Reported in the past century, lung cancer is rare, since the beginning of this century, industrialization began to rise in parallel, while in the last 40-50 years have shown a marked increase. Stomach cancer-related deaths in men past the first sıradayken lung cancer today is the first place. In 2001 alone, 169,500 lung cancer deaths in the United States has given rise to (1). In 2005, according to data published by the American Cancer Society, lung cancer, 90,490 men and women, while 73,020 people for a total of 163,510 people has led to death (2). Again in 2008, according to data published by the American Cancer Society, lung cancer, 90,810 men, women, and a total of 161,840 people, including the 71,030 people has led to death. These rates are all causes of death among cancers in men by 31%, with 27% in the first place in women is
Tobacco use
Illustrates the use of tobacco as the biggest cause of the increase in lung cancer. The history of tobacco use goes back to 4000 years before. Tobacco, as a drug for the first used by Native Americans, while America's Christoph Columbus since 1492 by the discovery of widespread use across the entire continent (4). Today, adults 1 / 3 'ü (1.3 billion people) were current smokers. Içilmekte nearly 6 trillion cigarettes per year and gradually decreases in age of starting smoking (5, 6). Approximately 5 million people a year die from smoking related illnesses. By 2025 about 10 million people a year lose their lives causes related to tobacco use, among adults in the 1 / 3 'reputation is expected to die of causes related to smoking (6) Interestingly, 75% of smokers living in less developed countries and lower levels of life ( 7). In the last 30 years in some European countries such as England and Finland and the United States declined in the amount of cigarettes smoked, and this number is increasing in China and other Asian countries
Tobacco use causes lung cancer in men 90% women are in the first place with 79% (9). Non-smokers compared with women who had smoked during her lifetime risk of developing cancer in people 20 to 40 times increased (10, 11). Non-smokers lung cancer rate is only 2% (12). The relationship between smoking and lung cancer in patients with squamous cell and small cell, adenocarcinoma and large cell that is stronger than karsinomlarla
Number of cigarettes per day increased risk of developing lung cancer and cigarette smoking is directly proportional to the years time. Furthermore, erkenliği age of starting smoking, smoke lungs, deep drawing, smoking, drinking and smoking until the end of the continuous holding in the mouth increases the risk of developing the disease. More men than women smoking is 5-10 times greater risk. Pipe and cigar smokers than non-smokers with lung cancer more than 5 times, although this rate is less than that of non-içenlerdekine
Epithelial metaplasia were found in a very small part of the bronchi of non-smokers, smokers, smoking is more than the amount of time and in proportion to the number of epithelial metaplasia and basal cell hyperplasia has. They started with bronchial cancer, creates a focus. Changes due to carcinogens, and these regions are more vulnerable regions of genes are changed due to exposure to this kind of
Although nicotine is not carcinogenic cigarette smoke causes addiction. Türevlerdir polycyclic hydrocarbons and nitrosamines in cigarette smoke carcinogenic substances. 3-4 polycyclic hydrocarbons benzo [a] piren'in carcinogen is thought to be most effective. Apart from these many toxic substances carcinogenic effects. More than 4000 chemical compounds derived from tobacco smoke is a carcinogen that more than 60 substances
Cigarette smoke contains known carcinogens, co-carcinogens and tumor-causing substances in the main cause of lung cancer. Cigarette smoke particulate phase (tar) and gas phase can be divided into two phases. Both types are very different from free radicals and oxidants. Oksiradikaller gas phase at high concentrations and nitrogen oxides (free radicals), especially nitric oxide contain. This phase of organic radicals, nitric oxide (NO), a slow oxidation nitrojendiokside (NO2) is converted. NO2, more reactive towards organic compounds. Gas phase radicals are short-lived. However, high concentrations of tar phase radicals are quite stable. Tar melting characteristic of radicals in water, so the structure of the lung fluid and biological damage that can have long-lived radicals. The radical system is long enough for life spread throughout the lung lining fluid, intracellular organelles, and DNA can reach you. Phase also contains large amounts of nicotine, tar and nitrosamines. Digoksigenin through the reduction of tar phase radicals, superoxide and hydrogen peroxide are formed, they also lead to a DNA damage (16). Both these carcinogenic substances in the tar phase and the gas phase, experiments in laboratory animals has been shown to cause lung cancer
Cigarette smoke is one of the most important class of carcinogenic polycyclic aromatic hydrocarbons 3 (benzo [a] pyrene, nitrosamines and aromatic amines) is the most nitrosamines, especially the 4 - (metilnitrozamin) -1 - (3-pyridyl)-1-butanon (NNK) lung adenomas and adenocarcinomas, particularly because it focuses on these triggers, including tumor growth. Because of their DNA on DNA damage and mutations lead to a false tıpkıyapımlara. Bronchial tissues of patients with lung cancer with increasing number of cigarettes smoked increased the amount of DNA was damaged. In addition, although the reason is not known exactly due to the use of women as non-susceptible to lung cancer than men were found to be
Showing posts with label Lung Diseases Infections. Show all posts
Showing posts with label Lung Diseases Infections. Show all posts
Histoplasmosis
Histoplasmosis
Cause of this disease is very rare in Turkey kapsulatumdur Histoplasma. Histoplasmosis often benign nature. Initial lesions similar to primary tuberculosis. Widespread round nodule in the lung lesions and two metastatic yoğunlaşmalara-s similar. The lesions healed after the corn looks like popcorn in the lungs is common husule calcifications. A small number of patients, histoplasmosis is a common and progressive and are rarely fatal shows going.
Diagnosis of sputum culture kapsulatumun appearance of histoplasmosis is provided. Histoplasmin positive skin reaction and complement fixation.
Amphotericin B treatment are common and progressive cases.
Nokardiosis
Asteroides'dir nokardia factor, such as acid-resistant tuberculosis bacilli and disease in clinical, radiographic signs similar to tuberculosis. Abscess and fistula to the skin and sometimes it will show the lesion abseleşme. In some cases husule brain abscess from brain tumors, tuberculoma or tuberculous meningitis is thought. Sulfamitlerdir the most effective drug treatment. Tetracycline is effective in some species.
Cause of this disease is very rare in Turkey kapsulatumdur Histoplasma. Histoplasmosis often benign nature. Initial lesions similar to primary tuberculosis. Widespread round nodule in the lung lesions and two metastatic yoğunlaşmalara-s similar. The lesions healed after the corn looks like popcorn in the lungs is common husule calcifications. A small number of patients, histoplasmosis is a common and progressive and are rarely fatal shows going.
