Streptococcus mielii pneumonia
Introduction
Introduction to Streptococcus M. pneumonia Streptococcus mutans is a group of Streptococcus, which is further divided into -hemolytic streptococcus (S. angionosus), or -hemolytic streptococcus (S. constellatus) and Streptococcus mutans. (S.intermedius). According to Shancheng Report, 11.7% (14/120) of 105 CFU/ml of Streptococcus mutans were detected in swabs of healthy adults (20-80 years old). Therefore, if the bacteria are detected from the cockroaches, it is not necessarily the pathogenic bacteria. S. milleri is a common bacterium in the mouth and can also cause respiratory infections, including pneumonia. basic knowledge The proportion of illness: 0.03% Susceptible people: no special people Mode of infection: non-infectious Complications: lung abscess
Cause
Cause of Streptococcus mümeris pneumonia
(1) Causes of the disease
Streptococcus mutans is a group of Streptococcus, which is further divided into -hemolytic streptococcus (S. angionosus), or -hemolytic streptococcus (S. constellatus) and Streptococcus mutans. (S.intermedius), according to the Shancheng report, in the swallow swab specimens of healthy adults (20-80 years old), 11.7% (14/120) of 105 CFU/ml or more of Streptococcus mutans were detected, so if The bacteria are detected in the sputum, not necessarily the pathogenic bacteria.
(two) pathogenesis
The disease may occur after inhalation through the respiratory tract, and the exact pathogenesis is not well understood.
Prevention
Streptococcus M. pneumoniae prevention
Avoid the rain, cold, fatigue, drunkenness and other predisposing factors.
For susceptible populations, the pneumococcal vaccine can be injected. In the 1920s, the Streptococcus pneumoniae vaccine was used. It was abandoned due to the rise of antibiotics. With the increase of drug-resistant bacteria, vaccination has been revived for more than a decade. Attention is paid to the use of a multi-type combination of purified capsular antigen vaccines. Currently, there are commercially available vaccines containing 23 antigens in the specific polysaccharide antigen of Streptococcus pneumoniae, covering 85% to 90% of infections caused by Streptococcus pneumoniae. Although the level of precise protection is not well understood, because it is usually not possible to determine the antibody titer, it is generally believed that antibodies are present in the serum 2 to 3 weeks after the injection of the pneumococcal vaccine in healthy people, and the antibody titer continues to increase in 4 to 8 weeks. It can reduce the incidence of pneumococcal pneumonia, the effective rate is more than 50%, the period of protection is at least 1 year, for high-risk groups, repeated vaccination after 5 to 10 years.
Complication
M. streptococci pneumonia complications Complications, lung abscess, empyema
Complicated with lung abscess and empyema.
Symptom
M. streptococci pneumonia symptoms common symptoms abscess empyema
There were 3 cases of acute tonsillitis, 3 cases of pneumonia, 11 cases of pleurisy with empyema, 7 cases of empyema, and 1 case of emphysema infection, aged from 26 to 81 years old. (more than 55 years old), including 15 cases of community infection, 2 cases of infection in nursing homes, 1 case of nosocomial infection, another scholar also confirmed that 80% of empyema caused by Streptococcus mutans is a community infection, from bacterial species There were 1 case of Streptococcus angina, 6 cases of Streptococcus mutans, and 11 cases of Streptococcus mutans.
There were many basic patients, including 5 cases of cerebrovascular accident, 2 cases of liver dysfunction, 2 cases of malignant tumor, 2 cases of diabetes, 1 case of emphysema, and the condition was more serious. 10 cases of patients were seriously addicted to tobacco. In 8 cases of alcoholics, the severity of inhalation as an infection route should be specifically pointed out.
Examine
Examination of Streptococcus mellitus pneumonia
When a bacterial infection occurs in the lungs or bronchus of the human body, the amount of sputum is significantly increased, and the sputum bacteria are cultured to isolate the pathogenic bacteria, which is helpful for the diagnosis and treatment of infectious diseases of the lower respiratory tract.
The normal value of sputum bacterial culture: normal human lower respiratory tract is sterile, no pathogens, fungi, tuberculosis should be detected.
1. Bacterial culture, the bacteria are mostly pure culture.
2. Chest X-ray examination, normal in the early stage, flaky shadows can appear around 24h.
Diagnosis
Diagnosis and identification of Streptococcus mümeris pneumonia
diagnosis
According to the history and clinical manifestations of respiratory symptoms, plus blood culture positive can be diagnosed.
Differential diagnosis
Caseous pneumonia
The clinical manifestations of acute tuberculous pneumonia are similar to those of pneumococcal pneumonia. The X-ray also has lung consolidation, but tuberculosis often has low heat and fatigue. It is easy to find tuberculosis in the sputum. X-ray shows that the lesion is mostly above the lung tip or clavicle, and the density is uneven. The disease does not dissipate for a long time, and can form voids and spread in the lungs, while pneumococcal pneumonia is treated with penicillin for 3 to 5 days, the body temperature can return to normal, and the inflammation in the lungs is absorbed faster.
2. Pneumonia caused by other pathogens
The clinical manifestations of staphylococcal pneumonia and Klebsiella pneumoniae are serious. Gram-negative bacilli pneumonia is common in frail, chronic heart disease or immunocompromised patients, mostly secondary infections in the hospital, sputum, blood or pleural bacteria. Positive culture is an indispensable basis for diagnosis. Viral and mycoplasmal pneumonia are generally mild, and white blood cells are often not significantly increased. Clinical procedures, sputum pathogen isolation and blood immunological tests are important for diagnosis.
3. Acute lung abscess
Early clinical manifestations are similar to pneumococcal pneumonia, but with the development of the disease course, a large number of characteristic pus sputum plaques appear, the pathogens are Staphylococcus aureus, Klebsiella and other Gram-negative bacilli and anaerobic bacteria. X-ray shows the abscess and fluid level, which is easier to identify.
4. Lung cancer
A few peripheral lung cancer X-ray images are similar to lung inflammation, but generally do not have fever or only low fever, peripheral white blood cell count is not high, cancer cells can be diagnosed in the sputum, central lung cancer can be associated with obstructive pneumonia, after antibiotic treatment The inflammation subsides, the tumor shadow becomes more and more obvious, or it is accompanied by hilar lymphadenopathy and atelectasis. For the effective antibiotic treatment, the inflammation will not dissipate for a long time, or it will appear again after dissipating, especially in older people. If necessary, do CT, sputum exfoliated cells and fiberoptic bronchoscopy to determine the diagnosis.
5. Other diseases
When pneumonia is accompanied by chest pain, it needs to be differentiated from exudative pleurisy, pulmonary infarction, pleural effusion and X-ray. The pulmonary infarction has the basis of venous thrombosis. The hemoptysis is more common, and there are few cases of oral herpes. Pneumonia sometimes has abdominal symptoms, and should be differentiated by X-ray and other examinations and underarm abscess, cholecystitis, pancreatitis.
