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admin | What Antibiotics Treat Bv | 01.04.2014
Jan 04, 2015 · In 2005, the International Headache Society released its latest classification system for headache. We have created a special mix of results resources for those looking for answers to the most common questions in life, We hope that our unique service will fill your need to be answered. Winter solstice is the shortest day of the year in the Northern Hemisphere and marks the official beginning of winter. Check out this amazing series of photographs that reveals the sun's shifting position in our sky throughout the year. When air is inhaled through the nose or mouth, it travels down the trachea to the bronchus, where it first enters the lung. In most cases, a person breathes in the infectious organism, which then travels through the airways to the lungs. Sometimes, the normally harmless bacteria in the mouth, or on items placed in the mouth, can enter the lungs. However, in normal situations, the airways protect the lungs from substances that can cause infection.
Tiny particles that reach the small tubes in the lungs (bronchioles) are trapped in a thick, sticky substance called mucus. If bacteria or other infectious organisms manage to avoid the airway's defenses, the body's immune system attacks them.
The lungs are two spongy organs in the chest surrounded by a thin, moist membrane called the pleura.
When a person takes a breath (inhales), air travels from the windpipe (trachea) into the lung through the main bronchus, which branches into tiny flexible tubes called bronchi. The bronchioles lead to a group of microscopic sacs called alveoli, which look like clusters of grapes.
Each alveolus has a thin membrane that allows oxygen and carbon dioxide to pass in and out of the capillaries, the smallest of the blood vessels. Many bacteria are grouped into one of two large categories by the laboratory procedure used to look at them under a microscope.
Streptococcus (S.) pneumoniae (also called pneumococcus), the most common cause of pneumonia. Staphylococcus (S.) aureus, the other major Gram-positive bacterium responsible for pneumonia, causes about 2% of CAP and 10 - 15% of hospital-acquired pneumonias. Haemophilus (H.) influenzae is the second most common organism causing community-acquired pneumonia, accounting for 3 - 10% of all cases. Klebsiella (K.) pneumoniae may be responsible for pneumonia in alcoholics and other people who are physically debilitated. Pseudomonas (P.) aeruginosa is a major cause of hospital-acquired pneumonia (nosocomial pneumonia). Neisseria (N.) meningitidis is one of the most common causes of meningitis (central nervous system infection), but the organism has been reported in pneumonia, particularly in epidemics of military recruits. Legionnaires' disease was first described in 1976 after an outbreak of fatal pneumonia at an American Legion convention. Impaired immunity leaves patients vulnerable to serious, life-threatening pneumonias known as opportunistic pneumonias. Workers exposed to cattle, pigs, sheep, and horses are at risk for pneumonia caused by anthrax, brucella, and Coxiella burnetii (which causes Q fever). Agricultural and construction workers in the Southwest are at risk for coccidoidomycosis (Valley fever).
Those working in Ohio and the Mississippi Valley are at risk for histoplasmosis, a lung disease caused by the fungus Histoplasma capsulatum. Workers exposed to pigeons, parrots, parakeets, and turkeys are at risk for psittacosis, a lung disease caused by the bacteria Chlamydia psittaci. Severe acute respiratory syndrome (SARS) is a contagious respiratory infection that was recognized as a worldwide threat in 2003.
As of May 2005, there was no known SARS transmission anywhere in the world, according to the U.S. While droplet transmission through close contact has been responsible for most cases of SARS, there is evidence that SARS might also spread by infected droplets carried on hands and other objects the droplets touch. The estimated incubation period is 2 - 10 days, although there have been documented cases where the onset of illness was considerably faster or slower. Today, intensive public health policies are proving to be effective in controlling outbreaks. Vague pain under and around the breastbone may occur, but the severe chest pain associated with typical bacterial pneumonia is uncommon.
Although the majority of pneumonias respond well to treatment, the infection kills 40,000 - 70,000 people each year. Mycoplasma and chlamydia are the most common causes of mild pneumonias and are most likely to occur in children and young adults.
Streptococcus pneumoniae is the most common cause of pneumonia and, in fact, all bacterial upper respiratory infections.
Staphylococcus aureus is a Gram-positive bacterium that often causes severe pneumonia in hospitalized and high-risk patients and following influenza A and B.
Pseudomonas aeruginosa and Klebsiella pneumoniae are Gram-negative bacteria that pose a risk for abscesses and severe lung tissue damage. In some cases of pneumonia the pleura become inflamed, which can result in breathlessness and acute chest pain when breathing. In about 20% of pneumonia cases fluid builds up between the pleural membranes, a condition known as pleural effusion. In most cases, particularly in Streptococcus pneumoniae, the fluid remains sterile (no bacteria are present), but occasionally it can become infected and even filled with pus, a condition called empyema. Pneumothorax occurs when air leaks from inside the lung to the space between the lung and the chest wall. Kidney complications and electrolyte imbalances are common in patients admitted to the hospital with pneumonia. Pneumonia that is contracted in the hospital is called hospital-acquired or nosocomial pneumonia.
