Showing posts with label emergency. Show all posts
Showing posts with label emergency. Show all posts
Friday, September 19, 2008
A Simple Guide to Croup
A Simple Guide to Croup
-----------------------------------
What is Croup?
---------------------------
Croup is an acute viral disease of the upper and lower respiratory tract associated with inspiratory stridor ( whistling obstructive sound during inhalation) and respiratory distress in severe cases.
It typically affects infants and children below 6 years old.
It causes a typically barking type of cough and hoarseness of the voice due to obstruction at the vocal box.
What are the causes of Croup?
----------------------------------------
Viral infections:
--------------------
1.parainfluenza virus, primarily types 1 and 2
2.Other viral infections such as adenorhinovirnese, enterovirus and mycoplasma pneumoniae
Genetic predisposition:
------------------------
Some families are more prone than others to get the disease.
It is also more common in males than females.
What are Signs and symptoms of Croup?
---------------------------------------------
Symptoms:
1.harsh barking cough
2.sneeze
3.inspiratory stridor (a high-pitched whistling sound during inspiration),
4.nausea and vomiting
5.fever.
6.Hoarseness -usually present
7.respiratory distress due to airway obstruction
8.lethargy
Signs:
1.Reduced breath sounds - air movement is reduced in the lungs
2.Prolonged inspiration on auscultation with laryngeal stridor
3.Chest retraction
4.Cyanosis(blue color) of the lips and fingers if not enough oxygen is entering.
This will considered as a medical emergency.
How is the diagnosis of Croup made?
------------------------------------------
1.Symptoms and signs of fever, laryngeal stridor and barking cough
2.blood tests (complete blood count, ESR and blood culture)
5.frontal X-ray of the C-spine
the presence of the the steeple sign confirms the diagnosis of croup.
What are the complications of Croup?
-----------------------------------------------
1.Respiratory distress
2.Bacterial tracheitis
What is the treatment of Croup?
------------------------------------
1.Rest, fluids and oxygen
2.Humidifiers and steam inhalations
3.Corticosteroids especially dexamethasone are the most commonly used agent as it reduces inflammation
4.Antibiotics are not useful because the cause is viral. If there is bacterial tracheitis, antibiotics may be needed
5.Bronchodilators such as theophylline, epinephrine, ventolin, bricanyl are all helpful to open the airways
6.Intubation and tracheostomy may be needed in severe cases.
What is the prognosis of Croup ?
------------------------------------------
This depends on the severity and type of infection.
Most cases, if treated early and correctly, recovered completely with return of normal lung function within 7 days.
What are the Preventive measures taken for Croup ?
--------------------------------------------------------
Vaccination against the influenza virus may help.
Friday, September 12, 2008
A Simple Guide to Retinal detachment
A Simple Guide to Retinal detachment
----------------------------------------------
What is Retinal detachment?
---------------------------------------
Retinal detachment is a condition in which there is a separation of the neurosensory retina from the underlying retinal pigment epithelium.
It is a medical emergency.
Who is affected by Retinal detachment?
------------------------------------------------
The following are at risk from Retinal detachment:
1. age above 55 yrs
4. very short sighted (myopia usually above 5-6 diopters)
3. history of serious eye injury (injury to orbits)
4. history of eye cataract surgery
5. Sports activities which can cause injuries to the eye (Boxing, karate etc) or increase pressure in the eye( bunjee jumping, diving etc)
6. family history of Retinal detachment -related to family history of diabetes, sickle cell disease and other underlying condition
What is the cause of Retinal detachment?
------------------------------------------------
There are 2 types of retinal detachment:
Primary:
-------------
There is a hole in the retina which allows the seepage of vitreous humor between the the neurosensory retinal layer and the retinal pigment eipthelium which cause the separation of the 2 layers.
The holes are usually at the periphery.
It is a degenerative condition which can be aggravated by trauma especially in the severe myopic(short sighted) and senile (old) eyes.
Secondary:
---------------
Other eye diseases which can separate the 2 layers are:
1.Choroiditis- inflammation of the choroid cause exudation of serous fluid under the retina layer
2.Toxemic retinopathy - inflammation of the retina cause exudation of serous fluid under the retina layer
3.proliferative diabetic retinopathy - abnormal blood vessels grow within the retina causing the retina to pull away from the wall of the eye
4.vitreous hemorrhage after injury to the orbits - blood clot and fibrovasular tissue developing from the blood clot can cause separation of the nuerosensory retina and pigmented retina layer.
5.Choroidal melanoma(a malignant tumor) - a growth below the layers of the retina can push the layer of retina from the back of the eye
What are symptoms and signs of Retinal detachment?
---------------------------------------------------------
Symptoms:
--------------
1.transient flashes of light
2.a sudden increase of floaters in one eye
3.a ring of floaters at the temporal region of the central vision
4.a feeling of heaviness in the eye
5.presence of cloud in front of the eye so that parts of an object are not seen
6.the sensation of a curtain falling over the central vision of eye
7.Straight lines that become curved
8.Central vision intact at first followed by complete and total loss of vision if untreated
Signs:
-----------------
1. In early stage, direct opthalmoscopy show very little abnormality
2. Indirect opthalmoscopy may show the presence of the detachment.
3. The pale white or grey folds of the detachment can be seen
How is Retinal detachment diagnosed?
