Infection may cause stillbirth by several mechanisms, including direct infection, placental damage, and severe maternal illness. When the inflammation is caused by an infectious microorganism, the term pneumonia is used. Membrane complement components act to limit complement activation on host cells or to facilitate uptake of antigens or microbes “tagged” with complement fragments. Pneumonia often occurs right after a viral infection such as flu or colds with runny nose, sore throat and dry cough. Some microscopic organisms actually keep people healthy, by helping in the body’s digestion and other functions, but others can cause illness. The symptomatology for clinical infectious disease (ie, fever, pneumonia, GI ulcers, hepatitis) ranges from the mild, subclinical case to life-threatening multi-organ disease. Despite some deaths in Victoria, the majority of cases of human swine flu have so far been mild and can be compared to the normal seasonal flu.
When air is inhaled through the nose or mouth, it travels down the trachea to the left bronchus and rightbronchus, where it first enters the lungs. However, secondary bacterial (e.g., Pseudomonas or Staphylococcus) or viral infections (e.g., HSV or adenovirus) can lead to permanent scarring and blindness . The air tube extending from the nose is called the nasopharynx. The tube carrying air breathed in through the mouth is called the oropharynx. The nasopharynx and the oropharynx merge into the larynx. The oropharynx also carries swallowed substances, including food, water, and salivary secretion, which must pass into the esophagus and then the stomach. It often follows a viral respiratory infection, such as the flu.
Prevalences of HSV-2 antibody, HSV-2 shedding and levels of HSV-2 DNA higher among HIV-1-seropositive than among HIV-1-seronegative women;… A useful method of picturing the respiratory system is to imagine an upside-down tree. The larynx flows into the trachea, which is the tree trunk, and thus the broadest part of the respiratory tree. The trachea divides into two tree limbs, the right and left bronchi. Each one of these branches off into multiple smaller bronchi, which course through the tissue of the lung. The lower limits of gestational age used to define a stillbirth have included lower gestational ages ranging from 20 to 28 weeks. Those at the greatest risk for contracting pneumonia include adults age 65 and older, children younger than five years of age, people with underlying chronic medical conditions such as diabetes, those who have compromised immunity, those who smoke or are exposed to smoke, and people who have asthma.
Schematic representing the activation of the complement cascade. Breathing is rapid and spiritual distress may be significant. Because viruses cannot convert food into energy and cannot reproduce on their own, some scientists do not consider them a life form. There are multiple safeguards along the path of the respiratory system. However, they can still infect other people. Chest radiography and physical exam are necessary. The epiglottis is a trap door of sorts, designed to prevent food and other swallowed substances from entering the larynx and then trachea.
Sneezing and coughing, both provoked by the presence of irritants within the respiratory system, help to clear such irritants from the respiratory tract. Mucus, produced through the respiratory system, also serves to trap dust and infectious organisms. Tiny hair like projections (cilia) from cells lining the respiratory tract beat constantly. They move debris trapped by mucus upwards and out of the respiratory tract. The nose filters out large particles. Cells lining the respiratory tract produce several types of immune substances which protect against various organisms. Other cells (called macrophages) along the respiratory tract actually ingest and kill invading organisms.
The organisms that cause pneumonia, then, are usually carefully kept from entering the lungs by virtue of these host defenses. However, when an individual encounters a large number of organisms at once, the usual defenses may be overwhelmed, and infection may occur. This can happen either by inhaling contaminated air droplets, or by aspiration of organisms inhabiting the upper airways. If an infection occurs very early in gestation, the fetus may not die immediately but have a congenital anomaly with a fetal death occurring later, e.g. Diabetes, chronic kidney disease, cancer, emphysema, heart disease, HIV/AIDS, and Sickle-cell disease pose a particular threat.Other patients who are at increased risk include those struggling with alcoholism, patients who were recently hospitalized, those taking immunosuppressant drugs, post-operative patients with an impaired ability to cough or clear the lungs, patients in intensive care unitswho are on breathing tubes, patients who have their spleen removed, and patients who are undergoing chemotherapy. There are two isoforms of C4 present in normal human serum, which are called C4A and C4B (16). All of Cold pneumonia (mycoplasma) have fever and prolonged cough.
Prions, which were discovered only recently, are not well understood. This leads to a leaky seal on the trap door, with possible contamination by swallowed substances and/or regurgitated stomach contents. Remember to: Cover your nose and mouth with a tissue when you cough or sneeze. When a person takes a breath (inhales), air travels from the windpipe (trachea) into the lung through the main (primary) right and left bronchi, which branch into smaller tubes called secondary bronchi. Viruses may interfere with ciliary function, allowing themselves or other microorganism invaders (such as bacteria) access to the lower respiratory tract. One of the most important viruses is HIV (Human Immunodeficiency virus), the causative virus in AIDS (acquired immunodeficiency syndrome). In recent years this virus has resulted in a huge increase in the incidence of pneumonia.
