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Pneumococcal Pneumonia

Klebsiella Pneumonia

Mycoplasmal Pneumonia

Symptoms

Cough, fever, single shaking chill, rust-colored sputum from degraded blood, shortness of breath, chest pain

Chills, fever, cough, chest pain, and grossly bloody, mucoid sputum

Gradual onset of cough, fever, sputum production, headache, fatigue, and muscle aches

Incubation period

1 to 3 days

1 to 3 days

2 to 3 weeks

Causative agent

The pneumococcus, Streptococcus pneumoniae, encapsulated strains

Klebsiella pneumoniae, an entero-bacterium

Mycoplasma pneumoniae; lacks cell wall

Pathogenesis

Inhalation of encapsulated pneumococci; colonization of the alveoli incites inflammatory response; plasma, blood, and inflammatory cells fill the alveoli; pain results from involvement of nerve endings

Aspiration of colonized mucus droplets from the throat. Destruction of lung tissue and abscess formation common; infection spreads via blood to other body tissues

Cells attach to specific receptors on the respiratory epithelium; inhibition of ciliary motion and destruction of cells follow

Epidemiology

High carrier rates for S. pneumoniae. Risk of pneumonia increased with conditions such as alcoholism, narcotic use, chronic lung disease, and viral infections that impair the mucociliary escalator. Other predisposing factors are chronic heart disease, diabetes, and cancer

Often resistant to antibiotics, and colonize individuals who are taking them. Klebsiella sp. and other Gramnegative rods are common causes of fatal nosocomial pneumonias

Inhalation of infected droplets; mild infections common and foster spread of the disease

Prevention and treatment

Capsular vaccine available contains 23 capsular antigens; conjugate vaccine for infants.Treatment: penicillin, erythromycin, and others

No vaccine available. A cephalosporin with an aminoglycoside

No vaccine available; avoidance of crowding in schools and military facilities advisable; tetracycline or erythromycin for treatment

Chapter 23 Respiratory System Infections

Ciliated epithelial cell

Cluster of l. pertussis

Chapter 23 Respiratory System Infections

Ciliated epithelial cell

Cluster of l. pertussis

Figure 23.13 Bordetella pertussis Fluorescent antibody stain of respiratory secretions from an individual with whooping cough.The bacteria stain a greenish-yellow color.The large orange object is a ciliated epithelial cell. Notice the cluster of B. pertussis at one end of the cell, the location of the cell's cilia.

Figure 23.13 Bordetella pertussis Fluorescent antibody stain of respiratory secretions from an individual with whooping cough.The bacteria stain a greenish-yellow color.The large orange object is a ciliated epithelial cell. Notice the cluster of B. pertussis at one end of the cell, the location of the cell's cilia.

This symptom, termed paroxysmal coughing, is severe enough to rupture small blood vessels in the eyes. The coughing spasm is followed by forceful inspiration, the "whoop." Vomiting and seizures may occur during this phase of the illness.

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