People with chronic or severe medical conditions, such as lung problems, heart disease, neurologic disorders, and cancer.
Hospitalized patients are particularly vulnerable to Gram-negative bacteria and staphylococci, which can be especially dangerous in people who are already ill. Patients who are on corticosteroids or other medications that suppress the immune system are also prone to infection. Also, drugs that treat gastroesophageal reflux (GERD) may slightly increase one's risk for community-acquired pneumonia. Researchers have found that the risk is strongest when people have recently begun treatment with PPIs, and lessens over time. If a person inhales fluid (aspirates) from the esophagus into the lungs, it may trigger inflammation in these upper passages. Nevertheless, in many cases of mild-to-moderate CAP, the physician is able to diagnose and treat pneumonia based solely on a history and physical examination. Many hospitalized patients have similar symptoms, including fever or signs of lung infiltration on x-rays. In hospitalized patients, sputum or blood tests often indicate the presence of bacteria or other organisms, but such agents do not necessarily indicate pneumonia.
Although current antibiotics can destroy a wide spectrum of organisms, it is best to use an antibiotic that targets the specific one making a person sick.
In severe cases, a doctor needs to use invasive diagnostic measures to identify the cause of the infection. The patient coughs as deeply as possible to bring up mucus from the lungs, since a shallow cough produces a sample that usually only contains normal mouth bacteria. The sputum sample is sent to the laboratory, where it is analyzed for the presence of bacteria and to determine whether the bacteria are Gram-negative or Gram-positive.
CT and MRI can help detect the presence of tissue damage, abscesses, and enlarged lymph nodes. Complications of this procedure are rare, but can include collapsed lung, bleeding, and introduction of infection.
The physician inserts a fiber optic tube into the lower respiratory tract through the nose or mouth. The tube acts like a telescope into the body, allowing the physician to view the windpipe and major airways and look for pus, abnormal mucus, or other problems. The doctor removes specimens for analysis and can also treat the patient by removing any foreign bodies or infected tissue encountered during the process. It is a very old procedure that is not done often any more, since it is invasive and poses a slight risk for collapsed lung. Other obvious common causes of chronic cough include heavy smoking or the use of heart drugs known as ACE inhibitors.
Patients with bronchitis are less likely to have wheezing, shortness of breath, chills, very high fevers, and other signs of severe illness.
Those with pneumonia usually cough up heavy sputum, which is also more likely to contain blood.
A variety of guidelines and tools have been developed to help determine who can safely be treated at home and who cannot.
Patients who have been living in a nursing home or other residential facility are of greater concern.
Elderly patients and infants, particularly infants who are less than 1 month old, are more likely to be admitted. Patients with higher scores on these assessment tests often have many risk factors and usually are hospitalized.
When possible, treatment of community-acquired pneumonia should be started within 4 hours of admission to the emergency room or hospital to reduce the chances of mortality and decrease the amount of time a patient needs to spend in the hospital. Home care may be possible, even in severe cases, when there is good support and available home nursing services. Mild pain can be treated with aspirin (in adults only), acetaminophen (Tylenol), or ibuprofen (Advil, Motrin). A laboratory study reported that aromatic oils containing oregano, thyme, and rosewood destroyed S. Chest therapy using incentive spirometry, rhythmic inhalation and coughing, and chest tapping are all important techniques to loosen the mucus and move it out of the lungs. Before starting the breathing exercise, the patient should tap lightly on the chest to loosen mucus within the lung. Penicillin derivatives called aminopenicillins, particularly amoxicillin (Amoxil, Polymox, Trimox, Wymox, or any generic formulation), are now the most common penicillins used. Amoxicillin-clavulanate (Augmentin) is an augmented penicillin that works against a wide spectrum of bacteria. Certain penicillins used against Pseudomonas aeruginosa include ticarcillin and piperacillin. Many people have a history of an allergic reaction to penicillin, but research suggests that the allergy may not recur in a significant number of adults. First generation includes cephalexin (Keflex), cefadroxil (Duricef, Ultracef), and cephradine (Velosef). Third generation includes cefpodoxime (Vantin), cefdinir (Omnicef) cefditoren (Sprectracef), cefixime (Suprax), and ceftibuten (Cedex).
Sanfetrinem, a novel beta-lactam antibiotic known as a trinem is proving to be effective against S. Ceftobiprole is an investigational beta-lactam in phase III clinical trials for methicillin-resistant Staphylococcus aureus (MRSA), penicillin-resistant streptococci, and other Gram-negative pathogens. Fluoroquinolones (quinolones) interfere with bacteria''s genetic material to prevent them from reproducing. Ciprofloxacin (Cipro), a second-generation quinolone, remains the most potent quinolone against Pseudomonas aeruginosa. The fourth-generation quinolones moxifloxacin (Avelox) and clinafloxacin, which is still under development, are proving to be effective against anaerobic bacteria. These antibiotics are effective against atypical bacteria such as mycoplasma and chlamydia.
