呼吸系统疾病(英文)共82张课件

时间反复无常，鼓着翅膀飞逝呼吸系统疾病(英文)呼吸系统疾病(英文)时间反复无常，鼓着翅膀飞逝呼吸系统疾病(英文)TopicsRespiratorydisordersRespiratoryinfectionsPneumoniaRespiratoryDisorders50%ofconsultationwithgeneralpractitionersoracuteillnessinyoungchildrenandathirdofconsultationsinolderchildren20-35%ofacutepediatricadmissionstohospital,someofwhicharelife-threateningAsthmaisthemostcommonchronicillnessofchildhoodCysticfibrosisisthemostcommoninheriteddisorderinCaucasianscausingchronicdisease文本解读，简单来说就是对文人创作的作品进行探究，体会其包含的内容及其所表达的意义。高中语文教学中，文本解读就是指教师和学生对文本进行感知、理解并从中获得其内涵、意义的实践过程。文本解读对于启发学生思维、发挥他们的想象力和创造力具有重要作用。一、高中语文文本解读存在的问题1.答案统一，缺乏独到的见解在高中语文教学活动中，很多教师对于文本解读缺乏独到的见解，没有真正的对其探讨，而是单纯的依靠参考书及网络搜集的简析，缺乏创造性。教师没有潜心研究文本的思想内涵以及所表达的现实意义，而是按照参考书的简析进行教学，这不仅不能提高自身的文化修养，对学生也起不到很好的引导作用。学生在应试教育下，缺乏创新和主动性，得到的都是千篇一律的答案。这种统一的“标准答案”严重制约了学生的“天马行空”，忽略学生的想象力和创造力。2.文本解读过于简单高中语文教学中，文本解读是非常重要的内容，在文本解读过程中，教师应带领学生共同完成。由教师的感悟唤醒学生的解读感悟。因此，对于文本的研究，教师应做到细致、准确。只有自己完全理解了文中所表达的各项基本内容及其深刻含义才能很好的引导学生发挥他们的想象力，分析课文所体现的思想感情等。让学生主动探求对文本的理解和感悟。但是，在高中语文教学中，很多教师对于文本的解读过于简单，也没有花费较多的时间来详细分析课文。而却将过多的时间用在搜集资料，问题设计以及研究教学方法上，忽略了文本解读的重要性。比如在《雷雨》这篇文章中，参考书对于该篇文章的情节内容、周鲁两个家庭的命运以及人物形象都有了详细的解读。但是除了表面的解析，还要更近一步挖掘其人性的复杂以及其表达忏悔救赎的主体思想。这就要求语文教师具备一定扎实的功底，独到的见解，带领学生进行一场别开生面的“视听盛宴”，让学生真正掌握作者想要表达的内容，想要渲染的氛围。3.文本解读缺乏适度性随着素质教育的不断提倡，对于各大学科的教学也有了新的标准和要求。文本解读作为高中语文的重要内容也越来越得到重视。但是，很多学校和教师却歪曲了提倡文本解读的最初意义。文本解读过于细化，缺乏适度性，这不但不能起到很好的教学效果，反而加重了学生的学习负担。很多教师还会把文本解读的内容引向考纲和考点的内容，让学生理解文章的内容、体会作者思想感情的美感荡然无存。因此，高中语文教师在进行文本解读时，要把握分寸，抓住重点。4.树立正确的文本解读观在当前的语文教学中，高中语文教师必须树立正确的文本解读观，尊重作者的创作意图，尊重客观事实，细致深入的进行文本解读。作者创作的作品都带有一定的意图，同时也包含着自己的内心情感。教师在进行文本解读时，要尊重客观事实，不能歪曲作者的本意，要充分挖掘作者想表达的思想感情。比如在解读《故都的秋》一文时，不仅要考虑作者写文章时的心情，还要考虑作者当时所处的环境及其身世遭遇等。这样，才能完整的展现文章所表达的内容及其思想感情。二、掌握良好的文本解读方法1.变换视角，整体感知新课标理念要求教师在文本解读过程中必须要重视培养学生的整体把握能力，因此，教师在解读文本时应变换视角，整体感知课文。