Chest infections lower respiratory

An appropriate treatment regimen for the patient with uncomplicated lower respiratory tract infection usually can be established by patient history, physical examination, chest radiograph, and properly collected sputum for culture interpreted in light of current knowledge of the most common lung pathogens and their antibiotic susceptibility patterns within one s community. 

Suspicion of an lower respiratory tract infection Increased body temperature, coughing with or without sputum (productive or nonproductive), acute dyspnea, with or without general exhaustion and chest pains... 

Neu, H. C., and Chick, T. W. (1993). Efficacy and safety of clarithromycin compared to cefixime as outpatient treatment of lower respiratory tract infections. Chest 104, 1393-1399. 

A 24-year-old male was given ceftriaxone intramuscularly for a lower respiratory tract infection. He then immediately developed chest pain, dyspnoea and redness in the face and eyes. On admission to the hospital, his blood pressure was 90/60 mmHg. An electrocardiogram showed ST elevation, and per the author troponins were borderline elevated (value not given). Coronary angiography was normal on the left, but the right coronary artery showed slow coronary flow and ectasia [67 ]. 

In 1995 he requested tracheal decannulation, which occurred without problems. Volume ventilation with nasal pillows was established as a backup. He remains in the community, works and goes on vacation, enjoying good health. On two occasions he required out patient chest physiotherapy and in-exsufflation to assist with secretion clearance, associated with a lower respiratory infection. On these occasions, he was not satisfied that his secretions were being cleared completely by his manual resuscitator assisted cough or by GPB. 

Fink MP, Helsmoortel CM, Stein KL, Lee PC, Cohn SM. The efficacy of an oscillating bed in the prevention of lower respiratory tract infection in critically ill victims of blunt trauma a prospective study. Chest 1990 97 132-137. 

CF is an aufosomal recessive disease affecting more than 50,000 individuals worldwide, primarily, although not exclusively, white individuals. The disease affects epithelium-lined organs, such as the respiratory and intestinal tracts, of which the former are the site of major morbidity and mortality. Recurrent chest infections and colonization of the lower airways with organisms such as Staphylococcus aureus and Pseudomonas aeruginosa progress to subsequent bronchiectasis and finally respiratory ilure, the most common cause of death. 

---