Because AIDS results in a general decreased effectiveness of many aspects of the host’s immune system, a patient with AIDS is susceptible to all kinds of pneumonia. This includes some previously rare parasitic types which would be unable to cause illness in an individual possessing a normal immune system. Bacteria are stained with special dyes, then washed in a special solution. This causes this age group to be more at risk for the development of pneumonia. Viruses cause the majority of pneumonias in young children (especially respiratory syncytial virus, parainfluenza and influenza viruses, and adenovirus). Adults are more frequently infected with bacteria (such as Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus). Pneumonia in older children and young adults is often caused by the bacteria-like Mycoplasma pneumoniae (the cause of what is often referred to as “walking” pneumonia).
Pneumocystis carinii is an extremely important cause of pneumonia in patients with immune problems (such as patients being treated for cancer with chemotherapy, or patients with AIDS. duttonii is predominantly found in sub-Saharan Africa. There are now two vaccines recommended for adults, including one that provides some long-term protection against 23 different strains of S. MASP-3 is found complexed to ficolin-3 and may inhibit the ability of ficolin-3 to activate complement (409). Subsequently named Legionella pneumophila, it causes what is now called “Legionnaire’s disease.” The organism was traced to air conditioning units in the convention’s hotel. Immunity often develops after a germ is introduced to the body. Fever with a shaking chill is even more suspicious.
180 2007 Victorian Government Human Swine Flu Information Your doctor (GP) – for medical advice if you have a flu-like illness (fever, cough and fatigue) Nurse-on-Call Tel. Legionella pneumophila causes Legionnaires disease, a severe illness. They may appear streaked with pus or blood. Severe pneumonia results in the signs of oxygen deprivation. This includes blue appearance of the nail beds or lips (cyanosis). The invading organism causes symptoms, in part, by provoking an overly-strong immune response in the lungs. In other words, the immune system, which should help fight off infections, kicks into such high gear, that it damages the lung tissue and makes it more susceptible to infection.
“Bird flu” (type A influenza subtype H5N1) is spreading around the globe. This results in less functional area for oxygen-carbon dioxide exchange. The patient becomes relatively oxygen deprived, while retaining potentially damaging carbon dioxide. The patient breathes faster and faster, in an effort to bring in more oxygen and blow off more carbon dioxide. Mucus production is increased, and the leaky capillaries may tinge the mucus with blood. Mucus plugs actually further decrease the efficiency of gas exchange in the lung. When the parasites infect the placenta, placental insufficiency often results because of lymphocyte and macrophage accumulation, thickening of the trophoblast basement membrane, and increased expression of various proinflammatory cytokines, all of which impede maternal blood flow through the placenta.
For the most part, diagnosis is based on the patient’s report of symptoms, combined with examination of the chest. Within this short period, the nascent C3b must find a suitable electron donor in the form of an —OH or —NH2 group on a biological surface to form a covalent ester or amide bond, respectively; failure to do so will result in reaction of C3b with a water molecule, and inactive C3b will remain in solution. Laboratory diagnosis can be made of some bacterial pneumonias by staining sputum with special chemicals and looking at it under a microscope. When the infection is “on,” a person can spread it to others. X-ray examination of the chest may reveal certain abnormal changes associated with pneumonia. Localized shadows obscuring areas of the lung may indicate a bacterial pneumonia, while streaky or patchy appearing changes in the x-ray picture may indicate viral or mycoplasma pneumonia. The disease was first reported in China in 2003.
Prior to the discovery of penicillin antibiotics, bacterial pneumonia was almost always fatal. Today, antibiotics, especially given early in the course of the disease, are very effective against bacterial causes of pneumonia. Erythromycin and tetracycline improve recovery time for symptoms of mycoplasma pneumonia. They, do not, however, eradicate the organisms. Amantadine and acyclovir may be helpful against certain viral pneumonias. In addition to AIDS, other conditions put patients at risk for opportunistic pneumonia. Linezolid is the first of a new line of antibiotics known as oxazolidinones.
Another new drug known as ertapenem (Invanz) is reported to be effective in treating bacterial pneumonia. Prognosis Prognosis varies according to the type of organism causing the infection. Recovery following pneumonia with Mycoplasma pneumoniae is nearly 100%. Staphylococcus pneumoniae has a death rate of 30-40%. Most of the stillbirths occurred in the second and early third trimester. Streptococcus pneumoniae, the most common organism causing pneumonia, produces a death rate of about 5%. Thus, C1 inhibitor also serves to limit the generation of bradykinin.