Diagnosis of sputum culture kapsulatumun appearance of histoplasmosis is provided. Histoplasmin positive skin reaction and complement fixation.
Amphotericin B treatment are common and progressive cases.
Nokardiosis
Asteroides'dir nokardia factor, such as acid-resistant tuberculosis bacilli and disease in clinical, radiographic signs similar to tuberculosis. Abscess and fistula to the skin and sometimes it will show the lesion abseleşme. In some cases husule brain abscess from brain tumors, tuberculoma or tuberculous meningitis is thought. Sulfamitlerdir the most effective drug treatment. Tetracycline is effective in some species.
Moniliasis (candidiasis)
Factor of Candida albicans. Antibiotics, corticosteroids, and flow-lita disease increases the incidence of moniliasis. Respiratory system consists of two types of moniliasis.
1. Bronchial moniliasis
2. Pulmonary moniliasis.
The main symptom moniliasis'de persistent bronchial cough and boring. Chest radiography is usually normal.
Pulmonary moniliasis observed more frequently in patients with impaired general condition. The main symptoms of the disease, tachycardia, dyspnea, cough, sputum (sometimes bloody), chest pain. Chest radiography, especially in areas around the lower half of concentrations is not well pronounced. In some cases, skin lesions, combined with more intense and a great win.
Fungus isolated from sputum culture in Sabouraud Moniliasis Upon diagnosis is made.
Disease, predisposing factors must be eliminated before the treatment, for example, antibiotics and corticosteroids should be discontinued or inconvenience. Effective drug nistatin'dir. Amafoterisin alınır.Ancak better results with B, amphotericin B is used infrequently because of toxic complications.
Aktinomikosis
Aktinomiçes'tir factor. A rare fungal disease. Dental, oral care is often better than those without, and farmers. Trend showing a sharp abseleşmeye lung pleura and the skin lesions began endürasyonla is fistülüze. Sübfebril fever, malaise, cough and purulent sputum are mild. Multip the disease progresses, abscesses consists of small, fire increases, anemia, fatigue and weight loss comes husule. Hemoptysis, pleurisy, mediastinal abscess may occur.
Disease sputum, or biopsy of the fistula is diagnosed by examining the material culture.
Penicillin treatment, 10 million a day, will continue for weeks. Sulfamit and iodine therapy can be effective. This is better than two drugs are used along with penicillin.
1. Bronchial moniliasis
2. Pulmonary moniliasis.
The main symptom moniliasis'de persistent bronchial cough and boring. Chest radiography is usually normal.
Pulmonary moniliasis observed more frequently in patients with impaired general condition. The main symptoms of the disease, tachycardia, dyspnea, cough, sputum (sometimes bloody), chest pain. Chest radiography, especially in areas around the lower half of concentrations is not well pronounced. In some cases, skin lesions, combined with more intense and a great win.
Fungus isolated from sputum culture in Sabouraud Moniliasis Upon diagnosis is made.
Disease, predisposing factors must be eliminated before the treatment, for example, antibiotics and corticosteroids should be discontinued or inconvenience. Effective drug nistatin'dir. Amafoterisin alınır.Ancak better results with B, amphotericin B is used infrequently because of toxic complications.
Aktinomikosis
Aktinomiçes'tir factor. A rare fungal disease. Dental, oral care is often better than those without, and farmers. Trend showing a sharp abseleşmeye lung pleura and the skin lesions began endürasyonla is fistülüze. Sübfebril fever, malaise, cough and purulent sputum are mild. Multip the disease progresses, abscesses consists of small, fire increases, anemia, fatigue and weight loss comes husule. Hemoptysis, pleurisy, mediastinal abscess may occur.
Disease sputum, or biopsy of the fistula is diagnosed by examining the material culture.
Penicillin treatment, 10 million a day, will continue for weeks. Sulfamit and iodine therapy can be effective. This is better than two drugs are used along with penicillin.
Fungus pneumonia
What is pneumonia Fungus
Most fungal infections are diagnosed in Turkey, aspergillosis, moniliasis (candidiasis) and aktinomikosis'dir. Histoplasmosis, a rare fungal infections in Turkey nokardiosis. Other fungi are very rare diseases.
Aspergillosis
This fungus Aspergillus infection fumigatus'dur factor. Aspergillus spores inhaled dust grains than the disease since they are seen more frequently in farmers. Aspergilluslar simple bronchitis or bronchopneumonia, sometimes cause allergic astmaya. Chronic pulmonary aspergillosis in patients who used steroids and increases the chance of infection. The main symptoms of the disease is persistent cough, purulent, bloody sputum, fever and weight loss. In some patients, dyspnea, asthma symptoms like wheezing also monitored.
Intracavernous often seen as a homogeneous infiltration and Radiography. Clinical and radiological features of tuberculosis disease, cancer and similar to bronchiectasis. Husule Aspergilluslar sometimes brings intense round masses, tumors are similar, they are called misetoma or aspergilloma. Fungus balls (fungus ball) with the name of the known. X-ray appearance is similar to the tumor, but found the bed and the mass audience with a cavity between the cavity wall air space (halo), there would be helpful in differential diagnosis. Sputum appearance of Aspergillus fungi, definitive diagnosis is made.
Iodine for the treatment of aspergillosis, natamisin, nystatin, and 5 fluorositosin amlbterisin B is used. Natamisin'in suspension of 2.5% is 2.5 mg 2-3 times a day. This treatment with oral nystatin (from 500,000 to 1,000,000 units a day) will be added to better results.
Amphotericin B is a serious fungal infections, antibiotics are used. 5% glucose or dextrose solution for 1000 is given IV 6-8 hours. Usually administered dose of amphotericin B: 1 Day 1 Omg, 2 Days of 25 mg and 50 mg from day to day. Local solution of amphotericin B 10 mg of heparin to prevent venous thrombosis is made. A monthly dose of medication should not be less than 1 gm. Many drugs given to kidney impairment may occur from 5 gm. Frequent urinalysis and kidney function, every week, blood count, serum electrolytes should be examined. Nephrotoxic effect of amphotericin B major complications, nausea, vomiting, loss of appetite, fever, chills, headache, fatigue, phlebitis, electrolytes abnormalities, and anemia. Just before the treatment given chlorpromazine (10-25 mg, IM) prevents some of these side effects.
