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1、ChestInfectionsLawrencePikeChestInfectionsAcutebronchitisAcuteexacerbationofchronicbronchitisCommunityacquiredpneumoniaAcutebronchitisAcutebronchitisistypicallyself-limitinglasting7to14days.Usuallycausedbyadenovirus,rhinovirusorinfluenzavirus.Bacteriararelycauseacutebronchitis,however,the
2、ymayactassecondaryinvadersfollowingaviralinfection.BacteriaimplicatedincludeStreptococcuspneumoniae,Haemophilusinfluenzae,MoraxellacatarrhalisandoccasionallyStaphylococcusaureus(especiallyduringinfluenzaepidemics).AcuteexacerbationofchronicbronchitisIncreasedpurulentsputum,worseningcough,
3、pyrexiaandincreasedbreathlessness.Haemophilusinfluenzae,StreptococcuspneumoniaeandMoraxellacatarrhalisarecommonlygrownfromsputumsamples.CommunityacquiredpneumoniaAnacutelowerrespiratorytractinfectionwithpurulentsputum,cough,fever,breathlessnesscombinedwithsignsonexaminationandchangesonche
4、stx-ray.UsualbacteriaimplicatedincludeStreptococcuspneumoniae(mostcommon),Haemophilusinfluenzae,MoraxellacatarrhalisandoccasionallyStaphylococcusaureus(especiallyduringinfluenzaepidemics).AtypicalinfectionsincludethosecausedbyMycoplasmapneumoniae,Chlamydiapneumoniae,ChlamydiapsittaciandLe
5、gionellapneumoniae.Incidence17%ofall'acute'consultationsareforacuterespiratoryinfectionsInpreviouslyhealthysubjectsacutebronchitisisusuallyself-limitinginnature.However,around5%arepneumoniasAcuteexacerbationofchronicbronchitisisassociatedwithviralinfectionsin50%ofcases.Mycoplasmapneumonia
6、eoccursinepidemicswitha4-yearcycle.ItismostcommoninchildrenSymptomsandSignsClinicalpresentationsrangefromcoughwithoutsputumorchestsigns,toanillnesscharacterisedbyexpectorationofmucopurulentsputum,fever,dyspnoea,pleuriticchestpainanddiffuseorfocalsignsinthechest.Considerpneumoniainanypatie
7、nt,ofanyage,withcoughanddyspnoea,tachypnoeaandpleuriticchestpain;and/orfocalsignsinthechest,especiallyiftheyaresystemicallyunwell.Legionellapneumoniashouldbeconsideredifriskfactorssuchasrecenttravelorrecentrepairofplumbingarepresent.DifferentialDiagnosisInfluenzaCon