Individuals with other chronic illnesses (including cirrhosis of the liver, congestive heart failure, individuals without a functioning spleen, and individuals who have other diseases that result in a weakened immune system, experience complications. The germ should be isolated from the sick animal; that is, grown in a pure culture * from a sample from the infected site. Prevention Because many bacterial pneumonias occur in patients who are first infected with the influenza virus (the flu), yearly vaccination against influenza can decrease the risk of pneumonia for certain patients. This is particularly true of the elderly and people with chronic diseases (such as asthma, cystic fibrosis, other lung or heart diseases, sickle cell disease, diabetes, kidney disease, and forms of cancer). These bacteria are called anaerobic bacteria. G., S. K.
Cammarata, T. H. Oliphant, et al. Between 5 and 10 million people get pneumonia in the United States each year. Pneumonias are categorized by site and cause. Lobar pneumonia affects most of a single lobe; bronchopneumonia involves smaller lung areas in several lobes; interstitial pneumonia affects tissues surrounding the alveoli and bronchi of the lung. Atypical pneumonias diffusely affect lung tissues rather than anatomical lobes or lobules.
Community-acquired pneumonia is a lung infection that occurs in noninstitutionalized people, typically involving organisms such as viruses, Streptococcus pneumoniae, Klebsiella pneumoniae, Mycoplasma pneumoniae, Legionella pneumophila, Chlamydia pneumoniae, Moraxella species, or Pneumocystis carinii. Nosocomial pneumonia develops in patients in the hospital or nursing home; this type is most likely to be caused by gram-negative rods or staphylococcal species. Studies also have examined the role of HIV co-infection on pregnancy outcome. Pneumonias in immunocompromised patients sometimes are caused by Pneumocystis jiroveci or by fungal species such as Aspergillus. Their features have been summarized in Table 2. Some fungal pneumonias occur in specific geographical regions of the U.S. For example, histoplasmosis is common in the Ohio River Valley, and coccidioidomycosis is found in the San Joaquin River Valley of southern California.
Viral pneumonias may be caused by influenza, varicella-zoster, herpes, or adenoviruses. Most patients with pneumonia have cough, shortness of breath, and fever although these symptoms are not universal. Legionnaire disease, however, is a severe form of atypical pneumonia that usually strikes adults and seniors. Patients with atypical pneumonias usually have lower temperatures and nonproductive coughs and appear less ill. Pneumococcal vaccine effectively prevents many forms of streptococcal pneumonia. This vaccine is recommended for people over 65; those with chronic respiratory, cardiac, or neuromuscular diseases; and patients with diabetes mellitus or renal failure. Treatment is based on the clinical presentation (such as community-acquired versus nosocomial), results of the Gram stain of sputum specimens, the radiographical appearance of the pneumonia, the degree of respiratory impairment, and the results of cultures.
Many patients hospitalized with pneumonia require supplemental oxygen and analgesics. Respiratory failure is one of the top causes of death in patients with more severe pneumonia. The antibiotic used for subsequent therapy is guided by the results of cultured specimens taken on presentation. A large percentage of patients with pneumonia are not admitted to hospitals but are treated with antibiotics given on an outpatient basis. However, older adults, people with serious chronic diseases, and those with evidence of organ dysfunction, poor oxygenation, or acute decompensation may need hospitalization to reduce the risk of injury or death. Supportive care is provided to the patient to remove secretions and improve gas exchange. Such care includes position changes, deep breathing and coughing exercises, incentive spirometry, active and passive limb exercises, and assistance with self-care.
coli have crossed intact fetal membranes and caused amniotic fluid infection. Supplemental oxygen is usually prescribed to maintain an oxygen saturation of > 92%. A role for C4 in protection against certain fungal infections was suggested by the observation that C4B and C4A deficiencies were both associated with increased susceptibility to paracoccidioidomycosis in a study of 69 Brazilian patients and 225 healthy matched controls (91). Mechanical ventilation is required in patients with respiratory failure. Analgesics are provided as prescribed to manage pain and discomfort and encourage good pulmonary toilet. A large percentage of patients receive care to remove secretions and to improve gas exchange. Such care includes position changes, deep-breathing, and coughing exercises.
