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Chest Infection - Coggle Diagram
Chest Infection
how to assess
take full histroy, ask about onset symptoms, duration and frequency of cough, type, precipitating or exacerbating factors, diurnal variation, associate symptoms with throat, chest or gastrointestinal
smoking history
enviromental factors and occupational history
family history, recent RTI, or and travel history
ask about red flags, haemoptysis, hoarseness, peripheral oedema with weight gain, prominent dyspnoea, especially at night
systemic symptoms such as fever or weightloss
trouble swallowing
vomitting
consider comorbid conditions that may cause cough, allergies, asthma, COPD, bronchiectasis, HF, GORD, sleep apnoea syndrome
review medications such as angiotensin converting enzymes, ACE inhibitors or sitagliptin
pay attention to chest, heart, ears, pharynx and nose on examination
arrange investigations in primary care if appropriate such as pulse oximetry, peek flow, CRP, spirometry and chest Xray.
complications
cough syncope
depression/anxiety/anger/frustration
difficulties in relationships
disturbed sleep
dysphonia
fatigue
reduced quality of life
social isolation
reduced quality of life
stress urinary incontinence
Assessment
cough is the predominant symptoms in both acute bronchitis and community acquired pneumonia
PCR to rule out covid 19
onset and duration of symptoms: type of cough dry or productive, breathlessness, wheeze, pleuritic pain and fever
pay attention to chest on examination, measure observations, assess for signs of confusion
be aware, elderly people with pneumonia, symptoms may be less evident such as alter conscious level, gastrointestinal discomfort, typical symptoms may be absent
if clinical symptoms suggest CAP assess the severity of illness using CRB 65 score for mortality risk
in young people use clinical judgment to assess the severity of symptoms take into account features that suggest severe CAP
arrange hospital admission for people who require supplemental O2, check CRP if uncertain whether ABX are indicated, request CXR is CAP is suspected or at risk of underlying lung pathology
request sputum culture for moderate severity CAP for whom community management is appropriate
acute cough less than 3 weeks
most commonly viral upper respiratory tract infection such as cold or flu
coronavirus, acute bronchitis, tracheobronchitis, pneumonia, acute exacerbations of asthma, COPD, pulmonary disease, bronchiectasis, PE or pneumothorax
sub-acute cough
post infectious cough after pneumonia or whooping cough
chronic cough
sensitivity to inhalation of environmental irritants, hypersensitivity syndrome, term used to describe cough reflux caused by thermal chemical or mechanical stimulation
exposures to cigarette smoke, upper airway cough syndrome, asthma, eosinophilic bronchitis, GORD, ACE inhibitors.
other causes
bronchiectasis
COPD
variant asthma
environmental or occupational causes
foreign body aspiration
HF
ILD
Lung CA
obstructive sleep apnoea
pertussis
pulmonary TB
somatic cough syndrome
thoracic aortic aneurysm
Definition
acute bronchitis - lower respiratory tract infection caused by inflammation in the bronchial airways
pneumonia - and infection of the lung tissue in which the air sacs in the lungs becomes filled with microorganisms, fluid and inflammatory cells affecting the function of the lungs
diagnosis