从整体上把握课文的内涵，从不同的角度探究课文体现的意义。首先，从读者的角度感知文章，以平和的心态掌握作者的创作意图及其表达的美感和内涵。其次，从编者的角度分析文章，分析编者为何将其编入教材中，体会其意图，避免分析文本的盲目性。然后，要从教师的角度解读文本，找出文中的重点及引申含义。最后，还要从学生的角度解读文本。让学生自我推敲、自我分析，教师再加以指导，提高他们学习的积极性和主动性。2.立足文本，具体理解3.由此及彼，解读深悟深入探究是教师对文本理解的重要过程，也是考察教师基本功的关键环节。深入探究文章的中心思想及其隐含的重要意义是教师进行文本解读的最高层次。因此，教师也应不断的提高自身的文化修养，由浅入深，通过比较、参读等方式很好的去解读作品，去参悟内涵。三、高中语文教材处理探究要想更好的解析作品，对于语文教材的处理也要做到以下几点：1.点与面相结合所谓的“点”指的是教学重点，“面”则是文章的基本内容。在高中语文教材中，尤其对于小说、戏剧等作品的分析，做到点面结合，更容易让学生掌握其基本意义及其重点内容。首先要让学生对文章的情节有一定的了解，然后再对精彩语段以及关键内容重点讲解。比如《红楼梦》是一篇情节内涵复杂的长篇小说，对于该篇小说，教师在进行讲解时，首先要让学生了解文章的基本情节，然后在捋顺各种人物之间的关系。在通过重点的而环节分析来突出人物的性格特点，容易让学生掌握。2.理清思路，抓住基点3.阅读、创造、评论一体化在教材的处理上，阅读、创造、评论要一体化。首先就要反复阅读，不仅要读通句子，读出节奏，还要读出美感，读出感情。通过让学生改写文章、演讲文章、创作文章等语文活动来启发学生进行创造活动，加深对文章的理解。最后评论文本内容，也是最关键的环节。学生对文章评论过程也是深化文本理解的过程。将三者有效的结合起来，就能够更好的处理教材。综上所述，高中语文是高中课程的重要学科，教师在处理教材以及文本解读的过程中，必须要做到准确、细致，并不断完善自身的文化修养，带领学生进入到语文课程的完美“盛宴”中。由于传统教育思想根深蒂固，许多教师观念落后，预见不到信息化对现代教育发展的影响。他们认为，提高教学质量的唯一途径就是时间+汗水，导致了教学模式陈旧落后，习惯了传统的一支粉笔、一张嘴、一块黑板的课堂教学，上课不能借助远程教育资源调动学生的积极性，只能在课余布置大量的作业。学生的课业负担过重并且枯燥无味，以致学生越来越厌学。还有许多教师认为远程教育对农村教育不适用，反而耽误了教学时间，致使远程教育资源的应用推广难度较大。大部分教师不会用、不敢用、也不想用远程教育设备，教学水平低，不适应远程教育的要求。校本培训流于形式，主要原因是：一是教学任务繁重，时间不好安排；二是教师水平参差不齐，教学内容不好确定；三是培训教师不好配备，有的学校没有一个人会用远程教育设备。我认为要改变农村小学远程教育的现状，必须长期坚持“五个到位”。校本培训到位。对于校长的培训主要是思想上的培训，让他们转变观念，重视远程教育工作，同时加大对校长的考核力度。对于网络管理人员的培训主要让他们掌握计算机基础知识和多媒体技术，计算机网络的发展、分类及应用、国内国际网、教育资源网的接入、发送电子邮件、查询信息、获取网上资源及网络维护。对于光盘播放点人员培训主要培训他们掌握设备的使用、维护、播放的方法等。对于骨干教师培训主要让他们了解计算机辅助教学理论，能选择与评估计算机辅助教学软件，能编写计算机辅助教学软件脚本，并应用制作简单的软件能辅导其他教师在教学中使用计算机。对于学科教师的培训，重点是教师应用现代教育技术将教育资源融入到学科教学中。管理措施到位。要加强领导，周密安排，确保远程教育项目的顺利实施，学校在制定工作计划时，把远程教育工作纳入学校整体工作量化考核中，作为年终考核内容之一。要加强制度建设，建立健全各项制度。要加强考核力度，做到有奖有惩。收集整理到位。学校的收集整理是很重要的一环，除了要保证按时接收，按时分类整理之外，可采取以下几种途径来保存资源，进行全程应用。硬盘保存资源，学校可购置几个容量较多的硬盘作为资源库的储藏库，对一些需要保存得较久的，有利于连续应用的资源存在这一个硬盘内，这样，资源也不会丢失，硬盘每隔三个又可以重新利用。