Extended-release (ER) azithromycin (Zmax) is the first anti-pneumonia antibiotic that can be given in a single dose. In February 2007, the FDA withdrew approval of Ketek for the treatment of acute bacterial sinusitis.
Because of these side effects, telithromycin is only approved for patients with mild-to-moderate community-acquired pneumonia caused by penicillin- or macrolide-resistant S. Aminoglycosides (gentamicin, kanamycin, tobramycin, amikacin) are given by injection for very serious bacterial infections. Glycopeptides (vancomycin, teicoplanin) are used for Staphylococcus aureus infections that have become resistant to standard antibiotics. Trimethoprim-sulfamethoxazole (Bactrim, Cotrim, Septra) is less expensive than amoxicillin.
Linezolid (Zyvox) is the first antibacterial drug in a new class of synthetic antibiotics called oxazolidinones. If the organism causing the pneumonia is not known, was the disorder community- or hospital-acquired?
Individuals respond differently to the same antibiotic, depending on their age, health, size, and other factors. Many patients with heart disease, kidney disease, diabetes, or other comorbid conditions may still be treated as outpatients. For a more detailed discussion of the different types of antibiotics, see the "Antibiotic Classes" section below.
In addition, other important causes of CAP, particularly in younger people, are atypical bacteria, which respond to macrolides (erythromycin, clarithromycin, or azithromycin), ketolides, or newer fluoroquinolones. Whether the patient is well enough to be treated at home or requires hospitalization or nursing home care. Treatment options can include a single drug, such as levofloxacin or doxycycline, or combination treatment, such as a macrolide administered with a beta-lactam.
Antibiotics taken by mouth are generally sufficient for patients whose CAP is mild enough to be treated at home. A broad range of antibiotics are available for the treatment of hospital-acquired pneumonias. A study of children with leukemia found atovaquone to be an excellent alternative for preventing P. Patients with viral pneumonias are at risk for what are called "superinfections," which generally refers to a secondary bacterial infection, usually caused by S. Patients with pneumonia caused by varicella-zoster and herpes simplex viruses are usually admitted to the hospital and treated with parenteral acyclovir intravenously for 7 days. No antiviral drugs have been proven effective in adults with RSV, parainfluenza virus, adenovirus, metapneumovirus, the SARS coronavirus, or hantavirus. Infection with Clostridium difficile, a pathogen responsible for causing severe diarrhea, colitis, and abdominal pain (with overuse of antibiotics).
The reality TV star, who also has a son Mason, 3, with partner Scott Disick, admits that getting back into shape wasn't easy. The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline.
There are plenty of theories about getting over a breakup, like that it takes half the length of your relationship to get over someone, or that expressing strong, negative feelings about your ex immediately afterward can help you feel less depressed.
Regardless of what you’ve heard, every relationship is different and everyone handles breakups differently. In short, the more deep and connected the relationship was, the longer it may take to get over. To clarify, this is the phase when you feel like your heart has been ripped out of your body, your soul has been crushed, and you can’t seem to imagine life without your ex. However, after 90 days, that intense hormonal activity subsides, and we are able to see more clearly and rationalize the situation.


It’s important to note that this shift isn’t like turning a light switch on and off; it's definitely a long, gradual, and often emotionally painful process in finally getting over a breakup. Some jilted lovers may opt to jump right back into another relationship in an effort to expedite the healing process, but make sure you’re moving on for the right reasons. Lawrence also emphasizes that if you value yourself, you will quickly realize that pining away for someone who will only reject you is not just a waste of your time, but hazardous to your self-worth.
No matter how many theories there are about getting over a breakup, the standard saying that “time heals all wounds” may just be the best theory to live by, especially when it comes to lost relationships. We pride ourselves on always delivering your answer to you if we fail please tell us so that we may improve our service.
The sun is at its lowest in our sky because the North Pole of our tilted planet is pointing away from it. In six months, Earth will be on the other side of the sun and residents of the Northern Hemisphere will enjoy the longest day of the year. BackgroundPneumonia is an inflammation of the lung that is most often caused by infection with bacteria, viruses, or other organisms.
From the bronchus, air goes through the bronchi, into the even smaller bronchioles and lastly into the alveoli. This helps predict which organisms are most likely responsible for the illness and, therefore, which treatment is most likely to be effective. Hospital-acquired pneumonia is an infection of the lungs contracted during a hospital stay. A subgroup of hospital-acquired pneumonia is ventilator-associated pneumonia (VAP), a highly lethal form contracted by patients on ventilators in hospitals and long-term nursing facilities.