---------------------------------------------
1. Indirect opthalmoscopy with slit-lamp examination is the best method to detect early or shallow detachment and to identify the retinal holes.
2.Transillumination and ultrasound may be usefulto detect neoplasm
3.Flourescin angiography may be needed in special cases to establish the presence of retinal detachment.
What are the complications of Retinal detachment?
-------------------------------------------------------
Partial to complete loss of vision.
What is the treatment for Retinal detachment?
-------------------------------------------------
Retinal detachment is a medical emergency.
The most important part of treatment is finding the holes or tears and closing them.
Primary:
--------------
1.Vitrectomy (most common procedure)
Vitrectomy involves the removal of the vitreous gel followed by filling the eye with a gas bubble (SF6 or C3F8 gas).
Side effect is the more rapid progression of a cataract in the operated eye.
2.Cryotherapy and Laser Photocoagulation
Cryotherapy (freezing) and laser photocoagulation are used to create a adhesion around the retinal hole so that fluid cannot enter the hole and accumulate behind the retina resulting in the retinal detachment.
3.Adatomed Silicone Oil
Adatomed Silicone Oil is injected into the eye and mechanically holds the retina in place.
The oil is usually removed within a year.
4.Scleral buckle surgery
The choroid and retina are brought together by buckling the sclera with silicone bands sewn by the eye surgeon to the outside of the eyeball.
The most common side effect of this operation is more short sighted after the operation.
5.Pneumatic retinopexy
This operation is done under local anesthesia by injecting a gas bubble (SF6 or C3F8 gas) into the eye after which laser or freezing treatment is applied to the retinal hole. The patient may have to keep his head tilted for several days to keep the gas bubble in contact with the retinal hole in order to seal the hole..
6.Ignipuncture
Ignipuncture involves cauterization of the retina with a very hot pointed instrument.It is no longer used.
After treatment the results are usually good and vision is regained over a period of a few weeks.
Secondary:
----------------
1.Neoplasm: surgical removal of neoplasm
2.Traction detachment: vitreous surgery, prognosis is poor
3.Others:Fluids usually resorbs as underlying condition is treated.
How is Retinal detachment monitored?
-----------------------------------------
1.regular follow up with the eye doctor.
2.examining the retina for further damage
3.analysing the visual fields.
With proper monitoring and treatment most patients will be less likely to be at risk of blindness.
What is the prognosis of Retinal detachment?
----------------------------------------------------
The prognosis varies depending on the the underlying disease.
Prognosis is good if the condition is diagnosed and treated early although visual acuity may not be as good as before.
How can Retina Detachment be prevented?
------------------------------------------
Retinal detachment can be prevented:
1.educating people of the symptoms suggestive of a posterior vitreous detachment.
2.Eye examination to detect retinal tears which can be treated with laser or cryotherapy.
3.Avoid known risk factors for retinal detachment.
a.Cataract surgery
b.Trauma (boxing, kickboxing, karate, etc.)
c.high level of myopia
d.activities that increase pressure in the eye, including diving, skydiving, bungee jumping
----------------------------------------------
What is Retinal detachment?
---------------------------------------
Retinal detachment is a condition in which there is a separation of the neurosensory retina from the underlying retinal pigment epithelium.
It is a medical emergency.
Who is affected by Retinal detachment?
------------------------------------------------
The following are at risk from Retinal detachment:
1. age above 55 yrs
4. very short sighted (myopia usually above 5-6 diopters)
3. history of serious eye injury (injury to orbits)
4. history of eye cataract surgery
5. Sports activities which can cause injuries to the eye (Boxing, karate etc) or increase pressure in the eye( bunjee jumping, diving etc)
6. family history of Retinal detachment -related to family history of diabetes, sickle cell disease and other underlying condition
What is the cause of Retinal detachment?
------------------------------------------------
There are 2 types of retinal detachment:
Primary:
-------------
There is a hole in the retina which allows the seepage of vitreous humor between the the neurosensory retinal layer and the retinal pigment eipthelium which cause the separation of the 2 layers.
The holes are usually at the periphery.
It is a degenerative condition which can be aggravated by trauma especially in the severe myopic(short sighted) and senile (old) eyes.
Secondary:
---------------
Other eye diseases which can separate the 2 layers are:
1.Choroiditis- inflammation of the choroid cause exudation of serous fluid under the retina layer
2.Toxemic retinopathy - inflammation of the retina cause exudation of serous fluid under the retina layer
3.proliferative diabetic retinopathy - abnormal blood vessels grow within the retina causing the retina to pull away from the wall of the eye
4.vitreous hemorrhage after injury to the orbits - blood clot and fibrovasular tissue developing from the blood clot can cause separation of the nuerosensory retina and pigmented retina layer.
5.Choroidal melanoma(a malignant tumor) - a growth below the layers of the retina can push the layer of retina from the back of the eye
What are symptoms and signs of Retinal detachment?
