RESPIRATORY SYSTEM INFECTIONS

PNEUMONIA

Pneumonia is an infectious disease that attacks the lung and is caused by germs (viruses or bacteria). It occurs mainly in the winter and presents usually with cough, fever, chest pain, pleural pain and shortness of breath. It can affect the entire community and especially vulnerable groups of patients suffering from diabetes mellitus, heart failure, renal failure, malignancies and so on.

The main, but not the only microbe causing pneumonia is pneumococcus (streptococcus pneumoniae). To reduce the risk of pneumococcal pneumonia in susceptible groups, a pneumococcal vaccine is administered. Pneumonia caused by influenza can usually present with severe symptoms, prevention can be achieved with the influenza vaccine.

Diagnosis of pneumonia requires a clinical examination with emphasis on auscultation and chest X-ray. The disease is treated with broad spectrum antibiotics at home. 
If the patient experiences dyspnoea, hypoxia, tachypnoea, blood pressure dropping or prolonged fever despite treatment, then hospitalization is required to administer intravenous antibiotics to prevent complications. 
If pneumonia is accompanied by a collection of fluid in the pleural cavity, then the thoracocentesis is performed and a sample of the fluid is removed, which is sent for examination. In the case of empyema , i.e. the presence of puss in the thoracic cavity, an immediate drainage of the fluid is required by placing a chest drain.

TUBERCULOSIS

What is TB?

Tuberculosis is a serious contagious  disease that in some cases can even lead to death. In Greece, it is a serious public health problem. 
Tuberculosis is caused by a microbe, well-known bacillus of Koch or mycobacterium, the lungs act as a direct portal when contamination takes place and transfers to the human body.
Mycobacterium Tuberculosis infection is caused by contact with a diseased person. Mycobacterium tuberculosis exists in tiny droplets in the air, around the patient who coughs, sneezes or speaks strongly. The healthy person is infected when he inhales these droplets and they reach his lungs. If someone is infected with mycobacteria of tuberculosis, he may not be sick because their immune system will entrap mycobacteria. These will "sleep" and if the immune system fails for any reason they will be triggered. 
If an infection occurs where the microbial load is proven to be stronger than the immune system, then the host will be initially affected by active tuberculosis.

Symptoms 

• Cough with a long duration
• Fever
• Night sweats
• Enlarged lymph nodes
• Haemoptysis
• Weight loss without the individual being on a diet

Diagnosis of tuberculosis is sometimes difficult and the physician should take into account both the clinical picture and the results of appropriate hematological and imaging examinations. Very useful is the examination of sputum and bronchial lavage and bronchoscopic biopsy are taken by bronchoscopy.

Prevention

Tuberculosis is endemic in a malnourished population that has poor hygiene standards, in immunocompromised patients (chemotherapeutics, diabetes mellitus, kidney patients, AIDS patients, etc.). It is very important to have mantoux test  in such populations and to provide prophylactic treatment to the carriers of the disease.

Treatment

The treatment includes various combinations of special drugs, usually four (Isoniazid, Rifampin, Ethambutol and Pyrazinamide), and can last for 6 months or longer. 
If you have any reason to worry that you may be infected from tuberculosis, or have come into contact with a person who has tuberculosis, you should visit the doctor and inform him about the possibility of exposure to mycobacteria.