This usually happens if the body's "gag reflex," an extreme throat contraction that keeps substances out of the lungs, is not working properly. The mucus and particles are pushed up and out of the lungs by tiny hair-like cells called cilia, which beat like a drum.
If these defenses are weakened or damaged, however, bacteria, viruses, fungi, and parasites can easily infect the lung, producing pneumonia. Each lung is composed of smooth, shiny lobes; the right lung has three lobes and the left has two. These bacteria appear blue on the stain and are the most common organisms that cause pneumonia. This Gram-positive bacterium causes 20 - 60% of all community-acquired bacterial pneumonia (CAP) in adults.
It is the organism most often associated with viral influenza, and can develop about 5 days after the onset of flu symptoms. Experts have identified this bacterium as an uncommon cause of certain pneumonias, particularly in people with lung problems such as asthma or emphysema. The newly described organism that caused the disease was named Legionella pneumophila, shown in this picture. SARS is a respiratory infection caused by a newly-described coronavirus, which appears to have jumped from animals to humans. This virus is a leading cause of pneumonia and bronchitis in children, the elderly, and patients with damaged immune systems.
Adenoviruses are common and usually are not problematic, although they have been linked to about 10% of childhood pneumonias.
In adults, herpes simplex virus and varicella zoster (the cause of chickenpox) can cause pneumonia in people with impaired immune systems. However, if this mixture reaches the lungs, it can cause a serious condition called aspiration pneumonia.
Where you work and live can put you at higher risk for exposure to pneumonia-causing organisms. The World Health Organization (WHO) officially identified SARS as a global health threat, and issued an unprecedented travel advisory. SARS is a serious form of atypical pneumonia that causes acute respiratory distress and sometimes death. The best way to prevent SARS is to avoid direct contact with people who have SARS until 10 days after their fever and other symptoms are gone. The overall worldwide death rate due to SARS at the end of the outbreaks was 14 - 15%, although it was up to 50% in infected people over age 65. It is important to note that older people may have fewer or different symptoms than younger people. Atypical pneumonia is most commonly caused by mycoplasma, Legionnaires' disease, or chlamydia and usually appears in children and young adults. They may include fatigue, fever, weakness, headache, nasal discharge, sore throat, earache, and stomach and intestinal distress. PrognosisBetween 5 and 10 million people get pneumonia in the United States each year, and more than 1 million people are hospitalized due to the condition. Community-acquired pneumonia is responsible for 350,000 - 620,000 hospitalizations in the elderly every year.
Small children who develop pneumonia and survive are at risk for developing lung problems in adulthood, including chronic obstructive pulmonary disease (COPD). Pneumonia poses a special hazard for pregnant women, possibly due to changes in a pregnant woman's immune system. Pneumonia is also very dangerous in people with diabetes, cirrhosis, sickle cell disease, cancer, and in those whose spleens have been removed. They rarely require hospitalization when they are appropriately treated, although recovery may still be prolonged.
People who get this form of pneumonia may develop pockets of infection in their lungs (abscesses) that are difficult to treat and can cause the death of lung tissue (necrosis).
Respiratory syncytial virus (RSV) pneumonia rarely poses a danger for healthy young adults, but it can be life-threatening in infants and serious in the elderly.
An abscess in the lung is a thick-walled, pus-filled cavity that forms when infection has destroyed lung tissue. Respiratory failure is one of the top causes of death in patients with pneumococcal pneumonia. Bacteremia -- bacteria in the blood -- is the most common complication of pneumococcus infection, although it rarely spreads to other sites.
Ordinarily, the narrow zone between the two membranes contains only a tiny amount of fluid, which lubricates the lungs.
Empyema is more likely to occur with specific organisms such as Staphylococcus aureus or Klebsiella pneumoniae infections.
In some cases, air may fill up the area between the pleural membranes, causing the lungs to collapse. In rare cases, infection may spread from the lungs to the heart and possibly throughout the body. Some research suggests, however, that chlamydia may have powerful inflammatory effects in the blood vessels. Chlamydia pneumoniae, Mycoplasma pneumoniae, and RSV are becoming suspects in many cases of severe adult asthma.
Among the surgical procedures that pose a particular risk are removal of the spleen (splenectomy), abdominal aortic aneurysm repair, or operations that impair coughing.
This is particularly true for newborns or patients on breathing machines (mechanical ventilators).
Hospital patients who receive sedatives also have a higher risk of developing nosocomial pneumonia. Chronic obstructive lung disease (COPD), which includes chronic bronchitis and emphysema, affects 15 million people in the U.S. Patients at high risk for pneumonia should take gastric acid-suppressing drugs only when necessary and at the lowest possible dose. The impaired vigilance while swallowing contributes to an increased risk of aspiration pneumonia. Gastroesophageal reflux disease (GERD) is a condition in which acids from the stomach move up into the esophagus. Recruits on military bases and college students living in dormitories are at higher-than-average risk for Mycoplasma pneumonia.