光盘保存资源，对一些适用于课堂教学的资源或为农服务的资源，教学有用的课堂实录，教学辅导等内容可刻录成光盘进行有效利用。纸质保存资源，如一些习题，参考资料，可打印成册，建立分类档案，供老师们借阅参考。一期结束后，可将一期的资源进行筛选、分类、归档、整理，建立相应的保存方法，形成一套完整的可利用资源。资源应用到位。对远教资源的利用，不仅仅是收集、整理，更主要的是让其走进课堂，服务教学。通过远教播放设备，让学生观看优质课、示范课，达到师生共同学习名师名校教学方法的效果；充分利用空中课堂实录，让学生享受优秀教师的教育教学指导。教育研究到位。应用远教资源与学科整合，加快教改步伐。让远教资源走进课堂、面向学生、用于教学并与学科教育整合，加快教改步伐。推动广大教师运用远教资源上获取的先进的信息技术教育手段应于到课堂教学中去，积极推进多样化的教育技术手段与新型教学方式在教育教学过程中的应用，逐步实现教学内容的呈现方式、学生的学习自主式、教师的教学方式的变革，实现农村中小学教育质量的整体提高，促进学生的全面发展。利用远教资源举办的各种公开课教学，播放专家对课程改革实验工作的讨论及从卫星教育平台，教育网站刻录的教研教改、课程改革的信息资源，使广大教师，特别是课程改革实验教师对新课程体系、新课程标准、实验教材的教法和学法，有全面的理解和掌握。教育行政部门要整合教研、电教、技术装备等方面的力量，拟定出教改项目和课题，进行现代远程教育条件下教与学的研究。通过观摩教学、专题培训、优质电教课评比、课件制作竞赛等多种形式，推广好的经验与做法。通过学习交流和课题研究推动学校的信息化进程，扩大远程教育的应用范围，推动农村中小学的教育跨越式发展。针对“两种模式”的特点，加强资源的合理应用。农村远程教育的现状不容乐观，要彻底改变农村远程教育的现状还任重而道远。马彦荣，教师，现居甘肃会宁。时间反复无常，鼓着翅膀飞逝呼吸系统疾病(英文)呼吸系统疾病(TopicsRespiratorydisordersRespiratoryinfectionsPneumoniaTopicsRespiratorydisorders呼吸系统疾病(英文)共82张课件呼吸系统疾病(英文)共82张课件呼吸系统疾病(英文)共82张课件呼吸系统疾病(英文)共82张课件Case-1Jack,agefourmonths,issentathomebyhisgeneralpractitionerbecauseoftwodaysofrapid,labouredbreathingandpoorfeeding.Hewasbornat27weeks’gestation,birthweight979gandwasdischargedhomeatthreemonthsofage.Onexaminationhewasafeverof37.4Candarespiratoryrateof60breaths/min.Hischestishyperinflatedwithmarkedintercoatalrecession.Onauscultationtherearegeneralizedfinecracklesandwheezes.Case-1QuestionDoyouhaveanycommentsorwhatdoyouconcludeanythingfromthiscase?QuestionDoyouhaveanycommenCase-1Jack,agefourmonths,issentathomebyhisgeneralpractitionerbecauseoftwodaysofrapid,labouredbreathingandpoorfeeding.Hewasbornat27weeks’gestation,birthweight979gandwasdischargedhomeatthreemonthsofage.Onexaminationhewasafeverof37.4Candarespiratoryrateof60breaths/min.