---------------------------------------------------------
Symptoms:
--------------
1.transient flashes of light
2.a sudden increase of floaters in one eye
3.a ring of floaters at the temporal region of the central vision
4.a feeling of heaviness in the eye
5.presence of cloud in front of the eye so that parts of an object are not seen
6.the sensation of a curtain falling over the central vision of eye
7.Straight lines that become curved
8.Central vision intact at first followed by complete and total loss of vision if untreated
Signs:
-----------------
1. In early stage, direct opthalmoscopy show very little abnormality
2. Indirect opthalmoscopy may show the presence of the detachment.
3. The pale white or grey folds of the detachment can be seen
How is Retinal detachment diagnosed?
---------------------------------------------
1. Indirect opthalmoscopy with slit-lamp examination is the best method to detect early or shallow detachment and to identify the retinal holes.
2.Transillumination and ultrasound may be usefulto detect neoplasm
3.Flourescin angiography may be needed in special cases to establish the presence of retinal detachment.
What are the complications of Retinal detachment?
-------------------------------------------------------
Partial to complete loss of vision.
What is the treatment for Retinal detachment?
-------------------------------------------------
Retinal detachment is a medical emergency.
The most important part of treatment is finding the holes or tears and closing them.
Primary:
--------------
1.Vitrectomy (most common procedure)
Vitrectomy involves the removal of the vitreous gel followed by filling the eye with a gas bubble (SF6 or C3F8 gas).
Side effect is the more rapid progression of a cataract in the operated eye.
2.Cryotherapy and Laser Photocoagulation
Cryotherapy (freezing) and laser photocoagulation are used to create a adhesion around the retinal hole so that fluid cannot enter the hole and accumulate behind the retina resulting in the retinal detachment.
3.Adatomed Silicone Oil
Adatomed Silicone Oil is injected into the eye and mechanically holds the retina in place.
The oil is usually removed within a year.
4.Scleral buckle surgery
The choroid and retina are brought together by buckling the sclera with silicone bands sewn by the eye surgeon to the outside of the eyeball.
The most common side effect of this operation is more short sighted after the operation.
5.Pneumatic retinopexy
This operation is done under local anesthesia by injecting a gas bubble (SF6 or C3F8 gas) into the eye after which laser or freezing treatment is applied to the retinal hole. The patient may have to keep his head tilted for several days to keep the gas bubble in contact with the retinal hole in order to seal the hole..
6.Ignipuncture
Ignipuncture involves cauterization of the retina with a very hot pointed instrument.It is no longer used.
After treatment the results are usually good and vision is regained over a period of a few weeks.
Secondary:
----------------
1.Neoplasm: surgical removal of neoplasm
2.Traction detachment: vitreous surgery, prognosis is poor
3.Others:Fluids usually resorbs as underlying condition is treated.
How is Retinal detachment monitored?
-----------------------------------------
1.regular follow up with the eye doctor.
2.examining the retina for further damage
3.analysing the visual fields.
With proper monitoring and treatment most patients will be less likely to be at risk of blindness.
What is the prognosis of Retinal detachment?
----------------------------------------------------
The prognosis varies depending on the the underlying disease.
Prognosis is good if the condition is diagnosed and treated early although visual acuity may not be as good as before.
How can Retina Detachment be prevented?
------------------------------------------
Retinal detachment can be prevented:
1.educating people of the symptoms suggestive of a posterior vitreous detachment.
2.Eye examination to detect retinal tears which can be treated with laser or cryotherapy.
3.Avoid known risk factors for retinal detachment.
a.Cataract surgery
b.Trauma (boxing, kickboxing, karate, etc.)
c.high level of myopia
d.activities that increase pressure in the eye, including diving, skydiving, bungee jumping
Wednesday, September 10, 2008
A Simple Guide to Bronchitis
A Simple Guide to Bronchitis
-----------------------------------
What is Bronchitis?
---------------------------
Bronchitis is an acute disease which causes inflammation and infection of the trachea, bronchi and bronchioles of the lungs.
The mucous membranes of the bronchi of the lungs becomes inflamed from bacterial or viral infection or irritated by fumes and dust in the air resulting in swelling of the bronchial mucosa with excess mucous discharge causing narrowing of the air passages.
Because of the congestion of the brochi there is difficulty in breathing and insufficient oxygen to the body thus posing a danger to the patient's life .
What are the causes of Bronchitis?
----------------------------------------
Bacterial Infections:
----------------------------
1.Gram positive bacteria such as Streptococcus Bronchitise and Staphphylococcus may be serious and fatal in some cases.
2.Gram negative bacteria such as Klebsiella, E.coli, Pseudomonas, Mycobacteria(including tuberculosis), Legionaire's Disease,chlamydia
Viral infections:
--------------------
Influenza, arbovirus, Severe Acute Respiratory Syndrome(SARS) virus, coxsackie virus
Fungal infections:
-----------------------
Cryptococcus neoformans
Non-infectious:
------------------
1.chemicals such as fumes can damage the lungs and cause Bronchitis
2.Othostatic Bronchitis occurs in people who are bedridden and are unable to get rid of the fluids accumulated in their lungs
3.Aspiration Bronchitis occurs with saliva or fluids in the throat become sucked into the windpipe and the lungs.
This occurs in comatose patients and people having seizures or stroke.
What are Signs and symptoms of Bronchitis?
