Respiratory viruses – revision
based on presentation of prof. Votava
•The most important:
•
–influenzavirus A a B
–adenoviruses
–RSV and metapneumoviruses
–parainfluenzaviruses (type 1+3 = Respirovirus,  type 2+4 = Rubulavirus)
–rhinoviruses
–coronaviruses (incl. SARS agent)
•

Other respiratory agents of virological interest – revision
•Bacterial agents causing atypical pneumoniae:
•
•Mycoplasma pneumoniae – the most common
•Coxiella burnetii – Q-fever
•Chlamydia (Chlamydophila) psittaci – agent of  ornithosis & psittacosis
•Chlamydia (Chlamydophila) pneumoniae

Etiology of epiglottitis – revision
•Epiglottitis acuta:
• Serious disease – medical emergency
• The child may suffocate!
•
• Practically one and only important agent:
• Haemophilus influenzae type b
•

Etiology of laryngitis and tracheitis – revision
•Respiratory viruses again but other than agents of nasopharyngitis:
• parainfluenza and influenza A viruses & RSV
•Bacteria:
• C. pneumoniae, possibly Mycopl. pneumoniae, secondarily: S. aureus and Haem. influenzae
• laryngotracheitis pseudomembranosa (croup): Corynebacterium diphtheriae

Etiology of bronchitis – revision
•Acute bronchitis:
• Viruses: influenza, parainfluenza, adenoviruses, RSV
• Bacteria, secondarily after viruses: pneumococci, Haem. influenzae, Staph. aureus, moraxellae
(again “the gang of four”)
• Bacteria, primarily: Mycoplasma pneumoniae, Chlamydia pneumoniae, Bordetella pertussis
•
•Chronic bronchitis (cystic fibrosis):
•Pseudomonas aeruginosa, Burkholderia cepacia

Etiology of bronchiolitis – revision
•
•Isolated bronchiolitis in newborns and infants only:
•
• Pneumovirus (= respiratory syncytial virus, RSV)
• Metapneumovirus

Different types of pneumoniae – revision
1.Acute – community-acquired pneumonia
–in originally healthy
•adults
•children
–in debilitated persons
–after a contact with animals
1.
2.Acute – nosocomial pneumonia
–– VAP = ventilator-associated
•early
•late
–– others
•
•3. Subacute and chronic pneumonia
1.

Etiology of pneumoniae I            – revision
•Acute, community-acquired, in healthy adults
•bronchopneumonia and lobar pneumonia:
–Streptococcus pneumoniae
–Staphylococcus aureus
–Haemophilus influenzae type b
•atypical pneumonia:
–Mycoplasma pneumoniae
–Chlamydia pneumoniae
–Influenza A virus  (during an epidemic only)
–

Etiology of pneumoniae II      – revision
•Acute, community-acquired, in healthy children
•bronchopneumonia:
–Haemophilus influenzae type b (→ vaccination)
–Streptococcus pneumoniae
–Moraxella catarrhalis
–In newborns: Streptococcus agalactiae
–                           enterobacteriae
•atypical pneumonia:
–respiratory viruses (RSV, infl. A, adenoviruses)
–Mycoplasma pneumoniae
–Chlamydia pneumoniae
–in newborns: Chlamydia trachomatis D-K

Etiology of pneumoniae III           – revision
•Acute, community-acquired, in debilitated individuals:
–pneumococci, staphylococci, haemophili
–Klebsiella pneumoniae (alcoholics)
–Legionella pneumophila
•In more serious immunodeficiency:
–Pneumocystis jirovecii
–CMV
–atypical mycobacteria
–Nocardia asteroides
–aspergilli, candidae

Etiology of pneumoniae IV          – revision
•Acute, community-acquired, after a contact with animals:
•
•Bronchopneumonia
–Pasteurella multocida
–Francisella tularensis (tularemia)
–
•Atypical pneumonia
–Chlamydia psittaci (ornithosis)
–Coxiella burnetii (Q-fever)

Etiology of pneumoniae V           – revision
•Acute, nosocomial:
•VAP (ventilator-associated pneumonia)
–early (up to the 4th day of hospitalization):
– sensitive community strains of respiratory agents („gang of 4“)
–late (from the 5th day of hospitalization):
– resistant hospital strains
•Other nosocomial pneumoniae
–viruses (RSV, CMV)
–legionellae
–

Etiology of pneumoniae VI          – revision
•Subacute and  chronic:
–aspiration pneumonia and lung abscesses
•Prevotella melaninogenica
•Bacteroides fragilis
•peptococci and peptostreptococci
–lung tuberculosis and mycobacterioses
•Mycobacterium tuberculosis
•Mycobacterium bovis
•atypical mycobacteria (e.g. the complex M. avium–M. intracellulare)
•
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