Abscesses are more common with anaerobic bacteria, Staphylococcus aureus, Pseudomonas aeruginosa, or Klebsiella pneumoniae, and are uncommon with Streptococcus pneumoniae. Outpatient therapy of community-acquired pneumonia can be recommended for selected patients who are young, otherwise healthy, and not hypoxic, hypotensive, hypothermic, or in renal failure. Activities are scheduled to allow for plenty of rest. The patient is taught hand hygiene and encouraged to wash hands with soap and water or use an alcohol-based hand wipe entirely over both hands after blowing the nose, coughing, using the bathroom, or eating or drinking. Only disposable tissues are used for sneezing and coughing. Used tissues are deposited in a lined bag taped to the bedside and are disposed of frequently according to agency policy. Kidney complications and electrolyte imbalances are common in patients admitted to the hospital with pneumonia.
Each patient’s meal preferences and restrictions are discussed to plan a diet that ensures adequate high-caloric intake. Emotional support is provided, and all procedures and treatments are explained. The patient who smokes is taught the relationship between smoking and lung diseases (including the increased risk of respiratory infections) and referred for support group assistance with quitting as needed. Pneumonia prevention is aided by encouraging individuals to avoid indiscriminate antibiotic use, receive pneumonia and influenza vaccinations, perform deep-breathing and coughing exercises when confined to bed and after surgery, and ambulate early after surgery. Aspiration pneumonia is prevented in tube-fed patients by correct positioning and slow, low-volume feedings. coli. Pneumonia caused by inhalation of gastric contents, food, or other substances.
aureus (n = 3), H. This condition also occurs in newborns who inhale infected amniotic fluid, meconium, or vaginal secretions during delivery. An atypical pneumonia caused by Chlamydia species, characterized clinically by cough, low-grade fever, sore throat, and malaise. A chest x-ray taken during the illness is more likely to show diffuse lung involvement than a lobar pneumonia. Pneumonia occurring in outpatients, often caused by infection with streptococcus, Haemophilus influenzae, Staphylococcus aureus, and atypical organisms such as Legionella species. Bacterial pneumonia is linked with an increased risk of acute heart problems, such as heart attack or abnormal heart rhythm (arrhythmia). Pneumonia of unknown cause, accompanied by cellular infiltration or fibrosis in the pulmonary interstitium.
Progressive dyspnea and a nonproductive cough are symptoms characterizing this disease. Clubbing of the fingers is a common finding. Diffusion of oxygen and carbon dioxide is abnormal. Diagnosis is made by lung biopsy. Chronic obstructive lung disease (COPD), which includes chronic bronchitis and emphysema, affects 15 million people in the U.S. Infiltration of the lung by eosinophils, typically found in patients with peripheral eosinophilia. The cause is usually unknown; occasionally, the condition responds to the administration of corticosteroids.
In some cases, a specific underlying cause is found, such as the recent initiation of cigarette smoking or an allergic drug reaction. Infection with some parasites or fungi also can trigger the disease. Prevention is the most important factor, esp. Of all the bacterial infections associated with stillbirth, special emphasis should be given to group B streptococcal infection. Patients should be moved and turned frequently at least every 1 to 2 hr. In another report, the clinical courses of three C2-deficient patients (two were siblings) were recorded (256). Incentive spirometry may prove useful in patients who need added encouragement to deep breathe periodically.
Damage to lung tissue that results from aspiration of oils. It may occur repeatedly in patients with impaired swallowing mechanisms or in persons affected by esophageal disorders, such as esophageal carcinoma, achalasia, or scleroderma. Mineral oils and cooking oils often are responsible. The elderly, infants, and young children are at greatest risk for the disease. Distinguishing lipoid pneumonia from bacterial pneumonia may require endoscopy. Lung infection occurring in the first few days of life due to uterine exposure to infectious microorganisms or to infection during or immediately after birth. Common causes include viruses (such as herpes simplex) and bacteria (such as group B streptococcus, Chlamydia, Escherichia coli, Listeria).
Penicillin may be used when the pneumococcus is sensitive to this agent, but the incidence of penicillin resistance in pneumococci is rapidly growing. Third-generation cephalosporins, erythromycin, vancomycin, and linezolid, are alternative agents. Intravenous drug abusers are at risk for pneumonia from infections that start at the injection site and spread through the bloodstream to the lungs. People over the age of 65 or those with heart, lung, liver, kidney, or immunosuppressive diseases should be immunized as should infants under the age of two. Oral trimethoprim-sulfamethoxazole effectively protects against PCP, and is also the drug of choice for active infection. Other drugs that are active against PCP include pentamidine, trimethoprim in combination with dapsone, and atovaquone. Corticosteroids are used as adjunctive therapy when treating markedly hypoxic patients, e.g., those who present with an alveolar-arterial oxygen gradient of more than 35 mm Hg.
The introduction of highly active antiretroviral drug cocktails for AIDS patients has markedly reduced the incidence of PCP.