Hischestishyperinflatedwithmarkedintercoatalrecession.Onauscultationtherearegeneralizedfinecracklesandwheezes.Case-1QuestionWhatispneumonia?

QuestionWhatispneumonia?Pneumoniaisaninflammationoftheparenchymaofthelungs.

DefinitionPneumoniaisaninflammationoQuestionHowabouttheprevalenceofpneumonia?QuestionHowabouttheprevalenPneumoniaaccountsforapproximately15%ofallrespiratorytractinfections.Worldwide,about3millionchildrendieeachyearfrompneumonia,withthemajorityofthesedeathsoccurringindevelopingcountries.PneumoniaremainsthemostcommoncauseofmorbidityinChina.IncidencePneumoniaaccountsforapproxQuestionHowtoclassifypneumoniainclinic?QuestionHowtoclassifypneumAnatomyPathogensSeverityDurationOnsetsiteClassificationAnatomyClassificationBronchopneumoniaLobarorLobularPneumoniaInterstitialPneumoniaBasedonanatomyorX-raymanifestation

BronchopneumoniaBasedonanatBasedonetiologyBacterialpneumoniaViralPneumoniaMycoplasmaPneumoniaChlamydia

PneumoniaBasedonetiologyBacterialpnAcutePneumoniaProlongedPneumoniaChronicPneumoniaBasedontheprocessofpneumoniaAcutePneumoniaBasedonthepMildPneumoniaSeverePneumoniaBasedontheseverityofpneumoniaMildPneumoniaBasedontheseCommunityAcquiredPneumonia(CAP)HospitalAcquiredPneumonia(HAP)BasedontheonsetsiteofpneumoniaCommunityAcquiredPneumoniaBronchopneumoniaBronchopneumoniaQuestionWhyarechildrenlikelyhavebronchopneumonia?QuestionWhyarechildrenlikelCharactersofchildhoodairwayanatomicstructureandtheirrespiratoryphysiologyImmunefunctionofchildhoodHighriskfactors:prematurebaby,underlyingdisorders呼吸系统疾病(英文)共82张课件QuestionWhatcausebronchopneumonia?

QuestionWhatcausebronchopne•Bacteria:Streptococcuspneumoniae,Haemophilusinfluenzae•Viruses•MycoplasmaCausesofBronchopneumonia•Bacteria:StreptococcuspnePathologyofPneumoniaPathologyofPneumoniaInflammaoryexudateInflammaoryexudatePathologyofPneumoniaInflammaoryexudateInflammaorQuestionWhatarethepathophysiologyofpneumonia?QuestionWhatarethepathophysPathogensURTIBronchitisPneumoniaInflammatoryexudateObstructionofairwayGasexchangeabnormalVentilationabnormalhypoxemiahypercapniatoxinemiatachypneacyanosisralesfevercoughPathogensURTIBronchitisPneumonQuestionWhatarethesignsandsymptomsofpneumonia?

QuestionWhatarethesignsandTheclinical

signsandsymptomsofpneumoniadependprimarilyonthe

age

ofthepatient,the

causativeorganism,andthe

severity

ofthedisease.TheclinicalsignsandsymptomFeverCoughCyanosisTachypeneaRalesFeverCoughCyanosisTachypeneaRaout

breathinginWithinspiration,thesideofthenostrilsflaresoutwardsNasalFlaringoutbreathingWithinspiration,thelowerchestwallmovesinLowerChestWallIndrawingout

breathinginWithinspiration,thelowerchFeverCoughCyanosisTachypeneaRalesFeverCoughCyanosisTachypeneaRaClassicfindingsofpneumoniathatoccurinadultsandolderchildren,suchas

fever,coughandrales,

areoften

absent

ininfants

andtoddlers.Generallypresentwith

nonspecific

signsand

symptomsincluding

lethargy,irritability,

poorfeeding,

vomiting.Ifitappearrespiratoryfailureorotherabnormalityofothersystem-severepneumonia.

