Lower Respiratory Tract Infections (LRTIs)

LRTIs are infections that affect the lungs and bronchial tubes. They can be caused by bacteria, viruses, or other pathogens. The most common symptoms of LRTIs are coughing, shortness of breath, chest pain, and fever.

Diagnosis

When examining a patient with LRTI, practitioners should listen to the chest sounds. The sounds can be classified into three types: wheezing, crackles, and rhonchi. Chest X-rays can also be used to diagnose LRTIs. They can show signs of pneumonia such as consolidation or infiltrates.

Bronchitis vs Pneumonia

Bronchitis affects the bronchial tubes that carry air to your lungs. It is an inflammation of the lining of these tubes. On the other hand, pneumonia affects the air sacs in the lungs, called alveoli. The causes of bronchitis and pneumonia also differ. Bronchitis is usually caused by a virus, while pneumonia can be caused by viruses, bacteria, or fungi.

Causes of Pneumonia

Some common types of bacteria that can cause pneumonia include Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Viral pneumonia can be caused by different viruses such as the influenza virus and respiratory syncytial virus. Fungi from soil or bird droppings can also cause pneumonia.

Treatment

Treatment for LRTIs depends on the cause of the infection. Viral infections usually go away on their own with rest and over-the-counter medications for cough or fever. Bacterial infections are treated with antibiotics. Patients with severe LRTIs may need to be hospitalized.

In the UK, health care providers follow guidelines from the National Institute for Health and Care Excellence (NICE) when treating LRTIs. Antibiotics are not recommended for viral infections such as bronchitis. Antibiotics are only prescribed for bacterial infections such as pneumonia if the patient has severe symptoms or is at risk of complications.

The types of antibiotics that might typically be prescribed for pneumonia include amoxicillin plus a macrolide like Zithromax (azithromycin) or a tetracycline like Vibramycin (doxycycline) for healthy adults under 65 years. Infants, preschoolers, and school-aged children with suspected bacterial pneumonia may be treated with amoxicillin. Children with suspected atypical pneumonia can be treated with macrolides.

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