT
• Antipyretics or analgesics- may be indicated
for mild fever and discomfort, and pain and the
cold itself.
• Cough Suppressants- containing
dextromethorphan may be prescribed for a dry,
hacking cough, especially at night
• Rest is recommended
• Antihistamines – for runny nose, sneezing,
itching and to induce sleep.
• Decongestants- may be prescribed for children
and infants older than 12 months of age to
shrink swollen nasal passages
28. COMPLICATIONS
Colds may aggravate the symptoms of other
conditions, such as asthma and chronic
obstructive pulmonary disease (COPD).
Cold can also lead to:
• acute bacterial bronchitis – inflammation of
the windpipe (trachea)
• strep throat -bacterial infection that causes
inflammation and pain in the throat
• Pneumonia – lung infection
• Otitis media – any inflammation in the
middle ear due to nasopharyngeal secretions
29. PREVENTIONS
1. GOOD HANDWASHING!
2.Cough and sneeze into arm or
tissue, not into your hand.
3. Sanitize your hands if you have
hand sanitizer.
4. Use tissues
5. Disinfect stuff
6. Don’t share
30. Assessment diagnosis planning intervention rationale evaluation
v/s T-100.4 F (38 C)
• complaint of nasal
congestion
• headache
• burning eyes
• slight fever
• runny nose
• watery eyes
• chills (feeling cold)
• dry or sore throat
• hoarseness
• sneezing
• coughing
• irritability,
restlessness
Impaired sleeping
pattern related to
excess mucus
evidence by patient
stating “I have
trouble sleeping at
night because of my
stuffy nose” and
signs of nasal flaring.
After 3 days
child should feel
relieved of
production in nose as stuffy nose and
have no fever
1. Monitor vitals
2. Put patient in a
semi- fowlers position
3. Administer
analgesic
4. Give antihistamine
(Benadryl)
5. Give fluids
6. Adequate rest
7. Educate patient on
washing hands,
covering nose when
coughing and
sneezing.
8. Educate parents on
this condition…
1. Monitor for fever
2. To facilitate lung expansion
3. For fever, pain and cold
itself,
4. For runny nose, sneezing,
itching. induce sleep
5. Hydration is good to cough
out the mucous
6. Its important for the body
to get rest as the body’s
immune system is fighting off
the virus.
7. To prevent illness and
spread of infection.
8. Reassure parents that
common colds are normal and
can be frequent in children
and by age 5 they will develop
immunity to viruses
After 3 days child
states he feels
relieved of stuffy
nose and feels relief
of fever.
31. Assessment
8. dry or sore throat.
9. hoarsness
10. sneezing
11. coughing
12. irritability, restlessness
v/s T-100.4 F (38 C)
1. complaint of nasal congestion
2. headache
3. burning eyes
4. fever
5. runny nose
6. watery eyes
7. chills (feeling cold)
dry or sore thoat
32. DIAGNOSIS
1. Impaired sleeping pattern related to excess mucus production in nose
as evidence by patient stating “I have trouble sleeping at night because of
my stuffy nose” and signs of nasal flaring.
PLANNING
- After 3 days child should feel relieved of stuffy nose and
have no fever
33. 1. Do a physical examination
2. Monitor and record vital
signs
3.Put patient in a semi
fowlers position.
4. Administer analgesics
5. Give antihistamine
6. Give fluids.
7. Educate parent that child
needs adequate rest
intervention rationale
1. Check for signs and symptoms on
child
2. Monitor temperature for any
fever.
3. To facilitate lung expansion
4. For pain, reduce fever
5. For runny nose, sneezing, itching,
induce sleep
6. Hydration is good to cough out the
mucous
7. The body needs to rest as the
body’s immune system is fighting
off the virus.
34. 8.To prevent illness and spread of
infection.
9.Reassure parents that common
colds are normal and can be frequent
in children and by age 5 they will
develop immunity to viruses
8. Educate patient on washing
hands, covering nose when
coughing and sneezing.
9. Educate parents on this
condition…
35. EVALUATION
- After 3 days child states he feels relieved
of stuffy nose and feels relief of fever.