The risk for pneumonia in people who smoke more than a pack a day is three times that of nonsmokers. It is important to determine whether the cause of CAP is a bacterium, atypical bacterium, or virus, because they require different treatments. Rales on one side of the chest or that are heard while the patient is lying down strongly suggest pneumonia. Unfortunately, people carry many bacteria, and sputum and blood tests are not always effective in distinguishing between harmless and harmful kinds. The color of the mucus (sputum) sample coughed up from the lungs can reveal the severity of the disease. Cultures are done to determine the specific organism causing the pneumonia, but they usually cannot distinguish between harmless and dangerous organisms. Urine antigen tests for Legionella pneumophila (Legionnaires' disease) and Streptococcus pneumoniae may be performed in patients with severe CAP.
In critically-ill patients with ventilator-associated pneumonia, physicians have tried sampling fluid taken from the lungs or trachea. If a doctor detects pleural effusion during the physical exam or on an imaging study, and suspects that pus (empyema) is present, a thoracentesis is performed. This involves injecting high amounts of saline through the bronchoscope into the lung and then immediately sucking the fluid out. In very severe cases of pneumonia or when the diagnosis is unclear, particularly in patients with damaged immune systems, a lung biopsy may be required. This procedure typically uses a needle inserted between the ribs to draw fluid out of the lung for analysis.
Some experts argue, however, that a lung tap is more accurate than other methods for identifying bacteria, and the risk it poses is slight. Over 30 million people seek medical help each year for persistent coughing, which is nearly always temporary and harmless when other symptoms, such as fever, are not present.
Acute bronchitis is an infection in the passages that carry air from the throat to the lung. Chronic bronchitis causes shortness of breath and is often accompanied by infection, mucus production, and coughing, but it is a long-term and irreversible condition. In asthma, the cough is accompanied by wheezing and occurs mostly at night or during activity. Because of current terrorist concerns, it is important to differentiate between anthrax and community-acquired pneumonia. Often, caregivers can even be trained to administer intravenous antibiotics and chest therapy to patients at home. It should be noted, however, that codeine and other narcotics suppress coughing, so they should be used with care in pneumonia. If the pneumonia is severe enough for hospitalization, the standard treatment is intravenous antibiotics for 5 - 8 days.
In a 2002 study, 42% of patients who had two or more signs of instability when they left the hospital were either readmitted or died within 30 days, compared with 10.5% of completely stabilized patients. The patient uses an incentive spirometer at regular intervals to improve breathing and loosen sputum.
An extended-release form has been approved for treating adults with community-acquired pneumonia caused by bacterial strains that have become resistant to penicillin. The standard drug was methicillin, but it is no longer used routinely due to very high rates of resistance in hospital-acquired pneumonias.
Skin tests are available to help determine if those with a history of penicillin allergies could use these important antibiotics. Most of these agents are not very effective against bacteria that have developed resistance to penicillin.
Such drugs include levofloxacin (Levaquin), sparfloxacin (Zagam), and gemifloxacin (Factive). The agency decided that the serious risks of telithromycin outweigh its benefits for sinusitis treatment.
It is particularly useful for adults with mild bacterial upper respiratory infections who are allergic to penicillin. MedicationsDozens of antibiotics are available for treating pneumonia, but selecting the best drug is sometimes difficult. Mild-to-moderate cases can be treated at home with oral antibiotics, while severe pneumonia usually needs intravenous antibiotics administered in the hospital. Different organisms are usually involved in each setting, and the physician can use this information to guess the most likely organism causing the pneumonia. Community-acquired pneumonias, for example, are usually caused by the typical bacteria Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis, which have traditionally been treated with penicillin or other standard antibiotics.
Antibiotics used to treat such patients may differ from those used in patients with healthy immune systems. However, they should be given a fluoroquinolone (moxifloxacin, gemifloxacin, or levofloxacin) or a beta-lactam (preferably high-dose amoxicillin or amoxicillin-clavulanate), plus a macrolide, unless they live in an area with high S. Oseltamivir (Tamiflu) and zanamivir (Relenza) are the recommended drugs for influenza A or B infections. Treatment is largely supportive, with patients receiving oxygen and ventilator therapy as needed.
Ribavarin is the first treatment approved for RSV pneumonia, although it has only modest benefits. These reactions can range from mild skin rashes to rare but severe -- even life-threatening -- anaphylactic shock. Patients should inform their physician of all medications and OTC preparations they are taking and of any drug allergies they might have. Taking acidophilus supplements or eating yogurt with active acidophilius cultures may help restore healthy bacteria that offset the risk for such infections. SurgeryAlthough most patients with pneumonia do not need invasive therapy, it may be necessary in patients with abscesses, empyema, or certain other complications.
