any individual who has had contact with the healthcare system persons who have

Any individual who has had contact with the

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any individual who has had contact with the healthcare system, persons who have received infusion therapy or dialysis or have resided in a nursing home within 90 days of the diagnosis VAP (Ventilator Associated Pneumonia): occurs in 9- 27% of individuals who require intubation -Klebsiella: common in
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hospitalized, debilitated patients, diabetics, or alcoholics, elderly infected with this bacteria have a high mortality rate Some bacteria release toxins such as pneumolysin which is cytotoxic to virtually every cell in the lung Hospital-Acquired Pneumonia PNA which is diagnosed 48 hours after being admitted to the hospital Common causes include gram-negative bacteria such as Klebsiella, pseudomonas aeuroginosa, E. coli (also seen in healthcare associated) Viral Pneumonia Seasonal, mild, and self- limiting can set the stage for bacterial pneumonia Primary: influenza Secondary: chickenpox, measles Influenzae most common: virus not only destroys the ciliated epithelial cells but also invades the goblet cells and bronchial mucous glands sloughing of destroyed bronchial epithelium prevents mucociliary clearance Tuberculosis Infection caused by Mycobacterium tuberculosis, an acid-fast bacillus Individuals with AIDS are highly susceptible: HIV single greatest risk factor Cancer, immunosuppressive medications, poor nutritional status, renal failure, and other debilitating disease can reactivate disease Latent: asymptomatic Fatigue, weight loss, lethargy, anorexia, low-grade fever that occurs in the afternoon, night sweats Cough that produces purulent sputum develops slowly and becomes more frequent over several weeks Dyspnea, chest pain, hemoptysis Extrapulmonary TB: common with HIV, meningitis symptoms, bone pain, and urinary symptoms Highly contagious and spread through airborne droplets When inhaled become lodged in lung periphery usually upper lobe and cause nonspecific pneumonitis (lung inflammation) Can also lodge into lymph nodes where they encounter lymphatics and initiate an immune response Bacterium can survive within macrophages, resist lysosomal killing, and form well-organized granulomas and transit into a stage of dormancy rendering itself extremely resistant to host and drug treatment Immune response initiated that seal off colonies of
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bacilli forming granulomatous lesions called tubercles, infected tissue within the tubercle die forming cheese-like material called caseation necrosis Once the bacilli are isolated in the tubercle and immunity develops, TB may remain dormant for life When immune system is impairs, progressive action disease occurs and may spread through the blood and lymphatics to other organs Pulmonary Malignancies
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