儿科学课件-肺炎.PPTVIP

Bacteria Antibiotics Duration G+ coccus Penicillin ， 1st and 2nd cephalosporin 7—10 days G- bacillus 2nd and 3rd cephalosporin 1—2 weeks S. aureus金葡菌 Piperacillin Sodium ，Vancomycin 3—4 weeks M. pneumoniae支原体 Macrolides大环内脂 2—3 weeks Question How about the clinical course of pneumonia ? With treatment, pneumonia caused by bacteria can usually be cured in 1 or 2 weeks Pneumonia caused by a virus often lasts longer Clinical Course Several Pneumonias Bronchiolitis is the most common serious respiratory infection of infancy Two to three per cent of all infants are admitted to hospital with the disease each year during annual winter epidemics Respiratory syncytial virus (RSV) is the pathogen in 75-80% cases Clinical features: Age: 2-6 month Season Wheezing X-ray Duration: 7-10 days Bronchiolitis毛细支气管炎 Hyperinflation of the lungs with flattening of diaphragm Investigations RSV can be identified rapidly using a fluorescent antibody test on nasopharyngeal secretions The chest X-ray shows hyperinflation膨胀充气 of the lungs due to small airways obstruction and air trapping Blood gas analysis, which is required in only the most severe cases, shows lowered arterial oxygen and raised CO2 tension Management Supportive. Humidified oxygen is delivered into a head-box Mist, antibiotics and steroids are not helpful Nebulised bronchodialators do not reduce the severity or duration of the illness The antiviral drug ribavirin only marginally shortens viral excretion and clinical symptoms, and should be considered only for infants with underlying cardiopulmonary disorders or immunodeficiency Fluids may need to be given by nasogastric tube or intravenously Mechanical ventilation is required in about 2% of infants admitted to hospital There are over 60 types of adenoviruses, which account for 2-10% of all re