---------------------------------------------
Symptoms:
1.cold or runny nose is usually the first symptom
2.Fever may be present
3.cough initially dry, followed by productive purulent sputum which can yellow, green or bloody
4.Breathlessness due to airway obstruction
5.chest pain especially the sides of the chest due to coughing and fever
6.Myalgia (bodyaches) and headache which may be related to the fever
Signs:
1.Moist sounds and wheezing on auscultation with sthetoscope due to narrowing of the airways(bronchi)
2.rhonchi or wheezing sounds due to narrowing of the airways from pressure in the congested lungs
3.Reduced breath sounds - air movement is reduced in the lungs
4.Hyporesonance on percussion of the lungs
5.Cyanosis(blue color) of the lips and fingers if not enough oxygen is entering.
This will considered as a medical emergency.
Children and babies with Bronchitis may not have signs of a chest infection.
They are however quite ill, with fever and lethargy.
How is the diagnosis of Bronchitis made?
------------------------------------------
1.Symptoms and signs of fever, breathless and productive cough
2.blood tests (complete blood count, ESR and blood culture)
3.Sputum culture to determine the type of micro-organism
4.Chest X-rays to establish site and character of the bronchial infection
5.CT or MRI of the lungs may be done if required especailly if there is suspicion of lung cancer.
What are the complications of Bronchitis?
-----------------------------------------------
1.Pneumonia
2.adult respiratory distress syndrome
3.Emphysema
What is the treatment of Bronchitis?
------------------------------------
1.Rest, fluids and oxygen
2.Bronchidilators such as aminophylline, ventolin, bricanyl
3.Antibiotics depending on the organism found:
a.cephalosporin, penicillin, ampicillin, tetracycline, for most streptococci, staphalococci, hemophilus
b.cephalosporins, gentamycin for pseudomonas
c.Tetracycline or erythromycin for mycoplasma and chlamydia
d.Erythromycin and rifampicin for Legionaire's disease.
3.Antivirals such as Tamiflu for Influeza infection
Acyclovir may be given for herpes virus infection
4.High dosages of antifungals may be given for Fungal Bronchitis for a prolonged period of time
5.corticosteroids is useful to reduce complications
6.Humidifiers and steam inhalations
5.cough mixtures and mucolytic agents such as bisolvon
What is the prognosis of Bronchitis ?
------------------------------------------
This depends on the severity and type of infection.
Most cases if treated early and correctly recovered completely with return of normal lung function.
In elderly and debilitated patients, breathing can be a problem and recurrence can occur.
What are the Preventive measures taken for Bronchitis ?
--------------------------------------------------------
1.Avoid smoking and dusty environment.
2.Healthy lifestyle with balanced diet and exercise.
3.Vaccination against the influenza virus may help.
-----------------------------------
What is Bronchitis?
---------------------------
Bronchitis is an acute disease which causes inflammation and infection of the trachea, bronchi and bronchioles of the lungs.
The mucous membranes of the bronchi of the lungs becomes inflamed from bacterial or viral infection or irritated by fumes and dust in the air resulting in swelling of the bronchial mucosa with excess mucous discharge causing narrowing of the air passages.
Because of the congestion of the brochi there is difficulty in breathing and insufficient oxygen to the body thus posing a danger to the patient's life .
What are the causes of Bronchitis?
----------------------------------------
Bacterial Infections:
----------------------------
1.Gram positive bacteria such as Streptococcus Bronchitise and Staphphylococcus may be serious and fatal in some cases.
2.Gram negative bacteria such as Klebsiella, E.coli, Pseudomonas, Mycobacteria(including tuberculosis), Legionaire's Disease,chlamydia
Viral infections:
--------------------
Influenza, arbovirus, Severe Acute Respiratory Syndrome(SARS) virus, coxsackie virus
Fungal infections:
-----------------------
Cryptococcus neoformans
Non-infectious:
------------------
1.chemicals such as fumes can damage the lungs and cause Bronchitis
2.Othostatic Bronchitis occurs in people who are bedridden and are unable to get rid of the fluids accumulated in their lungs
3.Aspiration Bronchitis occurs with saliva or fluids in the throat become sucked into the windpipe and the lungs.
This occurs in comatose patients and people having seizures or stroke.
What are Signs and symptoms of Bronchitis?
---------------------------------------------
Symptoms:
1.cold or runny nose is usually the first symptom
2.Fever may be present
3.cough initially dry, followed by productive purulent sputum which can yellow, green or bloody
4.Breathlessness due to airway obstruction
5.chest pain especially the sides of the chest due to coughing and fever
6.Myalgia (bodyaches) and headache which may be related to the fever
Signs:
1.Moist sounds and wheezing on auscultation with sthetoscope due to narrowing of the airways(bronchi)
2.rhonchi or wheezing sounds due to narrowing of the airways from pressure in the congested lungs
3.Reduced breath sounds - air movement is reduced in the lungs
4.Hyporesonance on percussion of the lungs
5.Cyanosis(blue color) of the lips and fingers if not enough oxygen is entering.
This will considered as a medical emergency.
Children and babies with Bronchitis may not have signs of a chest infection.
They are however quite ill, with fever and lethargy.
How is the diagnosis of Bronchitis made?