5 fluorositosin aspergillosis, fungal diseases, such as moniliasis effective. But not as effective as amphotericin B. In severe cases, B is provided with amfote-risin. 5 fluorositosinin dose of 50-150 mg / kg / day.
Most fungal infections are diagnosed in Turkey, aspergillosis, moniliasis (candidiasis) and aktinomikosis'dir. Histoplasmosis, a rare fungal infections in Turkey nokardiosis. Other fungi are very rare diseases.
Aspergillosis
This fungus Aspergillus infection fumigatus'dur factor. Aspergillus spores inhaled dust grains than the disease since they are seen more frequently in farmers. Aspergilluslar simple bronchitis or bronchopneumonia, sometimes cause allergic astmaya. Chronic pulmonary aspergillosis in patients who used steroids and increases the chance of infection. The main symptoms of the disease is persistent cough, purulent, bloody sputum, fever and weight loss. In some patients, dyspnea, asthma symptoms like wheezing also monitored.
Intracavernous often seen as a homogeneous infiltration and Radiography. Clinical and radiological features of tuberculosis disease, cancer and similar to bronchiectasis. Husule Aspergilluslar sometimes brings intense round masses, tumors are similar, they are called misetoma or aspergilloma. Fungus balls (fungus ball) with the name of the known. X-ray appearance is similar to the tumor, but found the bed and the mass audience with a cavity between the cavity wall air space (halo), there would be helpful in differential diagnosis. Sputum appearance of Aspergillus fungi, definitive diagnosis is made.
Iodine for the treatment of aspergillosis, natamisin, nystatin, and 5 fluorositosin amlbterisin B is used. Natamisin'in suspension of 2.5% is 2.5 mg 2-3 times a day. This treatment with oral nystatin (from 500,000 to 1,000,000 units a day) will be added to better results.
Amphotericin B is a serious fungal infections, antibiotics are used. 5% glucose or dextrose solution for 1000 is given IV 6-8 hours. Usually administered dose of amphotericin B: 1 Day 1 Omg, 2 Days of 25 mg and 50 mg from day to day. Local solution of amphotericin B 10 mg of heparin to prevent venous thrombosis is made. A monthly dose of medication should not be less than 1 gm. Many drugs given to kidney impairment may occur from 5 gm. Frequent urinalysis and kidney function, every week, blood count, serum electrolytes should be examined. Nephrotoxic effect of amphotericin B major complications, nausea, vomiting, loss of appetite, fever, chills, headache, fatigue, phlebitis, electrolytes abnormalities, and anemia. Just before the treatment given chlorpromazine (10-25 mg, IM) prevents some of these side effects.
5 fluorositosin aspergillosis, fungal diseases, such as moniliasis effective. But not as effective as amphotericin B. In severe cases, B is provided with amfote-risin. 5 fluorositosinin dose of 50-150 mg / kg / day.
Nozokomyal Pneumonia
Especially in patients hospitalized with chronic lung disease, thoracic surgical interventions, mechanical ventilation, oropharynx and aspiration of gastric problems, those with the enteric nasogastric-fed, those with tracheal tube, debilitan patients, those with mental confusion pnömonilerdir developed. Observed more frequently in those with more than seventy years.
Nozokomyal pneumonia bacteria, viruses, candida, legionella, hematogenous tuberculosis infections, aspiration, or droplet husule kantominasyonuyla income.
Clinical findings are similar to pneumonia and acute bacterial pneumonia Nozokomyal. Fever, prodüktüf cough, purulent sputum, and there are tachypnea. Complications of diseases that cause pneumonia can create Nozokomyal. For example, drug induced toxic and allergic problems, atelectasis, pulmonary embolism, myocardial infarction and adult respiratory distress syndrome (ARDS), congestive heart failure and complications such as tracheobronchitis can be monitored.
Nozokomyal clinical diagnosis of pneumonia, radiological and laboratory tests (eg blood count, sedimentation rate, respiratory ifrazların Gram staining and culture examination) and evaluated. If necessary, bronchoscopy, and bronchoscopic biopsy, bronchoalveolar lavage (BAL) from the exploited. If you have bacterial pneumonia, blood culture should be suspected. Pleural fluid biochemical analysis and especially in the liquid bacterial culture should be done is continued. If you have doubt in this regard, immunosuppressive diseases are reviewed.
Diseases and complications related to antibiotic treatment in accordance with the findings, particularly organized.
Nozokomyal pneumonia bacteria, viruses, candida, legionella, hematogenous tuberculosis infections, aspiration, or droplet husule kantominasyonuyla income.
Clinical findings are similar to pneumonia and acute bacterial pneumonia Nozokomyal. Fever, prodüktüf cough, purulent sputum, and there are tachypnea. Complications of diseases that cause pneumonia can create Nozokomyal. For example, drug induced toxic and allergic problems, atelectasis, pulmonary embolism, myocardial infarction and adult respiratory distress syndrome (ARDS), congestive heart failure and complications such as tracheobronchitis can be monitored.
Nozokomyal clinical diagnosis of pneumonia, radiological and laboratory tests (eg blood count, sedimentation rate, respiratory ifrazların Gram staining and culture examination) and evaluated. If necessary, bronchoscopy, and bronchoscopic biopsy, bronchoalveolar lavage (BAL) from the exploited. If you have bacterial pneumonia, blood culture should be suspected. Pleural fluid biochemical analysis and especially in the liquid bacterial culture should be done is continued. If you have doubt in this regard, immunosuppressive diseases are reviewed.
Diseases and complications related to antibiotic treatment in accordance with the findings, particularly organized.
Virus pneumonia (influenza pneumonia)
Virus pneumonia (influenza pneumonia), pneumonia disease
With primary or bacterial pneumonia virus has pnömonileriyle. Early symptoms are flu-like disease. Initially, cough, and sometimes small amounts, sometimes bloody sputum, tachycardia, and syanoz husule income. Railer inspiration gradually increased wet and dry lung bases in other areas is heard.
Extending from the periphery and pulmonary edema is similar to huluslardan radiograph infiltrates. In some cases, a small amount of pleural fluid is monitored.
There is usually leukocytosis, increased polymorphonuclear leukocytes core. Sputum leucocytes also increased, but less than polymorphonuclear leukocytes, lymphocytes çokdur. This finding of sputum bacterial pneumonia influenza virus pneumonia is an important feature that separates. Palliative treatment.