The 33-year-old posed by the pool in Miami on December 13 for the cover of America'sA Us Weekly wearing a yellow swimsuit.The 5ft brunette, who gave birth to Penelope on July 8, now weighs in at 106lbs after shedding 44lbs of baby weight. Some may get over an ex in just a few weeks, and for others, it may take months and even years.
There's actually scientific evidence that shows it takes 90 days to incorporate change into our life and for your brain to reset itself. Hokemeyer cautions that this technique could trigger “repetition impulse,” which is when we unconsciously repeat the same destructive relationship pattern to get it right. He is now Chief Content Officer overseeing media properties for the sites’ parent company, Purch.
This type of pneumonia tends to be more serious, because hospital patients already have weakened defense mechanisms, and the infecting organisms are usually more dangerous than those encountered in the community.
Fresh oxygen moves into the capillaries, and carbon dioxide passes from the capillaries into the bloodstream, where it is carried out of the body through the lungs.
Gram-negative bacteria commonly cause infections in hospitalized or nursing home patients, children with cystic fibrosis, and people with chronic lung conditions.
Outbreaks are often reported in hotels, cruise ships, and office buildings, where people are exposed to contaminated droplets from cooling towers and evaporative condensers. Influenza-associated pneumonia is particularly risky for the elderly and people with underlying heart disease. However, RSV is a major cause of pneumonia in infants, as well as adults with damaged immune systems.
Adenovirus 14 has been linked to an outbreak of severe community-acquired pneumonia in the Pacific northwest.
This may happen after a head injury or general anesthesia, or when a patient takes drugs or alcohol.
Long-term use of corticosteroids and drugs known as immunosuppressants also increases the risk for these pneumonias.


It wasn't clear at the time whether SARS would become a global pandemic or settle into a less aggressive pattern.
It is caused by a new member of the coronavirus family (the family that includes the virus that causes the common cold). Like other coronaviruses, the SARS virus may live on hands, tissues, and other surfaces for up to 6 hours in these droplets and up to 3 hours after the droplets have dried.
Live virus had even been found in the stool of people with SARS, where it has been shown to survive for up to 4 days. It is not known, however, how early people begin to be contagious before symptoms appear, or how long they might be contagious after the symptoms have disappeared. National Institutes of Health began a small clinical trial to test a preventive SARS vaccine.
Many more were sick enough to require breathing assistance from a machine (mechanical ventilation). As a result, pneumonia is the third most frequent cause of hospitalizations (births are first, and heart disease is second).
If pneumonia develops in patients already hospitalized for other conditions, death rates range from 50 - 70%, and are higher in women than in men. Research suggests that men with a history of pneumonia and other respiratory illnesses in childhood are more than twice as likely to die of COPD as those without a history of childhood respiratory disease.
This complication can lead to premature labor and increases the risk of death during pregnancy. This is especially true for AIDS patients, in whom pneumonia causes about half of all deaths. Severe and life-threatening cases are more likely to occur in elderly people with other medical conditions.
Mortality rates are 30 - 40%, in part because the patients who develop this infection are generally very ill or vulnerable. However, a 2002 study suggested that many patients experience long-term problems, including coughing, shortness of breath, fatigue, and neurological and muscular complications.
It typically occurs as a result of aspiration pneumonia, when a mixture of organisms is carried into the lung.
Acute respiratory distress syndrome (ARDS) is the specific condition that occurs when the lungs are unable to function and oxygen is so severely reduced that the patient's life is at risk. Bacteremia is a frequent complication of infection from Gram-negative organisms, including Haemophilus influenzae. The dark side of the chest (right side of the picture) fills with air from outside of the lung tissue. This effect may have certain adverse long-term consequences, even in healthy younger individuals. More than half of these cases may be due to strains of bacteria that have developed resistance to antibiotics. This association is strongest with protein pump inhibitors (PPIs) such as Prilosec and Nexium. Those who are chronically exposed to secondhand cigarette smoke, which can injure airways and damage the cilia, are also at risk. These substances act as sedatives and can diminish the reflexes that trigger coughing and sneezing. A dull thud, instead of a hollow drum-like sound, indicates certain conditions that suggest pneumonia. In some cases, a tube will be inserted through the nose into the lower respiratory tract to trigger a deeper cough. The test makes multiple copies of the genetic material (RNA) of a virus or bacteria to make it detectable. These techniques enabled the physicians to identify the pneumonia-causing bacteria and start the appropriate antibiotics. Structures that are dense (such as bone) will appear white, air will be black, and other structures will be shades of gray depending on density.