------------------------------------------
1.Symptoms and signs of fever, breathless and productive cough
2.blood tests (complete blood count, ESR and blood culture)
3.Sputum culture to determine the type of micro-organism
4.Chest X-rays to establish site and character of the bronchial infection
5.CT or MRI of the lungs may be done if required especailly if there is suspicion of lung cancer.
What are the complications of Bronchitis?
-----------------------------------------------
1.Pneumonia
2.adult respiratory distress syndrome
3.Emphysema
What is the treatment of Bronchitis?
------------------------------------
1.Rest, fluids and oxygen
2.Bronchidilators such as aminophylline, ventolin, bricanyl
3.Antibiotics depending on the organism found:
a.cephalosporin, penicillin, ampicillin, tetracycline, for most streptococci, staphalococci, hemophilus
b.cephalosporins, gentamycin for pseudomonas
c.Tetracycline or erythromycin for mycoplasma and chlamydia
d.Erythromycin and rifampicin for Legionaire's disease.
3.Antivirals such as Tamiflu for Influeza infection
Acyclovir may be given for herpes virus infection
4.High dosages of antifungals may be given for Fungal Bronchitis for a prolonged period of time
5.corticosteroids is useful to reduce complications
6.Humidifiers and steam inhalations
5.cough mixtures and mucolytic agents such as bisolvon
What is the prognosis of Bronchitis ?
------------------------------------------
This depends on the severity and type of infection.
Most cases if treated early and correctly recovered completely with return of normal lung function.
In elderly and debilitated patients, breathing can be a problem and recurrence can occur.
What are the Preventive measures taken for Bronchitis ?
--------------------------------------------------------
1.Avoid smoking and dusty environment.
2.Healthy lifestyle with balanced diet and exercise.
3.Vaccination against the influenza virus may help.
Monday, August 18, 2008
A Simple Guide to Pneumonia
A Simple Guide to Pneumonia
-----------------------------------
What is Pneumonia?
---------------------------
Pneumonia is a serious medical disease which causes inflammation and infection of the lung tissues of one or both lungs.
The alveoli of the lungs are filled with exudates and white blood cells sent by the body to contain the infection.
Because of the congestion of the lungs there is difficulty in breathing and insufficient oxygen to the body thus posing a danger to the patient's life .
It is one of the top causes of death in the world.
What are the causes of Pneumonia?
----------------------------------------
Bacterial Infections:
----------------------------
1.Gram positive bacteria such as Streptococcus pneumoniae and Staphylococcus may be serious and fatal in some cases.
2.Gram negative bacteria such as Klebsiella, E.coli, Pseudomonas, Mycobacteria(including tuberculosis), Legionaire's Disease,chlamydia
Mycobacterium tuberculosis pneumonia are more common in developing countries and in people whose immune systems are impaired(e.g. AIDS) and are preceded by active tuberculosis infections elsewhere.
Viral infections:
--------------------
Influenza, arbovirus, Severe Acute Respiratory Syndrome(SARS) virus, coxsackie virus
Fungal infections:
-----------------------
Cryptococcus neoformans
Non-infectious:
------------------
1.chemicals such as asbestos can damage the lungs and cause pneumonia
2.Othostatic pneumonia occurs in people who are bedridden and are unable to get rid of the fluids accumulated in their lungs
3.Aspiration pneumonia occurs with saliva or fluids in the throat become sucked into the windpipe and the lungs.
This occurs in comatose patients and people having seizures or stroke.
What are Signs and symptoms of pneumonia?
---------------------------------------------
Symptoms:
1.cold or runny nose is usually the first symptom
2.Fever is usually high
3.cough with productive purulent sputum which can yellow, green or bloody
4.Breathlessness due to congestion of the lungs
5.chest pain especially the sides of the chest due to coughing and fever
6.Myalgia (bodyaches) and headache which may be related to the fever
7.abdominal discomfort
8.lethargy especially in small children
Signs:
1.creptitation sounds on auscultation with stethoscope due to large amount of phlegm in the alveoli of the lungs
2.rhonchi or wheezing sounds due to narrowing of the airways from pressure in the congested lungs
3.Reduced breath sounds - air movement is reduced in the lungs
4.Hyporesonance on percussion of the lungs
5.Cyanosis(blue color) of the lips and fingers if not enough oxygen is entering.
This will considered as a medical emergency.
Children and babies with pneumonia may not have signs of a chest infection.
They are however quite ill, with fever and lethargy.
Elderly people also do not have much symptoms except for fever and breathlessness
How is the diagnosis of Pneumonia made?
------------------------------------------
1.Symptoms and signs of fever, breathless and productive cough
2.blood tests (complete blood count, ESR and blood culture) including viral and legionaire's disease
3.Sputum culture to determine the type of micro-organism
4.Chest X-rays to establish site and character of the lung infection
5.Pleural tap may be necessary if there is pleural effusion. The pleural aspirate is then sent for culture and microscopic examination.
6.CT or MRI of the lungs may be done if required especailly if there is suspicion of lung cancer.
What are the complications of Pneumonia?
-----------------------------------------------
1.Pleural effusion
2.septic shock,
3.adult respiratory distress syndrome
4.seizures also more in children
5.Emphysema
6.Pericarditis
What is the treatment of pneumonia?
------------------------------------
1.Hospitalization should be immediate as pneumonia can be a life threatening condition.