ImportantPointsClassicfindingsofpneumoniaComplicationsEmpyemaPyopneumothoraxPneumatoceleLungabscessesAtelectasisComplicationsEmpyemaLaboratoryExamination

WhitebloodcellcountandC-reactionprotein

Pathogensexamination:1)Sputumcultures2)Bloodcultures3)RapidscreeningtestsforvirusorbacterialBronchoscopyBloodgasanalysis:hypoxiaand/orhypercapniaLaboratoryExaminationWhiteRadiographEvaluation

TypicalX-raymanifestationofbronchopneumoniaispatchyinfiltratesbilaterallyComplication:lungabscesses,empyema,pyopneumothorax,pneumatocele,atelectasisCT

RadiographEvaluationTypicalNormalchestX-rayNormalchestX-rayPatchyinfiltratesPatchyinfiltratesLobarpneumoniaoftherightlowerzone

consolidationLobarpneumoniaoftherightllungabscesseslungabscessespyopneumothoraxpyopneumothoraxQuestionHowtodiagnosispneumoniaclinically?QuestionHowtodiagnosispneumAccordingtothetypicalclinicalmanifestationofbronchopneumonia.AccordingtoX-raymanifestation

PayattentiontotheatypicalmanifestationofinfantsEvaluatetheseverityofpneumoniaFindtheetiologyofpneumoniaAccordingtothetypicalclinDifferentialDiagnosis

BronchitisForeignBodyInspirationTuberculosisDifferentialDiagnosisBronchQuestionHowispneumoniatreated?

QuestionHowispneumoniatreatManagementSupportivecareAntimicrobialstherapyHospitalizationinselectedcases

ManagementSupportivecareSupportiveCareAdolescents.Respiratorycaremayrangefromoxygenation,

bronchodilatorsforwheezing,humidificationormist,suctioning,andposturaldrainage,intubationandmechanicalventilation.Hydration(sometimesintravenous)

ControloffeverManagementofcomplicationsSupportiveCareAdolescents.AntimicrobialTherapy

Adolescents.OrganismAntimicrobialS.pneumoniae

Penicillin(ifnotresistant).third-generationcephalosporine.g.cefotaxime\ceftriaxone(ifresistanttopenicillin)H.influenzae

AzithromycinorAmoxicillin(ifnotresistant)Betalactamase

Cefuroximeorthird-generationcephalosporin(ifbetalactamaseandresistant)S.aureusMethicillin(ifnotresistant)Vancomycin(ifMRSA-methicillinresistantS.aureus)ifpenicillinallergy:vancomycin,clindamycin

Chlamydia

Azithromycin(othermacrolidese.gerythromycin);alternative,sulfadrugs

MycoplasmaAzithromycin(othermacrolides);alternative,tetracycline(ifolderthan8years)

RSV

Ribavirin(optional)InfluenzaAmantadine(ifsevere)BacteriaAtypicalVirusesAntimicrobialTherapyAdolesceAgeGroup

Bacterial

Viral

EmpiricTherapyNeonate(0-28days)GroupBstreptococcus,gram-negativeentericE.coli,Klebsiella,Listeriamonocytogenes,S.aureus,othergram-positive)CytomegalovirusHerpessimplexAmpicillinandaminoglycoside(gentamicinortobramycinoramikacin,orthird-generationcephalosporin).Note:Avoidceftriaxone2°tobilirubin

Infants3-16weeks;afebrilepneumoniainfancy

ChlamydiatrachomatisUreaplasmaurealyticumCytomegalovirusPneumocystiscariniiErythromycinSulfonamideInfantsfebrileorillappearingage1-3monthsSameorganismsasforneonateplusS.pneumoniae,H.influenzae,S.aureusNotapplicableAntibiotic(nafcillin,oxacillin,ormethacillin)Broad-spectrumcephalosporin(e.g.,cefotaxime)ToddlerorpreschoolageS.pneumoniae,H.influenzaeM.pneumoniae,ChlamydiaRSVParainfluenzaAdenovirusInfluenzaAzithromycin

