LRTIs and SepsisPoppy

Bronchitis/Pneumonia

•Bronchitis▫Infection & inflammation of airways

•Pneumonia▫Infection & inflammation of alveoli

Signs and Symptoms

•Signs▫Fever ▫Tachypnoea▫Crackles▫↓or bronchial breath sounds

•Symptoms▫Dyspnoea▫Cough▫Sputum▫Wheeze

Investigations•PEFR•Full blood count (↑ WCC)•U&Es•CRP•Lactate•ABGs•CXR•Nose & throat swabs (PCR tests)•Sputum (microscopy, culture & sensitivities)

SEPSIS etc.• SIRS

▫ >1 of : Temp <36°C or >38°C HR >90/min RR >20/min WCC <4x109/dl or >12x109/dl

• SEPSIS▫ SIRS + known or suspected infection

• SEVERE SEPSIS▫ Sepsis + organ failure

• SEPTIC SHOCK▫ sepsis + hypotension (SBP <90mmHg) despite fluid resuscitation +

perfusion abnormalities eg. lactic acidosis, ↓UO, ↓GCS

SEPSIS 6

1. Give high-flow oxygen2. Take blood cultures3. Give empirical IV antibiotics4. Measure FBC & serum lactate5. Start IV fluid resuscitation6. Start accurate urine output

measurements

CURB-65

•Confusion•Urea

▫>7mmol/L•Respiratory rate

▫>30/minute•Blood pressure

▫<90mmHg systolic or <60mmHg diastolic•age ≥65 years old• if score >1 → admit & if score >2 → IV

treatment

Antibiotics• CAP

▫Streptococcus pneumoniae▫Staphylcoccus aureus▫Haemophilus influenzae▫Amoxicillin/Clarithromycin

• HAP▫48-72h after being admitted▫Often caused by multiple organisms

• Acute bronchitis▫Often viral – no antibiotics!

Any questions?