Respiratory Infections: A Scientific Basis for Management

Part 1 Pathogenesis of pneumonia: host defenses- overview of the system and discussion of cellular factors, includes specific pathogens especially fungus, mycobacteria non-specific host defences - cough, mucociliary clearance, etc. host defences - humoral immune system pathogenesis of airway colonisation host impairments with AIDS nutrition and respiratory infection. Part 2 Clinical approach to upper and lower respiratory tract infection - the approach in specific populations: upper respiratory infections, middle ear infections and sinus infection - adults and children bronchitis and acute febrile tracheobronchitis infants and pre-school children nosocomial pneumonia in children out-patients with community acquired pneumonia nosocomial pneumonia - outside the ICU - incl. COPD, heart disease pt. nosocomial pneumonia - mechanically ventilated and critically ill - ARDS immuno-compromised patient (2 separate chapters) respiratory infections in HIV infected persons mimics of pneumonia in HIV infected persons surgical patient - trauma, burn, post-operative, including aspiration elderly in the nursing home economically disadvantaged, incl. homeless immigrants, prison the patient with cystic fibrosis and respiratory infection pneumonia complicated by pleural effusion - incl. empyema non-resolving pneumonia and recurrent pneumonia - incl. mimics of pneumonia bronchiectasis lung abscess and other subacute pulmonary infections, including the prevention of aspiration. Part 3 Specific pathogens leading to pneumonia: pneumococcus haemophilus influenza legionella group of organisms atypical pneumonia - incl. TWAR, C. Psittaci, M. Pneumoniae anaerobic bacteria - lung abscess, empyema, aspiration gram-negative bacteria (excluding pseudomonas) pseudomonas aeruginosa other bacterial agents - group B strep, branhamella, etc fungal infection - endemic mycoses nocardia and actinomyces zoonoses - tularemia, plague, anthrax pneumocystis carinii mycobacterium tuberculosis mycobacteria other than tuberculosis viruses and influenza A and B. Part 4 Diagnostic methods: an approach to diagnostic methods - which should be used and in what circumstances? invasive diagnostic methods - bronchoscopy, bronchoalveolar lavage, transbronchial biopsy, protested specimen brush, open lung biopsy. Part 5 Therapy: antimicrobials anti-fungal agents inhaled antibiotics - nosocomial pneumonia, cystic fibrosis, HIV infection adjunctive support measures - oxygen, hydration, chest PT, bronchscopy etc. Part 6 Prevention: infection control methods selective contamination - European approach and prophylactic antibiotics therapy and prevention of pneumonia with monoclonal antibodies vaccines preventive interventions for HIV infected persons chronic bronchitis - role of antibiotics.