In the cases of the influenza virus and bacteria are serious prognosis. 3-4 days after symptoms of the flu chills, fever, cough, bloody or purulent sputum, pleural pain, dyspnea and syanoz develops. Upon examination, the concentration of one or more than one lobe of the findings, inspiration Railer more pronounced wet and dry sounds.
Chest radiography is similar to primary influenza pneumonia, but the lesions are more common.
Normal leukocytes, may be increased or decreased. Elevated white blood cell count in cases of police, the police has decreased in cases of leukopenia. Polymorphonuclear leukocytes with bacteria and bacteria are abundant in the virus prnömonilerinde sputum. Half of the cases associated with virus infection stafilokoktur bacteria. Other secondary pneumococcal bacteria and more rarely, other bacteria.
The virus-bacterial pneumonia is treated adhering to examine sputum culture. Cephalothin, methicillin, or cefoperazone okzasolin effective drugs. A-type influenza virus pneumonia which is used amantadine.
If you have an epidemic of influenza vaccine used. Influenza vaccine, especially lung and heart disease, diabetes mellitus or chronic kidney disease, immune insufficiency or in patients with the drug in areas immünosüpratif applied. This virus-bacterial pneumonia in patients with more frequent and more serious.
With primary or bacterial pneumonia virus has pnömonileriyle. Early symptoms are flu-like disease. Initially, cough, and sometimes small amounts, sometimes bloody sputum, tachycardia, and syanoz husule income. Railer inspiration gradually increased wet and dry lung bases in other areas is heard.
Extending from the periphery and pulmonary edema is similar to huluslardan radiograph infiltrates. In some cases, a small amount of pleural fluid is monitored.
There is usually leukocytosis, increased polymorphonuclear leukocytes core. Sputum leucocytes also increased, but less than polymorphonuclear leukocytes, lymphocytes çokdur. This finding of sputum bacterial pneumonia influenza virus pneumonia is an important feature that separates. Palliative treatment.
In the cases of the influenza virus and bacteria are serious prognosis. 3-4 days after symptoms of the flu chills, fever, cough, bloody or purulent sputum, pleural pain, dyspnea and syanoz develops. Upon examination, the concentration of one or more than one lobe of the findings, inspiration Railer more pronounced wet and dry sounds.
Chest radiography is similar to primary influenza pneumonia, but the lesions are more common.
Normal leukocytes, may be increased or decreased. Elevated white blood cell count in cases of police, the police has decreased in cases of leukopenia. Polymorphonuclear leukocytes with bacteria and bacteria are abundant in the virus prnömonilerinde sputum. Half of the cases associated with virus infection stafilokoktur bacteria. Other secondary pneumococcal bacteria and more rarely, other bacteria.
The virus-bacterial pneumonia is treated adhering to examine sputum culture. Cephalothin, methicillin, or cefoperazone okzasolin effective drugs. A-type influenza virus pneumonia which is used amantadine.
If you have an epidemic of influenza vaccine used. Influenza vaccine, especially lung and heart disease, diabetes mellitus or chronic kidney disease, immune insufficiency or in patients with the drug in areas immünosüpratif applied. This virus-bacterial pneumonia in patients with more frequent and more serious.
Lejyonellosis (Legion's disease)
Lejyonellosis (Legion's disease)
Legionella pneumophila bacteria agent. This gram-negative bacteria. Military units for the first time she was diagnosed disease is called Legion (legion = continent). A serious pneumonia. Of the disease in the early days of weakness, muscle aches, chest pain, headache, chills and sudden fever, then the mental disorders, abdominal pain, diarrhea is observed.
Lobar lung X-ray concentration, partial lesions are seen in the form of infiltration or nodule.
The main laboratory findings of leukocytosis of 10,000, lymphopenia, hyponatremia, albuminuria, microscopic hematuria, abnormal liver fonsiyonlarıdır.
Disease sputum, pleural fluid or bronchial lavage is diagnosed boyanmasıyla immunofluorescence.
Legion pneumonia erythromycin (0.5-1 gm, 4 times / day orally) is treated with. Tetracycline are also effective. Treatment time is 2-3 weeks. These cases do not respond to treatment, ciprofloxacin (750 mg X 2/gün, oral) is treated with.
Riketsia pneumonia (Q-fever pneumonia)
Coxiella burnetti'dir factor. Riketzia infection of a disease. Influenza or typhoid-like symptoms are observed. In rare cases the virus is similar to pneumonia and infections can develop. The disease tetracycline (2-3 gm / day, orally) is treated with. Treatment time is 2 weeks.
Legionella pneumophila bacteria agent. This gram-negative bacteria. Military units for the first time she was diagnosed disease is called Legion (legion = continent). A serious pneumonia. Of the disease in the early days of weakness, muscle aches, chest pain, headache, chills and sudden fever, then the mental disorders, abdominal pain, diarrhea is observed.
Lobar lung X-ray concentration, partial lesions are seen in the form of infiltration or nodule.
The main laboratory findings of leukocytosis of 10,000, lymphopenia, hyponatremia, albuminuria, microscopic hematuria, abnormal liver fonsiyonlarıdır.
Disease sputum, pleural fluid or bronchial lavage is diagnosed boyanmasıyla immunofluorescence.
Legion pneumonia erythromycin (0.5-1 gm, 4 times / day orally) is treated with. Tetracycline are also effective. Treatment time is 2-3 weeks. These cases do not respond to treatment, ciprofloxacin (750 mg X 2/gün, oral) is treated with.
Riketsia pneumonia (Q-fever pneumonia)
Coxiella burnetti'dir factor. Riketzia infection of a disease. Influenza or typhoid-like symptoms are observed. In rare cases the virus is similar to pneumonia and infections can develop. The disease tetracycline (2-3 gm / day, orally) is treated with. Treatment time is 2 weeks.
Atypical Pneumonia
What is Atypical Pneumonia
Pneumococcal pneumonia with atypical pneumonia symptoms of the disease is insidious, unlike the classic. Fatigue, headache, fever, dry cough and lobar infiltration has not. Atypical pneumonia main mikoplasma pneumonia, viral pneumonia in some, and Q legion of fire of disease.
The virus of atypical pneumonia
This type of atypical pneumonia are rare. The major psittakosis, varicella, measles, herpes zoster, koksaki, adenovirus, ECHO viruses pnömonilerdir of.
