Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Part 1 Diagnosis, host defence and antimicrobials
- Part 2 Respiratory infections due to major respiratory pathogens
- Part 3 Major respiratory syndromes
- 17 Community-acquired pneumonias
- 18 Community-acquired fungal pneumonias
- 19 Hospital–acquired pneumonia
- 20 Anaerobic bacterial pneumonia, lung abscess, pleural effusion/empyema
- 21 Pneumonia in the immunocompromised host
- 22 HIV-associated respiratory infections
- 23 Infection in children
- 24 Pulmonary infection in cystic fibrosis
- 25 Upper respiratory tract infections
- 26 Respiratory infections associated with foreign travel
- 27 Intensive care management of the critically ill patient with pneumonia
- 28 Diseases associated with persistent or recurrent pulmonary infiltrates
- 29 Chronic air flow obstruction, acute and chronic bronchitis, and bronchiectasis
- 30 Miscellanous agents of pneumonia and lower respiratory tract infections
- Index
28 - Diseases associated with persistent or recurrent pulmonary infiltrates
from Part 3 - Major respiratory syndromes
Published online by Cambridge University Press: 05 October 2010
- Frontmatter
- Contents
- List of contributors
- Preface
- Part 1 Diagnosis, host defence and antimicrobials
- Part 2 Respiratory infections due to major respiratory pathogens
- Part 3 Major respiratory syndromes
- 17 Community-acquired pneumonias
- 18 Community-acquired fungal pneumonias
- 19 Hospital–acquired pneumonia
- 20 Anaerobic bacterial pneumonia, lung abscess, pleural effusion/empyema
- 21 Pneumonia in the immunocompromised host
- 22 HIV-associated respiratory infections
- 23 Infection in children
- 24 Pulmonary infection in cystic fibrosis
- 25 Upper respiratory tract infections
- 26 Respiratory infections associated with foreign travel
- 27 Intensive care management of the critically ill patient with pneumonia
- 28 Diseases associated with persistent or recurrent pulmonary infiltrates
- 29 Chronic air flow obstruction, acute and chronic bronchitis, and bronchiectasis
- 30 Miscellanous agents of pneumonia and lower respiratory tract infections
- Index
Summary
Introduction
Some patients with pulmonary infiltrates and a supposed infectious pneumonia may not respond in a seemingly appropriate fashion to antimicrobial therapy. Their progress may be unduly prolonged, the pneumonic process may recur or may not resolve on antibiotics. There are four possibilities viz: (a) a truly infectious pneumonia of common aetiology, e.g. caused by Streptococcus pneumoniae, Haemophilus or Legionella spp, which is resolving at a perceived slow but a normal expected rate; (b) an infectious pneumonia of either an uncommon aetiology, for example, Mycobacterium tuberculosis, or of a common aetiology but in which the organism is resistant, the mode of antimicrobial treatment is not appropriate (e.g. low dosages) or there are suppurative or indirect complications arising from the pneumonia, but which, once recognised and treated appropriately, will respond accordingly; (c) an infectious pneumonia which is resolving slowly or which recurs as a result of an underlying host mechanical defect, or immunocompromisation, including aged and pregnant patients; (d) an apparent infectious pneumonia which does not resolve or recurs and is in reality non-microbial in origin. This chapter will address each of these categories, highlighting some of the more major examples (Fig. 28.1). The special setting of nosocomial pneumonia is addressed in Chapter 19.
Definitions: slowly resolving, chronic and recurrent pneumonia
These terms are, to some extent, arbitrary and variable. Some reports focus on radiographical abnormalities, others on the accompanying acute/chronic pulmonary and systemic features such as cough, malaise and fatigue.
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- Information
- Infectious Diseases of the Respiratory Tract , pp. 526 - 553Publisher: Cambridge University PressPrint publication year: 1998