Respiratory Tract Infections - Assignment Example

Respiratory Tract Infections Name: Unit: Date of submission: Abstract Respiratory tract infections (RTIs) include common diseases that affect the respiratory tract. The respiratory tract consists of the parts of the body that aid in breathing. Therefore, RTIs affect the lungs, throat, sinuses, and airways. RTI agents result in morbidity, acute bronchitis, and bronchopneumonia. The severity of the RTI depends on the pathogen responsible for the infection. RTIs are divided into upper respiratory tract infections (URTIs) and lower respiratory tract infections (LRTIs). The proper management and treatment of RTIs depend on the establishment of the causative agent. The causative agent can be established by physical examination or application of laboratory processes. Common causative agents of RTIs include bacterial, fungal, and viral infections. RTIs are very common and constitute a significant health burden around the world. Introduction The respiratory system is categorised into two main parts. The upper part that is composed of the nose, ear, and throat and the lower part made up of the lungs and the trachea. RTIs are similarly categorised into upper respiratory tract infections (URTIs) and lower respiratory tract infections (LRTIs) (Barton and Spence, 2011, p. 24). Susceptibility to RTIs depends on the immune system. As a result, their effect on different people will vary. For instance, children are more vulnerable to RTIs because their immune systems are not developed. Research related to general practice and drug prescriptions shows that 60% of antibiotics are used in the management of RTIs (Turner, 2010, p. 14). Common causative agents include viral, bacterial, and fungal pathogens. The following paper will discuss RTI significance, the differences between upper and lower RTIs, manifesting symptoms for patients with RTIs, and the possible management of RTIs. Significance of RTIs Mortality and morbidity caused by RTIs are a considerable world-wide health challenge. The common etiological agents for respiratory tract infections that pose a significant challenge to health include viruses, influenza, parainfluenza, and adenovirus (Makela, 2000, p. 544). These agents are responsible for acute respiratory tract infections. Depending on the aetiological agents, RTIs have been found to cause major global health challenges. RTIs are responsible for a large number of hospitalisations among children. According to Treanor (2010, p. 32) RTIs increase the health burden, which translates to a significant economic impact in the health sector. In 2009, the H1N1 virus, commonly referred to as swine flu, caused significant health damage across the globe. Therefore, pandemics and epidemics that are related to RTIs have great significance to the health and economy of affected nations. Difference between URTIs and LRTIs The major difference between URTIs and LRTIs is centred on the affected area of the body and the type of infection. The causative agent also varies, though this is not a definite distinction. Infections of the upper respiratory tract are mainly caused by viruses while lower respiratory tract infections are often caused by bacteria (Barton and Spence, 2011, p. 24). Upper respiratory tract infections occur above the chest. The common depictions of URTIs include colds, sinusitis, throat infections, influenza, and tonsillitis. The upper respiratory tract is composed of the nose, bronchi, larynx, and throat. The upper tract is susceptible to acute respiratory infections. The most common infection of the upper respiratory tract is the common cold (Barton and Spence, 2011, p. 27). On the other hand, lower respiratory tract infections affect the trachea and the lungs. Common LRTIs include influenza, which affects the lungs and the bronchi but also transcends from the lower respiratory tract to affect parts of the upper respiratory tract such as the nose and throat. Other common infections of the lower respiratory tract include bronchitis, which affects the bronchi, pneumonia, which affects the lungs and surrounding tissue, and bronchiolitis, which affects the small airways commonly referred to as the bronchioles (Bartlett and Finegold, 2000, p. 58). URTIs and Main Causative Microbial Agents Various agents cause upper respiratory tract infections; common causative agents include bacterial and viral pathogens. Infections in the upper respiratory tract are localised but they sometimes spread to the surrounding areas. URTIs present syndromes that have varying aetiologies. a) Common Cold The causative agent for colds is rhinovirus. Other viruses that may cause the common cold include respiratory syncytial virus (RSV) and the influenza virus. Symptoms include a runny nose, sneezing, nasal congestion, and feeling unwell (Makela, 2000, p. 547). In some instances, sore throat, fever, and cough may occur. Various viral agents cause the common cold. Therefore, laboratory tests may be applied to establish the existence of viral agents. However, in many cases, the diagnosis depends on a physical examination of the upper respiratory tract combined with the patient’s history and symptoms (Turner, 2010, p. 32). b) Influenza The primary causative agent of influenza is the influenza virus. Symptoms include fever, cough, and malaise. Influenza can lead to pneumonic infections that are caused by bacteria. Influenza is very infectious. In 2009, the world experienced a pandemic spread of H1N1, which was caused by influenza A. The laboratory diagnosis of influenza is based on polymerase chain reaction (PCR) using specimens from the respiratory tract. Other laboratory tests include serological methods that analyse the presence of the virus in a serum sample (Treanor, 2010, p. 35). c) Pharyngitis Pharyngitis is characterised by sore throat, inflammation of the pharynx, and fever. There are various causative agents of pharyngitis. However, most of the causative agents are viral. Pharyngitis has different syndromes. Streptococcus pyogenes (GAS) is the most important bacterial causative agent. Laboratory diagnosis entails the identification of the type of pharyngitis caused by