Amoxacillin-clavulanate:notactiveagainstatypicalorganisms(Mycoplasma,Chlamydia)OrganismsCausingPneumoniaandEmpiricTherapyinPediatric

AgeGroup

Bacterial

Viral

EmpiQuestionHowabouttheclinicalcourseofpneumonia?QuestionHowabouttheclinicalWithtreatment,pneumoniacausedbybacteriacanusuallybecuredin1or2weeksPneumoniacausedbyavirusoftenlastslongerClinicalCourseAdolescents.ClinicalCourseAdolescents.SpecificPneumoniasSpecificPneumoniasBrochiolitisBrochiolitisisthemostcommonseriousrespiratoryinfectionofinfancyTwotothreepercentofallinfantsareadmittedtohospitalwiththediseaseeachyearduringannualwinterepidemics.Ninetypercentareaged1-9monthsbronchiolitisisrareafteroneyearold.Respiratorysyncytialvirus(RSV)isthepathogenin75-80%casesBrochiolitisBrochiolitisistClinicalFeatures

Coryzalsymptomsprecedeadrycoughandincreasingbreathlessness.Wheezingisoftenbutnotalwayspresent.Feedingdifficultiesassociatedwithincreasingdyspnoeaareoftenthereasonforadmissiontohospital.Recurrentapnoeaisaseriouscomplicationininfantsinthefirstfewmonthsoflife.Infantsbornprematurelywhodevelopbronchopulmonarydysplasiaandinfantswithcongenitalheartdiseasearemoreseverelyaffected.Thefindingonexaminationarecharacteristic:

Sharp,drycoughTachypnoeaSubcostalandintercostalsrecessionHyperinflationofthechest

ClinicalFeaturesCoryzalsInvestigationsRSVcanbeidentifiedrapidlyusingafluorescentantibodytestonnasopharyngealsecretions.ThechestX-rayshowshyperinflationofthelungsduetosmallairwaysobstructionandairtrapping.Bloodgasanalysis,whichisrequiredinonlythemostseverecases,showsloweredarterialoxygenandraisedCO2tension

InvestigationsRSVcanbeideHyperinflationofthelungswithflatteningofdiaphragmHyperinflationofthelungswiManagementIssupportive.Humidifiedoxygenisdeliveredintoahead-boxMist,antibioticsandsteroidsarenothelpfulNebulisedbronchodialatorsdonotreducetheseverityordurationoftheillnessTheantiviraldrugribavirinonlymarginallyshortensviralexcretionandclinicalsymptoms,andshouldbeconsideredonlyforinfantswithunderlyingcardiopulmonarydisordersorimmunodeficiencyFluidsmayneedtobegivenbynasogastrictubeorintravenouslyMechanicalventilationisrequiredinabout2%ofinfantsadmittedtohospitalManagementIssupportive.HuEtiology：Respiratorysyncytialvirus(RSV)isthepathogenin75-80%casesClinicalfeatures:Age:3-6monthSeasonWheezingX-rayDuration:7-10daysManagement:

BronchiolitisEtiology：RespiratorysyncytiaStaphylococcusaureus

.

S.aureusisanuncommonbutimportantcauseofpneumoniathatcanoccurinanyagegroup.

S.aureusisarapidlyprogressivefulminantillnessS.aureuspneumoniaeasilyoccurscomplications.Bloodculturesarepositivein20-30%ofpatients.Thepleuraleffusionsshouldbedrainedbythoracentesisor,iflarge,byachesttube.

Pneumatocelesarealsocommonandarefoundin45-60%ofpatientswithS.aureuspneumonia.

Methicillinorvancomycinshouldbeadministeredfor3-4weeks.

