1. Respiratory Tract Infections
Dr. Muhammad Atif Qureshi
MBBS, FCPS
Associate Professor Medicine

2. Infections of Respiratory Tract
Pharyngitis
Laryngitis
Tracheitis
Bronchitis
Alveolitis
Pneumonia
Tuberculosis
Aspergilosis

3. Laryngitis Clinical features Weak or loss of voice Hoarseness
Rawness in throat or tickling sensation
Dry cough
Dry throat
Sore throat

8. Laryngitis – Acute causes
The majority of laryngitis cases is only temporary and gets better when the underlying illness improves.
Vocal straining
Viral infections – common cold
mumps or measles
Bacterial infections
Diphtheria

9. Laryngitis – Chronic causes
Cases of laryngitis that last more than 3 weeks .
Vocal cord injuries or strain as well as vocal cord growths referred to as nodules or polyps.
Irritants inhaled - chemical allergens, fumes or smoke
Chronic Sinusitis
GERD
Alcohol
Smoking
Habitual vocal overuse – such as cheerleaders or singers
Fungal, bacterial infections
The risk issues for laryngitis consist of:
Respiratory infection - bronchitis, a cold or sinusitis
Overuse of the voice
Exposure to irritants - alcohol, cigarette smoke, stomach acid, or workplace chemicals

10. Laryngitis Treatment
Acute viral Laryngitis usually becomes better on its own in 7 days.
Treatments for chronic laryngitis – treat cause- smoking, excessive alcohol or heartburn.
Antibiotics
In viral laryngitis, antibiotics not very effective.
But bacterial infection usually need antibiotics.
Corticosteroids
Corticosteroids may reduce inflammation of vocal cords. But, only if very urgent need to treat laryngitis.

11. Treatment-Home Remedies
Breathing of moist air
Humidifier.
Rest the voice as much as conceivable
Avoid singing or talking too long or too loudly.
Drink lots of fluids
Avoid caffeine and alcohol
Keep the throat moist
Do this by sucking on a lozenge, chewing gum or gargling with salt water.
Avoid using decongestants
These drugs dry the throat out.
Avoid whispering
This places more straining of the voice than speech that is normal

12. Laryngitis-Complications
Laryngeal edema

13. Tracheitis

14. Tracheitis- causes Viral infections Streptococcus pneumonia
Haemophilus influenza
Moraxella catarrhalis

15. Tracheitis- Clinical Features
Usually follow an upper respiratory infection, initial symptoms such as cough, runny nose, or a low-grade fever may appear.
After two to five days, symptoms of infection and airway obstruction may develop. These symptoms may include:
Deep, severe cough
Breathlessness
High fever
Wheezing
Cyanosis
Stridor - A high-pitched sound while breathing can be a sign of serious infection and represents partial airway obstruction, a potentially fatal condition. 

16. Tracheitis - Diagnosis
Physical examination
Blood oxygen level
Nasopharyngeal culture
Tracheal culture
X-ray of the trachea

17. Acute Tracheitis: Complications
Review possible medical complications related to Acute Tracheitis:
Airway obstruction
Toxic shock syndrome
more complications

18. Acute Bronchitis
Clinical Features
Diagnosis
Treatment

21. Chronic Bronchitis
Clinical features
Diagnosis
Treatment

23. Pneumonia
Bronchopneumonia
Lobar pneumonia

24. Community-acquired pneumonia (CAP)
Pneumonia in persons who have not recently been hospitalized.
Can affect all ages.
CAP occurs throughout the world and is a leading cause of illness and death.
Causes of CAP include bacteria, viruses, fungi and parasites.

26. Causes of pneumonia
H. influenza
S. pneumonae
Klebsiella Pneumonae

28. Symptoms of CAP Dyspnea Cough with greenish or yellow sputum
High grade fever with sweating, chills, and rigors
Sharp or stabbing chest pain increased by breathing
Less commonly:
Hemoptysis
Headache
Anorexia
excessive fatigue
Cyanosis
Nausea and vomiting
Diarrhea
Arthralgias and muscle aches

29. Symptoms of CAP commonly include:
In older people typical symptoms may not be present early in disease :
New or worsening confusion
Hypothermia
Overly sleepy

30. Risk factors
Some people have a high risk
Obstruction - foreign bodies especially in infants or lung cancer in elders.
Underlying lung diseases - emphysema, smoking, cystic fibrosis, pulmonary sequestration.
Immunocompromised people are more likely to get CAP, like AIDS etc.

31. Diagnosis Symptoms on history Signs on physical examination
Laboratory investigations
Blood counts
Arterial blood gases
X-ray chest
VQ-scan
CT scan
Blood cultures

36. Chest auscultation

45. Ventilation perfusion scan

47. Treatment General management Rest Antipyretics Pain relief Oxygen
Cough syrups
Oral or intravenous antibiotics

48. Treatment Macrolides Flouroquinolones
Doxycline first choice in UK for atypical pneumonias

51. Complications
SEPSIS
Streptococcus pneumoniae is the most common cause.
Individuals with sepsis require hospitalization in an intensive care unit, i.v. antibiotics. Sepsis can cause liver, kidney, and heart damage.
RESPIRATORY FAILURE
May need mechanical ventilation
PLEURAL EFFUSION AND EMPYEMA
Thoracocentesis
Chest tube insertion
Lung Abscess

52. Pulse oxymetry

53. Prognosis Mortality in CAP less than 1%.
Fever typically responds in the first two days of therapy and other symptoms resolve in the first week.
The x-ray, may remain abnormal for at least a month.
Among individuals hospitalized, the mortality rate averages 12% overall, but is as much as 40% in people who have bacterimia and septicemia or require intensive care.

56. Thank You