Mikoplasma Pneumonia
Atypical pneumonia is a type of the most common and comprises 20% of all pneumonias. This pneumonia is more frequent in children and adolescents. Cause of a small bacterium mycoplasma pneumoniae. However, pathological changes of the lungs similar to pneumonia virus. The disease begins with insidious or acute. Of about 38 degrees of fever, persistent dry cough, headache, generalized muscle aches, colds, sore throat, cold chills-the main symptoms of the disease.
Upon examination, fine-medium age Railer heard. Submatite and dullness is increased by the disease progresses and more rough Railer quality wins. Sibilan, ronflan Railer heard.
Radiography in places nodular, partially or perihilar infiltrates, lobar or lobular concentration is seen in some cases.
75% of the cases after the first week of the disease occurs in the blood cold aglütünasyon. Aglütünasyon cold virus, bacterial pneumonia and can be positive in some blood diseases. Peripheral and central neurological abnormalities Mikoplasma pneumonia, thrombocytopenia, may develop complications such as skin erythema.
Mikoplasma pneumonia tetracycline or erythromycin (1.5-2 gm / day, orally) is treated with.
Pneumococcal pneumonia with atypical pneumonia symptoms of the disease is insidious, unlike the classic. Fatigue, headache, fever, dry cough and lobar infiltration has not. Atypical pneumonia main mikoplasma pneumonia, viral pneumonia in some, and Q legion of fire of disease.
The virus of atypical pneumonia
This type of atypical pneumonia are rare. The major psittakosis, varicella, measles, herpes zoster, koksaki, adenovirus, ECHO viruses pnömonilerdir of.
Mikoplasma Pneumonia
Atypical pneumonia is a type of the most common and comprises 20% of all pneumonias. This pneumonia is more frequent in children and adolescents. Cause of a small bacterium mycoplasma pneumoniae. However, pathological changes of the lungs similar to pneumonia virus. The disease begins with insidious or acute. Of about 38 degrees of fever, persistent dry cough, headache, generalized muscle aches, colds, sore throat, cold chills-the main symptoms of the disease.
Upon examination, fine-medium age Railer heard. Submatite and dullness is increased by the disease progresses and more rough Railer quality wins. Sibilan, ronflan Railer heard.
Radiography in places nodular, partially or perihilar infiltrates, lobar or lobular concentration is seen in some cases.
75% of the cases after the first week of the disease occurs in the blood cold aglütünasyon. Aglütünasyon cold virus, bacterial pneumonia and can be positive in some blood diseases. Peripheral and central neurological abnormalities Mikoplasma pneumonia, thrombocytopenia, may develop complications such as skin erythema.
Mikoplasma pneumonia tetracycline or erythromycin (1.5-2 gm / day, orally) is treated with.
Anaerobic Bacterial pneumonia
Anaerobe bacterial pneumonia, anaerobic bacteria
Alcoholics, debilitan patients and those without good oral health care (infected tooth, gingivitis, and so on.) And those with upper respiratory tract infections such as pneumonia more often consist of sinüsitis.
The main factors bakteroid group bacteria, streptococcus, staphylococcus, aureus, klebsiella and psödomonaslardır.
Anaerobic bacterial infections of acute or insidious starts. Sometimes foul-smelling sputum, and sometimes bloody. High fever, chills sometimes happens. Often there is pain in the pleura.
On physical examination, the symptoms of lung concentration, pleurisy, in some cases, the findings observed scattered odaklarıyla infection.
The main view radiographic pneumonitis, pneumonia, abscess, and empyema related. These findings separately, or both, along with three of them are observed. Abscesses, a homogeneous concentration (mass), necrosis (thick-walled Intracavernous intizamsız) radiological appearance of the disease manifestations. This kavernlerde air-fluid level, and there is a concentration around the lung parenkimasında. The disease progresses rapidly. Empyema occurs in almost every case.
15,000 to 25,000 white blood cell count, especially related to the increase in polymorphonuclear leukocytes core. Anaerobic lung infections, an average of three different micro-organisms, for example, anaerobic bacteria, there are other bacteria and spirochaetes.
Anaerobic bacteria effective antibiotic penicillin pneumonia. 5-10 million units per day is given IV or IM. Penicillin-resistant cases, cefoperazone (2-3 gm / day IV or IM), kloranfenikol (2-3 gm / day, orally), clindamycin (300-600 rag / day, orally) and tetracycline (2-3 gm / day, orally ) are given antibiotics.
Treatment is continued until 4 weeks. These infections microorganisms acquire resistance to drugs easier. By sputum culture is often an effective treatment. Diabetes, if you have diseases such as anemia, increases success in their treatment.
Alcoholics, debilitan patients and those without good oral health care (infected tooth, gingivitis, and so on.) And those with upper respiratory tract infections such as pneumonia more often consist of sinüsitis.
The main factors bakteroid group bacteria, streptococcus, staphylococcus, aureus, klebsiella and psödomonaslardır.
Anaerobic bacterial infections of acute or insidious starts. Sometimes foul-smelling sputum, and sometimes bloody. High fever, chills sometimes happens. Often there is pain in the pleura.
On physical examination, the symptoms of lung concentration, pleurisy, in some cases, the findings observed scattered odaklarıyla infection.
The main view radiographic pneumonitis, pneumonia, abscess, and empyema related. These findings separately, or both, along with three of them are observed. Abscesses, a homogeneous concentration (mass), necrosis (thick-walled Intracavernous intizamsız) radiological appearance of the disease manifestations. This kavernlerde air-fluid level, and there is a concentration around the lung parenkimasında. The disease progresses rapidly. Empyema occurs in almost every case.
15,000 to 25,000 white blood cell count, especially related to the increase in polymorphonuclear leukocytes core. Anaerobic lung infections, an average of three different micro-organisms, for example, anaerobic bacteria, there are other bacteria and spirochaetes.
Anaerobic bacteria effective antibiotic penicillin pneumonia. 5-10 million units per day is given IV or IM. Penicillin-resistant cases, cefoperazone (2-3 gm / day IV or IM), kloranfenikol (2-3 gm / day, orally), clindamycin (300-600 rag / day, orally) and tetracycline (2-3 gm / day, orally ) are given antibiotics.
Treatment is continued until 4 weeks. These infections microorganisms acquire resistance to drugs easier. By sputum culture is often an effective treatment. Diabetes, if you have diseases such as anemia, increases success in their treatment.
