multiple lung infections
Introduction
Introduction to multiple lung infections Multiple microbial pulmonary infections refer to lung infections of two or more (including two) pathogenic microorganisms, also known as mixed infections. Multiple infections Strictly speaking, it refers to a variety of pathogens that are primary and concurrent infections, excluding one pathogen primary infection and another pathogen infection. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific people Mode of infection: non-infectious Complications: interstitial pneumonia
Cause
Multiple lung infections
(1) Causes of the disease
The pathogen spectrum of multiple lung infections can be simultaneous infection of any different types of pathogens or different species (genus) of pathogens in the same type. The more common pathogen combinations are:
1. Multiple bacterial infections of two or more aerobic bacteria (including Gram-positive and Gram-negative, two Gram-negative bacilli or two Gram-positive cocci), aerobic and anaerobic bacteria, mycobacteria and Common bacteria co-infection.
2. Bacteria plus fungal infections Any bacterial and fungal infections, with aerobic bacteria and conditional pathogens such as Candida, Aspergillus are the most common.
3. Bacterial plus protozoal infection is common with Pneumocystis carinii and bacterial infection.
4. Bacterial plus virus infection Common respiratory virus infection is secondary to bacterial infection. In immunosuppressed patients, there is a common infection of bacteria and cytomegalovirus.
(two) pathogenesis
1. Clinical disease spectrum multiple infections are common in aspiration pneumonia and lung abscess, bronchiectasis, nosocomial pneumonia, especially ventilator-associated pneumonia, immune damage to host pneumonia and various other severe pneumonia.
2. Risk factors for the elderly, underlying diseases (chronic airway disease, diabetes, renal failure, cardiac insufficiency, etc.), disturbance of consciousness, alcoholism, malnutrition, immunosuppression, mechanical ventilation and other invasive techniques (such as fiberoptic bronchoscopy) Check), early antibiotic treatment, latent infection or some endemic epidemic disease epidemic area or special environmental exposure, end-stage disease, long-term hospitalization, special ICU, etc. can be risk factors for multiple lung infections.
Prevention
Multiple lung infection prevention
Active treatment should be carried out for pathogens. If the curative effect is not satisfactory during the treatment, the susceptibility test should be performed as early as possible, and then the sensitive drugs should be selected for treatment.
Complication
Multiple pulmonary infection complications Complications interstitial pneumonia
Often bacterial and cytomegalovirus co-infection.
Symptom
Multiple lung infection symptoms Common symptoms Wet rales upper respiratory tract and oral cavity... Lung infection
Anaerobic bacteria combined with other pathogen infections may have clinical features of anaerobic infections such as cough and sputum, and other types of multiple infections lack characteristic symptoms. In general, patients with multiple infections have more severe symptoms.
Multiple lung infections, although clinically quite common, are difficult to diagnose. One is because some pathogens such as viruses do not meet the clinical needs of laboratory diagnostic techniques. Second, due to the difficulty in collecting lower respiratory tract specimens, there is a large number of colonizations in the upper respiratory tract and oral cavity. Bacteria, but in the long-term hospitalization or antibacterial treatment process, its flora often changes, oral cough specimens are susceptible to contamination, culture of a variety of bacterial growth does not mean that there are multiple infections, on the contrary, sterile growth or single bacterial growth can not Eliminate multiple infections.
Examine
Multiple lung infections
Cough is screened and cultured in qualified samples. If two or more bacteria are dominant growth, they reach 106 CFUml, which has important reference value.
X-ray lesions are more extensive and necrotizing pneumonia is more common.
Diagnosis
Diagnosis and diagnosis of multiple lung infections
Clinically, patients with multiple above-mentioned multiple infections and risk factors or patients with moderate or severe pulmonary infection who are not treated with standardized antibiotics should be alert. Considering the possibility of multiple infections, lung abscess and bronchiectasis are common anaerobic. Mixed infection of bacteria and aerobic bacteria, if the clinical symptoms are typical, can be treated according to multiple infections. In other types of pneumonia, multiple infections including the diagnosis of double infection require exact pathogen evidence, blood and pleural fluid specimens are the most diagnostic Value, lower respiratory tract anti-pollution or bronchoalveolar lavage specimens need to be combined with quantitative culture. Cough is screened and qualified specimens are cultured. If two or more bacteria are dominant growth, they reach 106 CFUml, which has important reference value and conditional disease. Sexual fungi also need to be sampled from the lower respiratory tract using anti-pollution techniques. The results of culture of oral sputum specimens are meaningless. Virus detection is difficult to cultivate, serum immunology and molecular biology techniques have reference value. Histopathological examination of Pseudomonas aeruginosa Pneumonia and certain specific pathogen infections (fungi, Pneumocystis carinii, branching rod ) Combined with special staining has important diagnostic value.