2.Antibiotics depending on the organism found:
a.cephalosporin, penicillin, ampicillin, tetracycline, for most streptococci, staphalococci, hemophilus
b.cephalosporins, gentamycin for pseudomonas
c.Tetracycline or erythromycin for mycoplasma and chlamydia
d.Erythromycin and rifampicin for Legionaire's disease.
3.Antivirals such as Tamiflu for Influenza infection
Acyclovir may be given for herpes virus infection
4.High dosages of anti-fungals may be given for Fungal pneumonia for a prolonged period of time
3.corticosteroids is useful to reduce complications
4.High-flow oxygen
5.intravenous fluids
What is the prognosis of pneumonia ?
------------------------------------------
This depends on the severity and type of infection.
Most cases if treated early and correctly recovered completely.
The elderly, babies and bedridden has a higher mortality.
What are the Preventive measures taken for pneumonia ?
--------------------------------------------------------
Vaccinations against Haemophilus influenzae in children and adults has reduced the incidence of this form of pneumonia.
Pneumococcal vaccine against Streptococcus pneumoniae has been given to newborns to prevent pneumonia.
Vaccinations are recommended in:
Adults age 65 or older
Patient over two years of age
1. with diseased lungs, heart, liver, or kidneys
2. health problems like diabetes, alcoholism, AIDS
3. taking any medications or therapy that can affect the body's immune system
e.g chemotherapy
-----------------------------------
What is Pneumonia?
---------------------------
Pneumonia is a serious medical disease which causes inflammation and infection of the lung tissues of one or both lungs.
The alveoli of the lungs are filled with exudates and white blood cells sent by the body to contain the infection.
Because of the congestion of the lungs there is difficulty in breathing and insufficient oxygen to the body thus posing a danger to the patient's life .
It is one of the top causes of death in the world.
What are the causes of Pneumonia?
----------------------------------------
Bacterial Infections:
----------------------------
1.Gram positive bacteria such as Streptococcus pneumoniae and Staphylococcus may be serious and fatal in some cases.
2.Gram negative bacteria such as Klebsiella, E.coli, Pseudomonas, Mycobacteria(including tuberculosis), Legionaire's Disease,chlamydia
Mycobacterium tuberculosis pneumonia are more common in developing countries and in people whose immune systems are impaired(e.g. AIDS) and are preceded by active tuberculosis infections elsewhere.
Viral infections:
--------------------
Influenza, arbovirus, Severe Acute Respiratory Syndrome(SARS) virus, coxsackie virus
Fungal infections:
-----------------------
Cryptococcus neoformans
Non-infectious:
------------------
1.chemicals such as asbestos can damage the lungs and cause pneumonia
2.Othostatic pneumonia occurs in people who are bedridden and are unable to get rid of the fluids accumulated in their lungs
3.Aspiration pneumonia occurs with saliva or fluids in the throat become sucked into the windpipe and the lungs.
This occurs in comatose patients and people having seizures or stroke.
What are Signs and symptoms of pneumonia?
---------------------------------------------
Symptoms:
1.cold or runny nose is usually the first symptom
2.Fever is usually high
3.cough with productive purulent sputum which can yellow, green or bloody
4.Breathlessness due to congestion of the lungs
5.chest pain especially the sides of the chest due to coughing and fever
6.Myalgia (bodyaches) and headache which may be related to the fever
7.abdominal discomfort
8.lethargy especially in small children
Signs:
1.creptitation sounds on auscultation with stethoscope due to large amount of phlegm in the alveoli of the lungs
2.rhonchi or wheezing sounds due to narrowing of the airways from pressure in the congested lungs
3.Reduced breath sounds - air movement is reduced in the lungs
4.Hyporesonance on percussion of the lungs
5.Cyanosis(blue color) of the lips and fingers if not enough oxygen is entering.
This will considered as a medical emergency.
Children and babies with pneumonia may not have signs of a chest infection.
They are however quite ill, with fever and lethargy.
Elderly people also do not have much symptoms except for fever and breathlessness
How is the diagnosis of Pneumonia made?
------------------------------------------
1.Symptoms and signs of fever, breathless and productive cough
2.blood tests (complete blood count, ESR and blood culture) including viral and legionaire's disease
3.Sputum culture to determine the type of micro-organism
4.Chest X-rays to establish site and character of the lung infection
5.Pleural tap may be necessary if there is pleural effusion. The pleural aspirate is then sent for culture and microscopic examination.
6.CT or MRI of the lungs may be done if required especailly if there is suspicion of lung cancer.
What are the complications of Pneumonia?
-----------------------------------------------
1.Pleural effusion
2.septic shock,
3.adult respiratory distress syndrome
4.seizures also more in children
5.Emphysema
6.Pericarditis
What is the treatment of pneumonia?
------------------------------------
1.Hospitalization should be immediate as pneumonia can be a life threatening condition.
2.Antibiotics depending on the organism found:
a.cephalosporin, penicillin, ampicillin, tetracycline, for most streptococci, staphalococci, hemophilus
b.cephalosporins, gentamycin for pseudomonas
c.Tetracycline or erythromycin for mycoplasma and chlamydia
d.Erythromycin and rifampicin for Legionaire's disease.