Klebsiella Pneumonia
What is Klebsiella pneumonia
A serious pneumonia. Factor of gram-negative bakteridir.Yaşlılarda, alcoholics, diabetics, and uncontrolled debilitan more frequently observed in patients. Disease sudden chills, fever, dyspnea, sputum, chest pain and severe exhaustion begins. Greenish sputum, purulent, blood-line, sometimes rusty and sticky.
Sübmatite or dullness in the examination of disease, pektoriloki, bronchial breathing, and age Railer monitored.
Radiology has three features:
1. Exudate collection and interlobar lung parenkimasında sissürün itilmesine and bombeleşmesine causes an increase in volume.
2. Approximately 1 / 3 cases and Intracavernous abseleşme occurs.
3. Exudate is often converted to empyema.
Sputum gram-negative bacteria that cause disease and are abundant polymorphonuclear leukocytes. There are many times, leukocyte count is normal or leukopenia. Sometimes the leukocytosis observed.
The main complications of the disease abscess, Intracavernous, empyema, pneumothorax, pericarditis, meningitis and anemia.
Treatment duration of at least 2 weeks. The main drugs used in treatment of Klebsiella pneumonia cefoperazone and cephalothin (2-3 gm / day, and IV, IM), gentamicin (160 mg / day, IM) and kloranfenikol (2-3 gm / day, orally), dir. Sputum culture and antibiotic sensitivity often examined and antibiotics should be chosen accordingly.
A serious pneumonia. Factor of gram-negative bakteridir.Yaşlılarda, alcoholics, diabetics, and uncontrolled debilitan more frequently observed in patients. Disease sudden chills, fever, dyspnea, sputum, chest pain and severe exhaustion begins. Greenish sputum, purulent, blood-line, sometimes rusty and sticky.
Sübmatite or dullness in the examination of disease, pektoriloki, bronchial breathing, and age Railer monitored.
Radiology has three features:
1. Exudate collection and interlobar lung parenkimasında sissürün itilmesine and bombeleşmesine causes an increase in volume.
2. Approximately 1 / 3 cases and Intracavernous abseleşme occurs.
3. Exudate is often converted to empyema.
Sputum gram-negative bacteria that cause disease and are abundant polymorphonuclear leukocytes. There are many times, leukocyte count is normal or leukopenia. Sometimes the leukocytosis observed.
The main complications of the disease abscess, Intracavernous, empyema, pneumothorax, pericarditis, meningitis and anemia.
Treatment duration of at least 2 weeks. The main drugs used in treatment of Klebsiella pneumonia cefoperazone and cephalothin (2-3 gm / day, and IV, IM), gentamicin (160 mg / day, IM) and kloranfenikol (2-3 gm / day, orally), dir. Sputum culture and antibiotic sensitivity often examined and antibiotics should be chosen accordingly.
Staphylococcus pneumonia
What is Staphylococcus pneumonia
Inifeksiyonudur staphylococcus pneumonia, a serious lung. Gram-positive staphylococcus aureus'dur factor. There are three main features of this pneumonia.
1. A serious infection and lung abscess occurs.
2. This bacterial resistance to antibiotics used in a short period of time wins.
3. Publication consists of those around the patient and hospital infection kontami-nasyonu.
Staphylococcus pneumonia symptoms of major illness, chills, fever, cough, sputum, chest pain (pleural pain), tachypnea, tachycardia. Physical examination findings similar to pneumococcal pneumonia.
Chest radiograph of a lobe, is the concentration of a segment or multiple segments. Sometimes it consists of extensive bronchopneumonia. PLO-resin, and the abscess is often viewed pneumatocele.
Sputum gram-positive staphylococci in the form of grapes, and poly-MORPH-core leukocytes are seen. Blood leukocytes from 15,000 to 25,000 'to exit. Leukopenia is a serious infection may be a poor prognosis is indicated.
The main complications of the disease of lung abscess, brain and kidney abscess, meningitis, endocarditis, pneumothorax and empyema.
Staphylococcal pneumonia is a serious infection, patients should be hospitalized for treatment. Effective antibiotics are used in high doses and at least two weeks. By sputum culture is often an effective antibiotic is chosen. Penicillin-sensitive staphylococci in 50% of cases. 5-20 million units per day given IM or IV. Penicillin-resistant to other antibiotics are used for cases that antibiogramı sputum.
Inifeksiyonudur staphylococcus pneumonia, a serious lung. Gram-positive staphylococcus aureus'dur factor. There are three main features of this pneumonia.
1. A serious infection and lung abscess occurs.
2. This bacterial resistance to antibiotics used in a short period of time wins.
3. Publication consists of those around the patient and hospital infection kontami-nasyonu.
Staphylococcus pneumonia symptoms of major illness, chills, fever, cough, sputum, chest pain (pleural pain), tachypnea, tachycardia. Physical examination findings similar to pneumococcal pneumonia.
Chest radiograph of a lobe, is the concentration of a segment or multiple segments. Sometimes it consists of extensive bronchopneumonia. PLO-resin, and the abscess is often viewed pneumatocele.
Sputum gram-positive staphylococci in the form of grapes, and poly-MORPH-core leukocytes are seen. Blood leukocytes from 15,000 to 25,000 'to exit. Leukopenia is a serious infection may be a poor prognosis is indicated.
The main complications of the disease of lung abscess, brain and kidney abscess, meningitis, endocarditis, pneumothorax and empyema.
Staphylococcal pneumonia is a serious infection, patients should be hospitalized for treatment. Effective antibiotics are used in high doses and at least two weeks. By sputum culture is often an effective antibiotic is chosen. Penicillin-sensitive staphylococci in 50% of cases. 5-20 million units per day given IM or IV. Penicillin-resistant to other antibiotics are used for cases that antibiogramı sputum.
Pneumococcal Pneumonia
Pneumococcal pneumonia (Streptococcus pneumoniae)
Parenkimasının pneumonia or pneumonitis in lung inflammation is called. Pneumonitis to pneumonia pneumonia mean the same thing by coming together more segments are used to pneumonia or patchy intizamsız.
Community-acquired pneumonia, the most common of all pneumonias izlenilenidir. Pneumococcal pneumonia community-acquired pneumonia and nosocomial pneumonia 80% 10% cover.
