John T Macfarlane, Nottingham City Hospital, Nottingham, UK
Published online: April 2001
DOI: 10.1038/npg.els.0002218
Bacteria are a common cause of both upper and lower respiratory tract infections. An understanding of the classification, likely pathogens, clinical presentation and investigation is needed to plan the logical management of patients.
Keywords: bronchitis; pneumonia; antibiotics; lower respiratory tract infection; upper respiratory tract infection
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Figure 1. Photomicrograph of a section of lung from an adult who died from pneumococcal lobar pneumonia. The alveolar walls can be easily seen and are only slightly thickened. The alveolar spaces are filled with exudate and acute inflammatory cells.
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Figure 2. A Gram stain of sputum from a patient with pneumococcal pneumonia. Gram-positive cocci can be seen, some having been phagocytosed by neutrophils.
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Figure 3. Chest radiograph of a 68-year-old man admitted with right lower lobe pneumonia associated with pleurisy and a right pleural effusion. A large heart is also present.
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| References | |
| American Thoracic Society (1996) Hospital acquired pneumonia in adults: diagnosis, assessment of severity, initial antimicrobial therapy, and preventative strategies. A consensus statement. American Journal Respiratory and Critical Care Medicine 1553: 1711–1725. | |
| British Thoracic Society (1997) BTS guidelines for the management of chronic obstructive pulmonary disease. Thorax 52 (supplement 5): 51–528. | |
| Fahey T, Stocks N and Thomas T (1998) Quantitative systemic review of randomised controlled trials comparing antibiotic with placebo for acute cough in adults. British Medical Journal 316: 906–910. | |
| Ferguson AD, Prescott RJ, Selkon JB, Watson D and Swinburn CR (1996) The clinical course and management of thoracic empyema. Quarterly Journal of Medicine 89: 285–289. | |
| Little P, Williamson I, Warner G et al. (1997) Open randomised trial of prescribing strategies in managing sore throat. British Medical Journal 314: 722–727. | |
| Macfarlane JT (1994) An overview of community acquired pneumonia with lessons learned from the British Thoracic Society study. Seminars in Respiratory Infections 9: 153–165. | |
| Macfarlane JT and Wong CA (1997) Prevention of community acquired pneumococcal and influenza infection in adults: a re-evaluation of vaccination. European Respiratory Monograph 3: 56–81. | |
| Mossad SB (1998) Treatment of the common cold. British Medical Journal 317: 33–36. | |
| Murray CJL and Lopez AD (1997) Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet 349: 1269–1276. | |
| book Reynolds HY (1994) "Normal and defective respiratory host defenses". In: Pennington JE (ed.) Respiratory Infections: Diagnosis and Management, 3rd edn, pp.1–34. New York: Raven Press. | |
| Woodhead MA (1992) Management of pneumonia. Respiratory Medicine 86: 459–469. | |
| Further Reading | |
| British Thoracic Society (1993) Guidelines for the management of community acquired pneumonia in adults. British Journal of Hospital Medicine 49: 346–350. | |
| book Macfarlane JT, Finch RG and Cotton RE (1993) A Colour Atlas of Respiratory Infections. London: Chapman and Hall Medical. | |
| Niederman MS (1994) Pneumonia. Medical Clinics of North America 79: 941–1206. | |
| American Thoracic Society (1993) Guidelines for the initial management of adults with community-acquired pneumonia: diagnosis, assessment of severity, and initial antimicrobial therapy. American Review of Respiratory Diseases 148: 1418–1426. | |
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