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Diseases of the Respiratory System

Dr. Ashish V. Jawarkar
The Upper Respiratory System
Consists of:
Nose
Pharynx

(throat)
Middle ear
Eustachian
tubes
Dr. Ashish V. Jawarkar
The Lower Respiratory System
Consists of:
Larynx
Trachea
Bronchial
Alveoli
Pleura

Dr. Ashish V. Jawarkar

tubes
Upper Respiratory System defense

•Coarse hairs in the nose filter large
particles from air entering the respiratory
tract.
•The ciliated mucous membranes of the
nose and throat trap airborne particles and
remove them from the body.
•Lymphoid tissue, tonsils, and adenoids
provide immunity to certain infections.
Dr. Ashish V. Jawarkar
Dr. Ashish V. Jawarkar
Lower respiratory tract defense
The lower respiratory

system is usually sterile
because of the action of the
ciliary escalator.
Microorganisms hoping to
infect the respiratory tract
are caught in the sticky
mucus and moved up by the
mucociliary escalator.
Dr. Ashish V. Jawarkar
Upper Respiratory System Diseases
Most respiratory tract infections

are self-limiting.
Often caused by bacteria & viruses
in combination

Dr. Ashish V. Jawarkar
Upper Respiratory System Diseases
Pharyngitis: inflammation of the pharynx
Laryngitis: swelling and irritation (inflammation) of
the voice box (larynx)

Tonsillitis: inflammation of the tonsils
Sinusitis: inflammation of the sinuses

Dr. Ashish V. Jawarkar
Agents of URTi
S. pneumonia – pharyngitis/tonsillitis
S. Pyogenes – pharyngitis / tonsillitis
C. diphtheria - diptheria
B. pertussis – whooping cough
Common cold – rhino virus

Dr. Ashish V. Jawarkar
Streptococcal Pharyngitis
Also called strep throat
Streptococcus pyogenes /

strep. pneumoniae
Gram positive cocci
chains

Dr. Ashish V. Jawarkar
Corynebacterium Diphtheriae
Gram positive club shaped rod

Dr. Ashish V. Jawarkar
Dr. Ashish V. Jawarkar
Dr. Ashish V. Jawarkar
Diphtheria
Diphtheria membrane: Fibrin, tissue, bacterial

cells

••Leading infectious killer of children in U.S. in 1935
Leading infectious killer of children in U.S. in 1935
Dr. Ashish V. Jawarkar
Diphtheria
Still common in developing countries where

immunizations aren't given routinely.
Up to 40% to 50% of those who don't get
treated can die.
The exotoxin inhibits protein synthesis, and
heart, kidney, or nerve damage may result.
Prevented by DTP vaccine

Dr. Ashish V. Jawarkar
Lab diagnosis
Microscopy – Gram’s , Albert’s
Culture – selective media containing tellurite,

Loeffler’s serum slope

Dr. Ashish V. Jawarkar
Pertussis / whooping cough
Causes whooping

cough
Mostly in children
Coughing thru
strained vocal
cords produces
sound

Dr. Ashish V. Jawarkar
diagnosis
Mostly clinical
Bacteria does not grow on ordinary media
Prevented by vaccination – DPT

Dr. Ashish V. Jawarkar
Lower Respiratory System Diseases
Bacteria, viruses, and fungi cause
 Bronchitis

– S. pneumoniae
 Pneumonia – S. pneumoniae, Klebsiella,
Mycoplasma
 Tuberculosis - M. tuberculosis

Dr. Ashish V. Jawarkar
Mycoplasma
Bacteria with no cell walls
Gram negative, better stained with Giemsa stain

Dr. Ashish V. Jawarkar
Grow on media enriched with serum
Colonies give fried egg appearance

Dr. Ashish V. Jawarkar
Mycoplasmal Pneumonia
Primary atypical pneumonia; walking pneumonia



No physical signs/symptoms
X ray shows lower lobe pneumonia

Genitourinary infections

Dr. Ashish V. Jawarkar
Dr. Ashish V. Jawarkar
Viral Pneumonia
Viral pneumonia occurs as a complication of

influenza, measles, or chickenpox
Viral etiology suspected if no other cause is
determined

Dr. Ashish V. Jawarkar
Respiratory Syncytial Virus (RSV)
The most common viral respiratory disease in

infants; 4500 deaths annually
Causes cell fusion (syncytium) in cell culture
Symptoms: Pneumonia in infants
Diagnosis: Serological test for viruses and
antibodies
Treatment: Ribavirin, palivizumab

Dr. Ashish V. Jawarkar
Influenza (Flu)
Symptoms: Chills, fever, headache, and muscle

aches


No intestinal symptoms

1% mortality, very young and very old
Treatment: Zanamivir and oseltamivir inhibit

neuraminidase
Prophylaxis: Multivalent vaccine (currently grown
in Embryonated egg cultures

Dr. Ashish V. Jawarkar
The Influenza Virus
Hemagglutinin

(HA) spikes used
for attachment to
host cells
Neuraminidase (NA)
spikes used to
release virus from
cell

Dr. Ashish V. Jawarkar
Fungal Infections
Fungal spores are easily

inhaled; they may germinate in the
lower respiratory tract.
The incidence of fungal diseases has
been increasing in recent years.
The mycoses can be treated with
amphotericin B.