GAS. Laboratory tests include culturing throat swabs and gram staining to test the existence of bacterial causative agents. Other quick test methods include the use of rapid antigen detection (RADTs) (Barton and Spence, 2011, p. 31). d) Sinusitis Sinusitis entails the inflammation of the mucosa. The causative agents of sinusitis are viruses. However, there are a minority of infections that are complicated by bacteria. The symptoms include nasal congestion, facial pain, rhinorrhoea, malaise, fever, and a reduced sense of smell. Laboratory diagnosis of sinusitis includes the use of radiological tests and computed tomography. In the case of radiology, plain X-ray imaging is applied. However, these methods are rare in primary care (Barton and Spence, 2011, p. 31). LRTIs and Main Causative Microbial Agents a) Community-Acquired Pneumonia Community-acquired pneumonia (CAP) is a very infectious disease of the lower respiratory tract. The causative agents are bacterial pathogens called Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis (Bartlett and Finegold, 2000, p. 61). These three agents account for over 85% of CAP incidences. Common symptoms include productive cough, pleuritic chest pain, and fever. Lab diagnosis of CAP requires gram straining of the sputum or culturing the sputum. Blood cultures and chest radiography are also used to diagnose CAP. The treatment of patients with CAP entails antibiotics. The antibiotics may be a combination of therapy or application of monotherapy. Common monotherapy includes the use of respiratory quinolones or the use of doxycycline. Combination therapy entails the use of ceftriaxone combined with doxycycline. For patients with compromised immunity, exposure to therapy is prolonged (Bartlett and Finegold, 2000, p. 73). b) Atypical Pneumonia Bacteria agents cause atypical pneumonia. However, the causative bacteria are not the same as the bacteria that cause typical pneumonia. The three causative bacteria include Mycoplasma pneumonia, Legionella pneumophila, and Chlamydophila pneumonia (Limber, 2011, p. 103). The diagnosis of atypical pneumonia includes the culturing of sputum, a blood test for specific antibodies, and blood cultures. Treatment entails the use of antibiotics either orally or intravenously. Severe cases call for the use of supplemental oxygen. c) Aspiration Pneumonia Aspiration pneumonia is characterised by swelling of the lungs or an infection of the large airways or lungs (Limber, 2011, p. 111). The infection occurs when there is an inhalation of secretions of the stomach or contents that are deposited into the lower respiratory tract. The bacterial causative agents depend on the normal flora of the oropharynx. Other pathogens include anaerobes such as Peptostrepcoccus, Fusobacterium, and Prevotella spp. Aspiration pneumonia can cause acute respiratory failure, injury to the lungs, or lung abscess. The treatment of aspiration pneumonia includes the removal of the obstructing object by use of bronchoscopy (Raherison and Taytard, 2003, p. 997). If the obstruction is identified early, a tracheal suction is undertaken. In severe cases, positive pressure intubation is considered an option. The use of antibacterial agents depends on the patient’s condition. d) Lung Abscess Lung abscess entails the formation of cavities that contain necrotic debris (Tokunega and Sugita, 2010, p. 103), as well as necrosis of the pulmonary tissues. Lung abscess is caused by bacteria that originate from the aspiration of oropharyngeal content. The common pathogens that cause lung abscess include Staphylococcus aureus and enteric gram-negative rods. High risk patients include those with periodontal disease, alcohol abusers, and those with disorders of seizures (Mwadumba and Bleeching, 2010, p. 237). A high percentage of lung abscesses (80–90%) are treated with antibiotics in which a broad spectrum of flucloxacillin and cephalosporin may be applied (Wali, 2010, p. 6). In severe cases, management entails the application of supportive measures such as oxygen, analgesia, postural drainage, and rehydration. Conclusion Common RTIs are caused by bacterial and viral infections. RTIs are localised or may spread to adjacent tissues. RTIs are categorised into upper respiratory tract infections and the lower respiratory tract infections. Regardless of the category, RTIs significantly affect health around the world; they can result in pandemics that have enormous economic implications. At the individual level, they cause body discomfort and reduce the productivity of affected people. The management and treatment of RTIs depends on the manifesting syndromes. However, in severe cases, laboratory tests are required to determine the agents responsible for infections. Common management and treatment of RTIs caused by bacterial pathogens include the use of antibiotics. References Barton, L. and Spence, R. (2011) ‘URTIs: Recommended diagnosis and treatment in general practice’, Prescriber, 22(8), pp. 23-34. Bartlett, J. and Finegold, S. (2000) ‘Anaerobic infections of the lung and pleural space’, Am Rev Respir Dis, 110(1), pp. 56-77.  Limper, A. (2011) Overview of pneumonia. Philadelphia, PA: Elsevier Saunders. Makela, T. (2000) ‘Viruses and bacteria in the aetiology of the common cold’, Journal of Clinical Microbiology, 36(2), pp. 539-552. Mwandumba, H. and Beeching, N. (2010) ‘Pyogenic lung infections: Factors for predicting clinical outcome of lung abscess and thoracic empyema’, Current Opinion Pulmonary Medicine, 6(3), pp. 234-9. Raherison, C., and Taytard, A. (2003) ‘Lower respiratory tract infections in adults: Non-antibiotic prescriptions by GPs’, Respiratory Medicine, 97(9), pp. 995-1000. Tokunaga, D. and Sugita, Y. (2010) ‘Etiology and outcome of community-acquired lung abscess’, Respiration, 80(2), pp. 98-105.  Treanor J. (2010) Influenza viruses, including avian influenza and swine influenza: Principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone. Turner, R. (2010) The common cold: Principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone. Wali, S. (2012) ‘An update on the drainage of pyogenic lung abscesses’, Annals of Thoracic Medicine, 7(1), 3-7. Read More