Bacterial pneumonia in the pneumonia and pneumococcal pneumonia is the most common bacteria, such as written below ACQUIRED PNEUMONIAE izlenile-nidir.Başlıca most common types of pneumonia:
The most common pneumococcal pneumonia
Fairly common Pyojen streptococci, staphylococci, klepsiella, haemo-fılus influenza
B.antrasis rare, pertussis, brusellosis, Enterobacter, E.koli N.meningitidis rare, Pseudomonas, proteus, nokardia
Etiology
Pneumococcal pneumonia diplococcus preumoniae'dır factor. Gram-positive. 75 There are so many types.
Pathology
Pneumonia is the period of 3 pathological.
1 - the period of fullness (engorgement) are initially edema. Dilated capillaries and dolgundur. Fluid leaks into the alveoli, exudation occurs.
2 - Karaciğerleşme (hepatisation) of the disease 2-3. takes on the day of a dark color, such as lung liver. This period is called the red hepatizasyon.
Lung 2-3 days after the yellow color changes, this period is called the yellow hepatizasyon, this period lasts for 3-4 days.
3 - Melt (resolution), the period of 7-10 days after onset of pneumonia alveoli into the air enters and exits the purification of pathological materials, ventilation starts.
Pathogenesis
Pneumonia is more observed in the winter months. Upper respiratory tract infections, smoking, alcohol, diabetes, aging, lung cancer, immunosuppressive diseases, immunosuppressive drugs and the incidence of pneumonia, surgical procedures and increase the seriousness.
Clinical Symptoms
Fifty percent of pneumonia cases are before the upper respiratory tract infection. Usually develops within a week of serious illness, fever 38 - 39.5 degree rise, many times higher than the evening fever. Line in the form of a cough and bloody rusty, sometimes yellow-green (purulent) sputum has. Often, chills, shivering, chills, pleuritic chest pain occurs. Some patients are herpes on his lips. 5-10 days after the fire suddenly "in the form of crisis," or gradually decrease "in the form of lysis," and the patient falls into the period of convalescence.
An acute view of the patient's physical examination followed, his face flushed and syanozedir. Fast and shallow breathing, high fever, tachycardia observed. Patient hemithorax inspiration and coughing, particularly painful. Thoracic movement is limited. Vocal fremitus normal or increased. If you have a complication of pleurisy vocal fremitus reduced. Dullness to percussion or sübmatite taken. Auscultation frotman, bronchial respiration, egofoni, bronkofoni, whispering and crepitan Railer pektoriloki'si duyulur.Yukarıda vary according to the physical examination findings in the cases.
Radiological
Pneumonia is the most important method in the diagnosis of lung radyografisi'dir. Fairies air cavities of the disease began, the concentration of pneumonia or visceral pleura adjacent interlobar. Air bronchogram is monitored. However, the air bronchogram seen atelectasis caused by cancer. Loklalizedir a lobe or segment of pneumonia many times. Two or more lobe pneumonia is more serious prog-noz. Applied to the treatment of pneumonia decreased concentration of 10-14 days required will be lost. Untreated cases, radiological abnormalities, it takes 6-8 weeks.
Laboratory findings
Polymorphonuclear leukocytes and gram-positive pneumococci in sputum is abundant. By sputum culture is often the type of bacteria, and antibiotic sensitivity up or down and no effect on (antibiotic) are examined and effective antibiotic is chosen.
Leukocyte 10,000 to 30,000 to increase. In some cases, higher. In some cases, WBC, normal, normal or low. Worse prognosis in patients with extreme leukocytosis or leukopenia. Leukocyte formula increased polymorphs. Sedimentation rate increases. In severe cases, hypoxemia observed.
Complications
The main complications of pneumonia pleurisy, empyema, lung abscess, superinfection (recurrent) 'roll. Rarely, endocarditis, meningitis, nephritis, arthritis, otitis media, sinusitis, and shock may occur. Early and effective (sensitive to factors) prevents or reduces the complications of treatment. Chronic obstructive pulmonary disease, bronchiectasis, cancer, malnutrition, and taken control of patients with diabetes mellitus, alcohol and cigarette smokers complications occur more frequently.
Pneumonia Treatment
Penicillin or ampicillin for treatment of pneumonia many times the most appropriate antibiotics. Penicillin and penicillin-sensitive staphylococcus streptococcus pneumonia-rind are also effective. 600,000 to 800,000 units procaine penicillin was injected intramuscularly 1-2 times a day or 2-4 times a day 7-10 days of treatment with intravenous penicillin 300,000 units on the crystal did not respond to penicillin edilir.Birkaç cases a day, or a complication that should consider the diagnosis was wrong. Cause of pneumonia in the elderly or hospitalized patients with gram-negative or staphylococcus aureus, is more broad-spectrum antibiotics, for example, a third-generation cephalosporin or broad spekrumlu are treated with penicillin. Alcoholics and psychiatric problems, especially those with high-dose penicillin or clindamycin followed aspiration pneumonia-ration is used. Mikoplasma pneumonia (atypical pneumonia) is treated with tetracycline or erythromycin antibiotics tikleriyle.
Successful drug susceptibility are evaluated by an antibiotic for the treatment of pneumonia.
Sekresyonlara effective drugs should be given of the respiratory tract. Need to consider some of the features according to the type of infection. Antibiotics and other drugs are ineffective in use or not given sufficient dose and duration of treatment prevents success. Gram-negative infections, especially pneumonia, the type and dose of medication should be carefully evaluated.
Patient with dyspnea, oxygen is given if syanoz. Cardiac patients, those with shock, diabetes, asthma, chronic bronchitis, emphysema, pneumonia, severe cases of chronic diseases and resistance to degrading and shows a dangerous course. In these patients with two or three antibiotics should apply a higher dose and longer period of time.
What is the Prognosis and prevansiyon
Despite effective antibiotic treatment, mortality is 1% of pneumococcal pneumonia. The average mortality rate is 5% of all pneumonias. The patient's age, degree of infection, complications and prognosis in the presence of other diseases affect.
Prevansiyon pneumococcal and influenza vaccines are provided. Especially the older people more likely to risk of chronic lung, liver, kidney, heart diseases, those, these vaccines are diabetics.
Most of the deaths followed the cases of superinfection or pneumonia disease with another. Bacteremia, leukopenia, shock, increases the mortality of the disease have more than one lobe.
Parenkimasının pneumonia or pneumonitis in lung inflammation is called. Pneumonitis to pneumonia pneumonia mean the same thing by coming together more segments are used to pneumonia or patchy intizamsız.
Community-acquired pneumonia, the most common of all pneumonias izlenilenidir. Pneumococcal pneumonia community-acquired pneumonia and nosocomial pneumonia 80% 10% cover.