Dr. Ashish V. Jawarkar
Dr. Ashish V. Jawarkar

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respiratory infections - microbiology

  • 1. Diseases of the Respiratory System Dr. Ashish V. Jawarkar
  • 2. The Upper Respiratory System Consists of: Nose Pharynx (throat) Middle ear Eustachian tubes Dr. Ashish V. Jawarkar
  • 3. The Lower Respiratory System Consists of: Larynx Trachea Bronchial Alveoli Pleura Dr. Ashish V. Jawarkar tubes
  • 4. Upper Respiratory System defense •Coarse hairs in the nose filter large particles from air entering the respiratory tract. •The ciliated mucous membranes of the nose and throat trap airborne particles and remove them from the body. •Lymphoid tissue, tonsils, and adenoids provide immunity to certain infections. Dr. Ashish V. Jawarkar
  • 5. Dr. Ashish V. Jawarkar
  • 6. Lower respiratory tract defense The lower respiratory system is usually sterile because of the action of the ciliary escalator. Microorganisms hoping to infect the respiratory tract are caught in the sticky mucus and moved up by the mucociliary escalator. Dr. Ashish V. Jawarkar
  • 7. Upper Respiratory System Diseases Most respiratory tract infections are self-limiting. Often caused by bacteria & viruses in combination Dr. Ashish V. Jawarkar
  • 8. Upper Respiratory System Diseases Pharyngitis: inflammation of the pharynx Laryngitis: swelling and irritation (inflammation) of the voice box (larynx) Tonsillitis: inflammation of the tonsils Sinusitis: inflammation of the sinuses Dr. Ashish V. Jawarkar
  • 9. Agents of URTi S. pneumonia – pharyngitis/tonsillitis S. Pyogenes – pharyngitis / tonsillitis C. diphtheria - diptheria B. pertussis – whooping cough Common cold – rhino virus Dr. Ashish V. Jawarkar
  • 10. Streptococcal Pharyngitis Also called strep throat Streptococcus pyogenes / strep. pneumoniae Gram positive cocci chains Dr. Ashish V. Jawarkar
  • 11. Corynebacterium Diphtheriae Gram positive club shaped rod Dr. Ashish V. Jawarkar
  • 12. Dr. Ashish V. Jawarkar
  • 13. Dr. Ashish V. Jawarkar
  • 14. Diphtheria Diphtheria membrane: Fibrin, tissue, bacterial cells ••Leading infectious killer of children in U.S. in 1935 Leading infectious killer of children in U.S. in 1935 Dr. Ashish V. Jawarkar
  • 15. Diphtheria Still common in developing countries where immunizations aren't given routinely. Up to 40% to 50% of those who don't get treated can die. The exotoxin inhibits protein synthesis, and heart, kidney, or nerve damage may result. Prevented by DTP vaccine Dr. Ashish V. Jawarkar
  • 16. Lab diagnosis Microscopy – Gram’s , Albert’s Culture – selective media containing tellurite, Loeffler’s serum slope Dr. Ashish V. Jawarkar
  • 17. Pertussis / whooping cough Causes whooping cough Mostly in children Coughing thru strained vocal cords produces sound Dr. Ashish V. Jawarkar
  • 18. diagnosis Mostly clinical Bacteria does not grow on ordinary media Prevented by vaccination – DPT Dr. Ashish V. Jawarkar
  • 19. Lower Respiratory System Diseases Bacteria, viruses, and fungi cause  Bronchitis – S. pneumoniae  Pneumonia – S. pneumoniae, Klebsiella, Mycoplasma  Tuberculosis - M. tuberculosis Dr. Ashish V. Jawarkar
  • 20. Mycoplasma Bacteria with no cell walls Gram negative, better stained with Giemsa stain Dr. Ashish V. Jawarkar
  • 21. Grow on media enriched with serum Colonies give fried egg appearance Dr. Ashish V. Jawarkar
  • 22. Mycoplasmal Pneumonia Primary atypical pneumonia; walking pneumonia   No physical signs/symptoms X ray shows lower lobe pneumonia Genitourinary infections Dr. Ashish V. Jawarkar
  • 23. Dr. Ashish V. Jawarkar
  • 24. Viral Pneumonia Viral pneumonia occurs as a complication of influenza, measles, or chickenpox Viral etiology suspected if no other cause is determined Dr. Ashish V. Jawarkar
  • 25. Respiratory Syncytial Virus (RSV) The most common viral respiratory disease in infants; 4500 deaths annually Causes cell fusion (syncytium) in cell culture Symptoms: Pneumonia in infants Diagnosis: Serological test for viruses and antibodies Treatment: Ribavirin, palivizumab Dr. Ashish V. Jawarkar
  • 26. Influenza (Flu) Symptoms: Chills, fever, headache, and muscle aches  No intestinal symptoms 1% mortality, very young and very old Treatment: Zanamivir and oseltamivir inhibit neuraminidase Prophylaxis: Multivalent vaccine (currently grown in Embryonated egg cultures Dr. Ashish V. Jawarkar
  • 27. The Influenza Virus Hemagglutinin (HA) spikes used for attachment to host cells Neuraminidase (NA) spikes used to release virus from cell Dr. Ashish V. Jawarkar
  • 28. Fungal Infections Fungal spores are easily inhaled; they may germinate in the lower respiratory tract. The incidence of fungal diseases has been increasing in recent years. The mycoses can be treated with amphotericin B. Dr. Ashish V. Jawarkar
  • 29. Dr. Ashish V. Jawarkar