3.Antivirals such as Tamiflu for Influenza infection
Acyclovir may be given for herpes virus infection
4.High dosages of anti-fungals may be given for Fungal pneumonia for a prolonged period of time
3.corticosteroids is useful to reduce complications
4.High-flow oxygen
5.intravenous fluids
What is the prognosis of pneumonia ?
------------------------------------------
This depends on the severity and type of infection.
Most cases if treated early and correctly recovered completely.
The elderly, babies and bedridden has a higher mortality.
What are the Preventive measures taken for pneumonia ?
--------------------------------------------------------
Vaccinations against Haemophilus influenzae in children and adults has reduced the incidence of this form of pneumonia.
Pneumococcal vaccine against Streptococcus pneumoniae has been given to newborns to prevent pneumonia.
Vaccinations are recommended in:
Adults age 65 or older
Patient over two years of age
1. with diseased lungs, heart, liver, or kidneys
2. health problems like diabetes, alcoholism, AIDS
3. taking any medications or therapy that can affect the body's immune system
e.g chemotherapy
Friday, August 15, 2008
A Simple Guide to Meningitis
A Simple Guide to Meningitis
-----------------------------------
What is Meningitis?
---------------------------
Meningitis is a serious medical disease which causes inflammation and infection of the meninges which are the protective lining of the spinal cord and brain.
What are the causes of Meningitis?
----------------------------------------
The causes of Meningitis may be divided into:
Infections:
------------
1.viral infections are the most common and are usually mild
(enterovirus, herpes simplex virus 2 and mumps) except for Hand mouth and foot disease(enterovirus EV7)which can cause fatality in children
2.bacterial infections such as meningoccocus (Neisseria meningitidis) and pneumococcus (Streptococcus pneumoniae) can be serious and fatal in some cases.
Meningococcal meningitis can cause outbreaks(spread easily).
E.coli, Group B streptococus and Pseudomonas infection are common in neonates.
Neisseria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae are common in infants and children
Streptococcus pneumoniae, N. meningitidis, Mycobacteria are more common in adults.
Mycobacterium tuberculosis meningitis are more common in developing countries and in people whose immune systems are impaired(eg. AIDS) and are preceded by active tuberculosis infections elsewhere.
3.fungi
Cryptococcus neoformans is the most common cause of fungal meningitis
Non-infectious:
------------------
Non infectious causes usually irritates the meninges through inflammation and auto immune reactions:
1.cancers,
2.systemic lupus erythematosus
3.drugs.
4.head injury
5.post neurosurgical procedures
What are Signs and symptoms of Meningitis?
---------------------------------------------
The triad of symptoms which often defines meningitis are:
1.Severe headache
2.Neck rigidity (unable to flex the neck forward),
A positive Kernig's sign means that the neck will painful when one hip is flexed to 90 degrees and the knee flexed to 90 degrees in a patient lying supine.
3.vomiting
Other symptoms are:
4.high fever
5.mental confusion.
6.Malaise
7.photo-phobia (inability to tolerate bright light),
8.phono-phobia (inability to tolerate loud noises),
9.irritability especially in small children
10.seizures .
11.swelling of the fontanelle may be present in infants
12.rash with numerous small, irregular red spots on the body, lower legs, soles of feet, palms
13.ulcers of the mouth (present in hand,mouth and foot disease).
How is the diagnosis of Meningitis made?
------------------------------------------
1.Classical symptoms and signs as above especially neck rigidity
2.blood tests (complete blood count, ESR and blood culture)
3.X-rays of chest and brain
4.cerebrospinal fluid (CSF) analysis via lumbar puncture is examined for white blood cells, red blood cells, protein content, glucose level and micro-organisms.
This test should not be done if there is suspected cerebral mass lesion or raised intracranial pressure (head injury, localizing neurological signs)
A pressure of over 180 mm suggests bacterial meningitis.
5.CSF glucose is low,protein high and cells high in bacterial meningitis,
CSF glucose is normal,protein normal and cells high in viral meningitis
CSF glucose is low,protein high and cells high in fungal meningitis
6.CT or MRI of the brain and spine with MRI preferred over CT because it can detect more easily areas of cerebral edema,tumors, ischemia, and meningeal inflammation.
What are the complications of Meningitis?
-----------------------------------------------
1.Neurological deficits
2.deafness
3.learning disorders in children
4.brain infarction,
5.septic shock,
6.adult respiratory distress syndrome
7.seizures also more in children
8.pneumonia especially in the elderly
What is the treatment of Meningitis?
------------------------------------
1.Hospitalization should be immediate as meningitis is an life threatening condition.
2.Antibiotics such as cephalosporin, ampicillin, chloramphenicol, intravenous vancomycin to be started even before doing lumbar puncture.
Acyclovir may be given for herpes virus infection
High dosages of anti-fungals may be given for Fungal meningitis for a prolonged period of time
3.corticosteroids is useful to reduce complications
4.High-flow oxygen
5.intravenous fluids
What is the prognosis of Meningitis?
------------------------------------------
This depends on the severity and type of infection.
Viral infections except for enterovirus EV7 usually recover quickly.
Bacterial infections such as meningococcus and pneumococcus are more dangerous.
What are the Preventive measures taken for Meningitis?