Bacterial pneumonia in the pneumonia and pneumococcal pneumonia is the most common bacteria, such as written below ACQUIRED PNEUMONIAE izlenile-nidir.Başlıca most common types of pneumonia:
The most common pneumococcal pneumonia
Fairly common Pyojen streptococci, staphylococci, klepsiella, haemo-fılus influenza
B.antrasis rare, pertussis, brusellosis, Enterobacter, E.koli N.meningitidis rare, Pseudomonas, proteus, nokardia
Etiology
Pneumococcal pneumonia diplococcus preumoniae'dır factor. Gram-positive. 75 There are so many types.
Pathology
Pneumonia is the period of 3 pathological.
1 - the period of fullness (engorgement) are initially edema. Dilated capillaries and dolgundur. Fluid leaks into the alveoli, exudation occurs.
2 - Karaciğerleşme (hepatisation) of the disease 2-3. takes on the day of a dark color, such as lung liver. This period is called the red hepatizasyon.
Lung 2-3 days after the yellow color changes, this period is called the yellow hepatizasyon, this period lasts for 3-4 days.
3 - Melt (resolution), the period of 7-10 days after onset of pneumonia alveoli into the air enters and exits the purification of pathological materials, ventilation starts.
Pathogenesis
Pneumonia is more observed in the winter months. Upper respiratory tract infections, smoking, alcohol, diabetes, aging, lung cancer, immunosuppressive diseases, immunosuppressive drugs and the incidence of pneumonia, surgical procedures and increase the seriousness.
Clinical Symptoms
Fifty percent of pneumonia cases are before the upper respiratory tract infection. Usually develops within a week of serious illness, fever 38 - 39.5 degree rise, many times higher than the evening fever. Line in the form of a cough and bloody rusty, sometimes yellow-green (purulent) sputum has. Often, chills, shivering, chills, pleuritic chest pain occurs. Some patients are herpes on his lips. 5-10 days after the fire suddenly "in the form of crisis," or gradually decrease "in the form of lysis," and the patient falls into the period of convalescence.
An acute view of the patient's physical examination followed, his face flushed and syanozedir. Fast and shallow breathing, high fever, tachycardia observed. Patient hemithorax inspiration and coughing, particularly painful. Thoracic movement is limited. Vocal fremitus normal or increased. If you have a complication of pleurisy vocal fremitus reduced. Dullness to percussion or sübmatite taken. Auscultation frotman, bronchial respiration, egofoni, bronkofoni, whispering and crepitan Railer pektoriloki'si duyulur.Yukarıda vary according to the physical examination findings in the cases.
Radiological
Pneumonia is the most important method in the diagnosis of lung radyografisi'dir. Fairies air cavities of the disease began, the concentration of pneumonia or visceral pleura adjacent interlobar. Air bronchogram is monitored. However, the air bronchogram seen atelectasis caused by cancer. Loklalizedir a lobe or segment of pneumonia many times. Two or more lobe pneumonia is more serious prog-noz. Applied to the treatment of pneumonia decreased concentration of 10-14 days required will be lost. Untreated cases, radiological abnormalities, it takes 6-8 weeks.
Laboratory findings
Polymorphonuclear leukocytes and gram-positive pneumococci in sputum is abundant. By sputum culture is often the type of bacteria, and antibiotic sensitivity up or down and no effect on (antibiotic) are examined and effective antibiotic is chosen.
Leukocyte 10,000 to 30,000 to increase. In some cases, higher. In some cases, WBC, normal, normal or low. Worse prognosis in patients with extreme leukocytosis or leukopenia. Leukocyte formula increased polymorphs. Sedimentation rate increases. In severe cases, hypoxemia observed.
Complications
The main complications of pneumonia pleurisy, empyema, lung abscess, superinfection (recurrent) 'roll. Rarely, endocarditis, meningitis, nephritis, arthritis, otitis media, sinusitis, and shock may occur. Early and effective (sensitive to factors) prevents or reduces the complications of treatment. Chronic obstructive pulmonary disease, bronchiectasis, cancer, malnutrition, and taken control of patients with diabetes mellitus, alcohol and cigarette smokers complications occur more frequently.
Pneumonia Treatment
Penicillin or ampicillin for treatment of pneumonia many times the most appropriate antibiotics. Penicillin and penicillin-sensitive staphylococcus streptococcus pneumonia-rind are also effective. 600,000 to 800,000 units procaine penicillin was injected intramuscularly 1-2 times a day or 2-4 times a day 7-10 days of treatment with intravenous penicillin 300,000 units on the crystal did not respond to penicillin edilir.Birkaç cases a day, or a complication that should consider the diagnosis was wrong. Cause of pneumonia in the elderly or hospitalized patients with gram-negative or staphylococcus aureus, is more broad-spectrum antibiotics, for example, a third-generation cephalosporin or broad spekrumlu are treated with penicillin. Alcoholics and psychiatric problems, especially those with high-dose penicillin or clindamycin followed aspiration pneumonia-ration is used. Mikoplasma pneumonia (atypical pneumonia) is treated with tetracycline or erythromycin antibiotics tikleriyle.
Successful drug susceptibility are evaluated by an antibiotic for the treatment of pneumonia.
Sekresyonlara effective drugs should be given of the respiratory tract. Need to consider some of the features according to the type of infection. Antibiotics and other drugs are ineffective in use or not given sufficient dose and duration of treatment prevents success. Gram-negative infections, especially pneumonia, the type and dose of medication should be carefully evaluated.
Patient with dyspnea, oxygen is given if syanoz. Cardiac patients, those with shock, diabetes, asthma, chronic bronchitis, emphysema, pneumonia, severe cases of chronic diseases and resistance to degrading and shows a dangerous course. In these patients with two or three antibiotics should apply a higher dose and longer period of time.
What is the Prognosis and prevansiyon
Despite effective antibiotic treatment, mortality is 1% of pneumococcal pneumonia. The average mortality rate is 5% of all pneumonias. The patient's age, degree of infection, complications and prognosis in the presence of other diseases affect.
Prevansiyon pneumococcal and influenza vaccines are provided. Especially the older people more likely to risk of chronic lung, liver, kidney, heart diseases, those, these vaccines are diabetics.
Most of the deaths followed the cases of superinfection or pneumonia disease with another. Bacteremia, leukopenia, shock, increases the mortality of the disease have more than one lobe.
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