Staphylococcusaureus.S.MycoplasmaPneumoniaMpneumoniaeisacommoncauseofsymptomaticpneumoniainolderchildren.Endemicandepidemicinfectioncanoccur.Theincubationperiodislong(2-3weeks),andtheonsetofsymptomsisslow.Althoughthelungistheprimaryinfectionsite,extrapulmonarycomplicationssometimesoccur.MycoplasmaPneumoniaMpneumoClinicalFeatures

Fever,cough,headache,andmalaisearecommonsymptomsastheillnessevolves.Ralesarefrequentlypresentonchestexamination,decreasedbreathsoundsordullnesstopercussionovertheinvolvedareamaybepresent.

ClinicalFeaturesFever,coLaboratoryfindings

Thetotalanddifferentialwhitebloodcellcountsareusuallynormal.Thecoldhemagglutinintitiershouldbedetermined,becauseitmaybeelevatedduringtheacutepresentation.Atiterof1:64orhighersupportsthediagnosis.

LaboratoryfindingsThetotaImagingChestx-raysusuallydemonstrateintersititialorbronchopneumonicinfiltrates,frequentlyinthemiddleorlowerlobes.Pleuraleffusionsareextremelyuncommon.ImagingChestx-raysusuallydComplicationsExtrapulmonaryinvolvementoftheblood,CNS,skin,heart,orjointscanoccurDirectCoombs-positiveautoimmunehemolyticanemia,CoagulationdefectsandthrombocytopeniacanalsooccurAwidevarietyofskinrashesincludingerythemamultiformaandStevens-JohnsonsyndromeComplicationsExtrapulmonaryTreatmentAntibiotictherapywitherythromycinfor7-10daysusuallyshortensthecourseofillness.Supportivemeasures,includinghydration,antipyretics,andbedrest,arehelpful.TreatmentAntibiotictherapChlamydialPneumoniaPulmonarydiseaseduetoCtrachomatisusuallyevolvesgraduallyastheinfectiondescendstherespiratorytract.Infantsmayappearquitewelldespitethepresenceofsignificantpulmonaryillness.Appropriateage:2-12weeksInclusionconjunctivitis,eosinophilia,andelevatedimmunoglobulinscan

beseen.ChlamydialPneumoniaPulmonarClinicalFeatures

About50%ofpatientswithchlamydialpneumoniahaveactiveinclusionconjunctivitisorahistoryofitRhinopharyngitiswithnasaldischargeorotitismediamayhaveoccurredormaybycurrentlypresentCoughisusuallypresent.ItcanhaveastaccatocharacterandresemblethecoughofpertussisTheinfantisusuallytachypenic.Scatteredinspiraotrtralesarecommonlyheard,butwheezesrarelySignificantfeversuggestsadifferentoradditionaldiagnosisClinicalFeaturesAbout50%LaboratoryfindingsAlthoughpatientsmayfrequentlybehypoxemic,CO2retentionisnotcommon.Peripheralbloodeosinphiliahasbeenobservedinabout75%ofpatients.Serumimmunloglobulinsareusuallyabnormal.IgMisvirtuallyalwayselevated,IgGishighinmany,andIgAislessfrequentlyabnormal.Ctrachomatiscanusuallybeidentifiedinnasopharyngealwashingsusingfluorescentantibodyorculturetechniques.LaboratoryfindingsAlthoughImagingChestx-raysusuallyrevealdiffuseinterstitialandpatchyalveolarinfiltrates,peribronchialthickening,orfocalconsolidation.Asmallpleuralreactioncanbepresent.Despitetheusualabsenceofwheezes,hyperexpansioniscommonlypresent.ImagingChestx-raysusuallyrTreatmentErythromycinorsulfisoxazoletherapyshouldbeadministeredfor14days.Oxygentherapymayberequiredforprolongedperiodsinsomepatients.TreatmentErythromycinorsSummaryPneumoniainpediatricpatientsencompassesawidespectrumofetiologiesandillnessfrommildtosevereandlifethreatening.Therapyshouldincludeanantibioticifabacteriaoratypicalbacteria(chlamydiaormycoplasma)issuspected.Noantibioticsarenecessaryforviralpneumonia.Supp