It is not usually needed in patients with community-acquired pneumonia, but it may be appropriate for patients with severely compromised immune systems who need immediate diagnosis, or in patients whose condition has worsened during treatment.
A lung biopsy involves taking some tissue from the lungs and examining it under a microscope. Given the increase in resistant bacteria, they believe its use should be reconsidered in young people. The same microbes that cause pneumonia can cause chronic bronchitis, and symptoms of the two disorders are often similar. According to one study, people with inhalation anthrax are more likely to have rapid heart rate and less likely to have headache, nasal symptoms, and muscle aches than those with pneumonia. Studies indicate that many patients do not need to be hospitalized for pneumonia, and can be safely treated at home. All of these assessment tools are looking for risk factors, and the more of these risk factors that are present, the less likely that the patient can be safely treated at home. Some doctors advise taking expectorants, such as guaifenesin (Breonesin, Glycotuss, Glytuss, Hytuss, Naldecon Senior EX, Robitussin) to loosen mucus. In cases of uncomplicated pneumonia, many patients may need only 2 or 3 days of intravenous antibiotics followed by oral therapy.
The spirometer is a hand-held clear plastic device that includes a breathing tube and a container with a movable gauge. Studies have shown the results to be equal to those ahchieved with 7 days of levofloxacin or clarithromycin ER in patients with CAP. They are derived from erythromycin and were developed to combat organisms that have become resistant to macrolides. Some are available in inhaled forms or by applying a solution directly to mucus membranes, skin, or body cavities. Patients with pneumonia need an antibiotic that is effective against the organism causing the disease. These antibiotics do not affect atypical organisms, such as legionella, mycoplasma, or chlamydia. Antibiotic therapy should be given for a minimum of 5 days -- longer if the patient still has a fever and more than one sign of clinical instability.
The American Academy of Pediatrics recommends this drug for children who are at high risk for serious complications of RSV. Blitz, Manhattan Reconstructive Foot Surgeon, from near and far for his revolutionary and cutting edge procedures. Prior to joining the company, Rob was an editor at The Star-Ledger in New Jersey, and in 1998 he was founder and editor of the science news website ExploreZone. The color of the bacteria after washing determines whether they are Gram-negative or Gram-positive.
Studies indicate that RSV pneumonia may be more common in adults, especially the elderly, than previously thought. In such cases, the gag reflex doesn't work as well as it should, so bacteria can enter the airways. According to reports from the CDC and WHO, more than 8,000 people became sick with SARS during the outbreak. The discovery of the SARS-related virus represents one of the fastest identifications of a new organism in history. And the virus may be able to live for months or years when the temperature is below freezing. An elderly person who experiences even a minor cough and weakness for more than a day should seek medical help. About 500,000 children are hospitalized for respiratory infections each year, and a third of them have pneumonia. Even when older individuals recover from CAP, they have higher-than-normal death rates over the next several years. Untreated abscesses can cause hemorrhage (bleeding) in the lung, but targeted antibiotic therapy significantly reduces their danger.
Failure can occur if pneumonia leads to mechanical changes in the lungs (ventilatory failure) or oxygen loss in the arteries (hypoxemic respiratory failure). It may be a complication of pneumonia (particularly Streptococcus pneumoniae ) or of the invasive procedures used to treat pleural effusion. Coughing up blood (hemoptysis) is another potentially serious complication of pneumonia, particularly in patients with lung problems such as cystic fibrosis.
In fact, methicillin-resistant Staphylococcus aureus and multidrug-resistant Pseudomonas aeruginosa are leading causes of death from hospital-acquired pneumonia.
In patients with COPD, vaccination with the pneumococcal vaccine can substantially reduce the risk of developing pneumonia or decrease its severity. A wide variety of organisms, including Myobacterium species, Histoplasma capsulatum, Coccidioides immitis, Aspergillus species, cytomegalovirus, and Toxoplasma gondii, can cause pneumonia. Reducing levels of germ-killing stomach acid may allow germs to spread in the upper gastrointestinal tract and move into the respiratory tract.
Current studies indicate an association between GERD and various problems that occur in the sinuses, ears, nasal passages, and airways of the lung.
Quitting smoking reduces the risk of dying from pneumonia to normal, but the full benefit takes 10 years to be realized. Alcohol also interferes with the actions of macrophages, the white blood cells that destroy bacteria and other microbes. These conditions include consolidation (in which the lung becomes firm and inelastic) and pleural effusion (fluid build-up in the space between the lungs and the lining around it). PCR is useful for identifying certain atypical bacteria strains, including mycoplasma and Chlamydia pneumoniae, and possibly, Haemophilus influenzae type b, but it is expensive. However, this made no difference in the length of stay in the ICU or hospital, and there was no significant difference in outcome. X-rays can provide information about obstructions, tumors, and other diseases, especially when coupled with the use of barium and air contrast within the bowel.