--------------------------------------------------------
Vaccinations against Haemophilus influenzae in children and adults has reduced the incidence of this form of meningitis.
Vaccines against type A and C Neisseria meningitidis are used to prevent these types of meningitis especially in those who travel abroad.
Vaccines against type B Neisseria meningitidis have yet to be produced athough a drug company is doing research on the production of this vaccine.
Pneumococcal vaccine against Streptococcus pneumoniae has been given to newborns to prevent pneumococcal meningitis.
Mumps vaccination as part of Measles, mumps and rubella vaccine(MMR) has reduced the incidence of mumps related form of meningitis
-----------------------------------
What is Meningitis?
---------------------------
Meningitis is a serious medical disease which causes inflammation and infection of the meninges which are the protective lining of the spinal cord and brain.
What are the causes of Meningitis?
----------------------------------------
The causes of Meningitis may be divided into:
Infections:
------------
1.viral infections are the most common and are usually mild
(enterovirus, herpes simplex virus 2 and mumps) except for Hand mouth and foot disease(enterovirus EV7)which can cause fatality in children
2.bacterial infections such as meningoccocus (Neisseria meningitidis) and pneumococcus (Streptococcus pneumoniae) can be serious and fatal in some cases.
Meningococcal meningitis can cause outbreaks(spread easily).
E.coli, Group B streptococus and Pseudomonas infection are common in neonates.
Neisseria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae are common in infants and children
Streptococcus pneumoniae, N. meningitidis, Mycobacteria are more common in adults.
Mycobacterium tuberculosis meningitis are more common in developing countries and in people whose immune systems are impaired(eg. AIDS) and are preceded by active tuberculosis infections elsewhere.
3.fungi
Cryptococcus neoformans is the most common cause of fungal meningitis
Non-infectious:
------------------
Non infectious causes usually irritates the meninges through inflammation and auto immune reactions:
1.cancers,
2.systemic lupus erythematosus
3.drugs.
4.head injury
5.post neurosurgical procedures
What are Signs and symptoms of Meningitis?
---------------------------------------------
The triad of symptoms which often defines meningitis are:
1.Severe headache
2.Neck rigidity (unable to flex the neck forward),
A positive Kernig's sign means that the neck will painful when one hip is flexed to 90 degrees and the knee flexed to 90 degrees in a patient lying supine.
3.vomiting
Other symptoms are:
4.high fever
5.mental confusion.
6.Malaise
7.photo-phobia (inability to tolerate bright light),
8.phono-phobia (inability to tolerate loud noises),
9.irritability especially in small children
10.seizures .
11.swelling of the fontanelle may be present in infants
12.rash with numerous small, irregular red spots on the body, lower legs, soles of feet, palms
13.ulcers of the mouth (present in hand,mouth and foot disease).
How is the diagnosis of Meningitis made?
------------------------------------------
1.Classical symptoms and signs as above especially neck rigidity
2.blood tests (complete blood count, ESR and blood culture)
3.X-rays of chest and brain
4.cerebrospinal fluid (CSF) analysis via lumbar puncture is examined for white blood cells, red blood cells, protein content, glucose level and micro-organisms.
This test should not be done if there is suspected cerebral mass lesion or raised intracranial pressure (head injury, localizing neurological signs)
A pressure of over 180 mm suggests bacterial meningitis.
5.CSF glucose is low,protein high and cells high in bacterial meningitis,
CSF glucose is normal,protein normal and cells high in viral meningitis
CSF glucose is low,protein high and cells high in fungal meningitis
6.CT or MRI of the brain and spine with MRI preferred over CT because it can detect more easily areas of cerebral edema,tumors, ischemia, and meningeal inflammation.
What are the complications of Meningitis?
-----------------------------------------------
1.Neurological deficits
2.deafness
3.learning disorders in children
4.brain infarction,
5.septic shock,
6.adult respiratory distress syndrome
7.seizures also more in children
8.pneumonia especially in the elderly
What is the treatment of Meningitis?
------------------------------------
1.Hospitalization should be immediate as meningitis is an life threatening condition.
2.Antibiotics such as cephalosporin, ampicillin, chloramphenicol, intravenous vancomycin to be started even before doing lumbar puncture.
Acyclovir may be given for herpes virus infection
High dosages of anti-fungals may be given for Fungal meningitis for a prolonged period of time
3.corticosteroids is useful to reduce complications
4.High-flow oxygen
5.intravenous fluids
What is the prognosis of Meningitis?
------------------------------------------
This depends on the severity and type of infection.
Viral infections except for enterovirus EV7 usually recover quickly.
Bacterial infections such as meningococcus and pneumococcus are more dangerous.
What are the Preventive measures taken for Meningitis?
--------------------------------------------------------
Vaccinations against Haemophilus influenzae in children and adults has reduced the incidence of this form of meningitis.
Vaccines against type A and C Neisseria meningitidis are used to prevent these types of meningitis especially in those who travel abroad.
Vaccines against type B Neisseria meningitidis have yet to be produced athough a drug company is doing research on the production of this vaccine.
Pneumococcal vaccine against Streptococcus pneumoniae has been given to newborns to prevent pneumococcal meningitis.
Mumps vaccination as part of Measles, mumps and rubella vaccine(MMR) has reduced the incidence of mumps related form of meningitis
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