21st May 2024

Respiratory Infections

Respiratory infections

Background

Respiratory infections can involve bacterial, mycobacterial, viral as well as fungal microorganisms. Pneumonia is often used as an umbrella term for a group of syndromes that result in infection of the lung parenchyma. Bacterial causes are often classified under the umbrella “typical” and “atypical”, depending on the causative organism. Viral and fungal infections are also important causative organisms.

Diagnosis

Clinical manifestations of respiratory infections tend to be relatively straightforward. More unusual presentations, such as abdominal pain, can occur. Nevertheless, clinical examination is always warranted with radiological and laboratory evaluation also indicated where required. The CURB-65 score is widely used as a scale for the assessment of respiratory infections. This comprises a point for each of; confusion, urea (> 7 mmol/L), respiratory rate ≥ 30 per minute, diastolic blood pressure ≤60 or systolic blood pressure less than 90 mmHg, and age over 65 years. A score of 4 or more warrants assessment by critical care.

Management

Oral or intravenous antibiotics are the mainstay of therapy, whilst ventilatory support in the form of non-invasive ventilation or continuous positive airway pressure support can be used, though not routinely. Corticosteroids are not routinely indicated.

References

• BMJ Best Practice, Community acquired pneumonia, December 2021. https://bestpractice.bmj.com/topics/en-gb/1113
• Regunath H, Oba Y. Community-Acquired Pneumonia. [Updated 2022 Nov 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430749/