However, features on the CT scan of patients with certain forms of pneumonia -- for example, that caused by Legionella pneumophila -- are usually different from features produced by other bacteria in the lungs. Studies find BAL to be an effective method for detecting specific infection-causing organisms. Acute bronchitis is almost always caused by a virus and usually clears up on its own within a few days. Asthma symptoms from occupational causes can lead to persistent coughing, which is usually worse during the work week. Antibiotics taken by mouth are prescribed when the patient has improved substantially or leaves the hospital. The patient exhales and then inhales forcefully through the tube, using the pressure of the inhalation to raise the gauge to the highest level possible. Unfortunately, bacterial resistance to amoxicillin has increased significantly, both among S.
Cefditoren has also been shown to be 85% effective against Haemophilus influenzae and 90% effective against penicillin-resistant strains of S. They are now used for serious hospital-acquired infections and for bacteria that have become resistant to other beta-lactams. A single-dose antibiotic decreases the likelihood that a patient will discontinue taking the antibiotic early, which rapidly contributes to the development of drug-resistant bacteria. Telithromycin (Ketek), the first antibiotic in the ketolide class, was approved by the FDA in 2004 for the treatment of community-acquired pneumonia (CAP).
Currently in phase III studies of hospital-acquired pneumonia, it looks positive for the treatment of Gram-positive pneumonia. It should not be used in patients whose infections occur after dental work, or in people who are allergic to sulfa drugs. When the organism is unknown, "empiric therapy" is given, meaning the doctor chooses which antibiotic is likely to work based on factors such as the patient's age, health, and severity of the illness. However, some research suggests that patients with mild-to-moderate community-acquired pneumonia may be successfully treated with 7 days or less of antibiotics.
Taken early, these medications may be effective in reducing symptoms and reducing the duration of illness.
However, people who are sick, including those who are recovering from the flu (influenza) or an upper respiratory illness, have weakened immune systems that make it easier for bacteria to grow in their lungs. Knowing which group the bacteria belong to helps determine the severity of the disease, and how to treat it. The flu weakens the body's defense systems, making it easier for bacteria to grow in the lungs. Unlike other organisms that are inhaled, bacteria that cause aspiration pneumonia do not need oxygen to live. Abscesses are more common with Staphylococcus aureus, Pseudomonas aeruginosa, or Klebsiella pneumoniae, and are uncommon with Streptococcus pneumoniae. At least one study has also linked bacterial pneumonia with an increased risk of acute heart problems, such as heart attack or arrhythmia. Toxic fumes, industrial smoke, and other air pollutants may also damage cilia function, which is a defense against bacteria in the lungs.
Intravenous drug abusers are at risk for pneumonia from infections that start at the injection site and spread through the bloodstream to the lungs.
Although symptoms may differ, they often overlap, which can make it difficult to identify the organism by symptoms alone. One study found that using a real-time PCR test may help quickly diagnose Pneumocystitis pneumonia in HIV-positive patients.
Tests -- the methacholine inhalation challenge and pulmonary function studies -- may be effective in diagnosing asthma.
A number of strategies are being devised to determine when and which patients can be safely discharged. Imipenem has serious side effects when used alone, so it is given in combination with cilastatin to offset these adverse effects. The shorter treatment may increase patient tolerance, and improve the likelihood of adherence to the treatment regimen, as well as help limit the growing problem of antibiotic resistance.
Most resistant strains respond to fluoroquinolines such as levofloxacin (Levaquin), gemifloxacin (Factive) or moxifloxacin (Avelox), or to ketolides (telithromycin). Doctors most commonly recommend treatment with amoxicillin-clavulanate, cefpodoxime, cefprozil, cefuroxime, or a respiratory fluoroquinolone. Overwhelmed with excitement!'The full interview with Kourtney Kardashian is in the new issue of Us Weekly on newsstands Friday. All patients diagnosed with "bird flu" show signs of pneumonia, although symptoms may be mild. The outbreak is also an example of how quickly a networked health monitoring system can respond to an emerging threat. The presence of antibodies that are responding to mycoplasma or chlamydia infection are not present early enough in the course of pneumonia to allow for prompt diagnosis and treatment. Studies have shown that low-risk patients with mild-to-moderate pneumonia do just as well when treated as outpatients and return to work and normal activities faster than those treated in the hospital. Oseltamivir (Tamiflu) is the most effective treatment for this type of influenza, which can be fatal. Ampicillin is similar and is an alternative to amoxicillin, but requires more doses and has more severe gastrointestinal side effects.
Macrolide-resistance rates doubled between 1995 and 1999 as more and more children were being treated with these antibiotics. Some research suggests these agents may reduce the risk of a first heart attack in some patients by reducing inflammation in the blood vessels. In some situations, masks, and goggles may help prevent the spread of airborne or droplet infection.



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