A bacterial infection is always associated with a fever

When viruses, bacteria or fungi attack the airways


How to recognize and treat respiratory infections caused by viruses, fungi and bacteria, Prof. Dr. Susanne Lang, chief physician of the Medical Clinic II at the SRH Wald-Klinikum Gera, describe in her lecture at the 8th Symposium Lung on September 12, 2015 ...

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In COPD patients, respiratory infections lead to a sudden deterioration in lung function and symptoms of the disease (exacerbation). For COPD patients, acute exacerbations represent a potentially life-threatening disease that is associated with increased mortality. Moderately severe crises require hospital treatment and very severe exacerbations even require intensive therapy. After the acute exacerbation has subsided, many patients often do not return to their original state of health.

About half of the acute COPD exacerbations - according to some experts even more - are infection-related, mostly viral infections. Successful treatment strategies are vaccination for viral infections, antibiotic treatment for infections caused by bacteria and modern fungal agents for fungal infections. It is important to identify the cause of infections and to take precautionary measures. Infections with viruses and bacteria or fungi often occur together, so one does not exclude the other.

Viral diseases of the respiratory tract are so common that it is difficult to avoid infection. Infected patients spread the pathogen through the air by sneezing and coughing. The infection rate rises especially in the cold season, sometimes explosively as an epidemic
If a disease occurs locally and chronologically, it is referred to as an epidemic. For example, if a new variant of the changeable influenza virus encounters a population group that has not yet developed a defense against this particular pathogen, this virus variant can spread quickly. The spread does not stop until the pathogen affects people who, for example, have formed antibodies against it as a result of a flu vaccination.
The American Center for Disease Control speaks of a flu epidemic when the death rate from influenza and pneumonia (known as excess mortality) is more than 7.5% higher than in an average winter.
In contrast to a pandemic, an epidemic is limited to a certain region.
. In contrast to bacteria, viruses are not viable on their own, but rather attack existing cells in which they multiply. It is therefore comparatively difficult to develop drugs against viruses. The most successful are vaccinations that stimulate the immune system
The body's defense system consists of three functional circles:
(1) Bone marrow as a place where immune cells form.
(2) Various central immune organs such as thymus (imprinting T lymphocytes) and lymphatic organs near the gut (for imprinting B lymphocytes).
(3) Secondary lymphatic organs such as the spleen, lymph nodes and tonsils (tonsils).
A distinction is made between the so-called humoral defense (via the body fluids containing antibodies and factors from the so-called complement system) and the cell-mediated defense (with B and T cells, macrophages, antigen-presenting cells, granulocytes, etc.).
make "sharp" against the respective virus type. As a result, when the virus comes into contact, an immune reaction occurs that prevents the disease before the virus can establish itself in its host cell.

Viruses usually pave the way for bacterial infections, as they destroy infected host cells and thus clear the way for bacteria. The bacterial infection then follows the virus infection. Virus infections are also problematic for asthmatics, as they can provoke asthma attacks by inflaming the airways.

Vaccinations and general hygiene measures are best used against viral diseases of the respiratory tract to avoid infection. In addition, the immune system can be strengthened through health-conscious behavior (sauna, contrast showers, outdoor exercise, appropriate clothing). The extent to which dietary supplements (vitamin C, selenium) or the intake of aspirin help prevent infection is a matter of dispute.

For patients with respiratory diseases, the classic pneumonia pathogens continue to play the main role. Streptococcus pneumoniae is the most common bacterial trigger for pneumonia. Although only a small group of patients is affected by so-called problem germs, bacterial infections with hospital germs are increasing.

The pathogen is diagnosed primarily by examining sputum. For the assessment, however, the time between coughing up the mucus and the examination in the laboratory is essential. It should not exceed three hours. If the sputum sample is stored for a longer period, bacteria that are not responsible for the disease proliferate and displace the pathogens, which are then no longer recognized. Inflammation markers can be determined in the blood, and pneumonia can be seen in an X-ray. Clinically, the sputum looks yellow or greenish and a fever may occur.

Treatment with antibiotics is the essential measure for bacterial infections. Cortisone is used to reduce the swelling of the bronchial mucosa and thus relieve the shortness of breath in COPD and should not exceed five days. In individual cases, long-term antibiosis with azithromycin for 6 months can be prescribed in order to avoid frequent bacterial infections.

Fungi are extremely successful creatures that colonize the whole world - from Antarctica to the Gobi desert, fungi have been identified. However, only a few mushrooms are able to cause damage in the human body. Fungal spores are usually harmless to healthy people. Detection of fungal spores in the respiratory tract does not mean that there is a fungal infection. Fungi in the intestines and on the skin are even part of the normal colonization of germs. However, there are diseases that allow fungi to penetrate - and thus a fungal infection - in the first place. These include diseases that weaken the immune system such as cancer, HIV or congenital immune deficiencies. Also patients with chronic lung diseases such as cystic fibrosisCystic fibrosis
In the hereditary disease mucosal viscidosis, which affects around 8,000 people in Germany, a faulty gene causes the salt and water transport of the mucous membranes in the lungs, intestines and other organs to be altered, thereby forming abnormally thick mucus in the lungs, pancreas and small intestine which clogs the bronchi and digestive tract. Shortness of breath, chronic cough, but also disturbed digestion and susceptibility to infections are the consequences.
(Cystic fibrosis) or tuberculosis suffer from fungal infections because the viscous mucus in their bronchi can only be removed with difficulty and is therefore a good breeding ground for pathogens, or a cavity is created in the lung tissue in which a fungal ball can grow. Drugs that suppress the immune system, such as cortisone, also play an important role in the development of fungal diseases.

In her lecture, Prof. Lang will also explain in detail which clinical pictures and complaints are associated with an infection by yeasts (Candida) and molds (Aspergillus).

Source: Lecture by Prof. Dr. med. Susanne Lang, Chief Physician of the Medical Clinic II at the SRH Wald-Klinikum Gera, at the 8th Symposium Lung on Saturday, September 12, 2015 from 9:00 a.m. to 5:00 p.m. in Hattingen (North Rhine-Westphalia).
Please address inquiries regarding the symposium to:
Organizing Office Symposium Lung
Jens Lingemann
[email protected]
Telephone: 02324 - 999 959

All information about the event can be found here: Symposium-Lunge 2015
You can order your free program here

Corresponding to the topic, COPD-Deutschland eV, in cooperation with the patient organization Pulmonary Emphysema-COPD Germany, has published a patient guide entitled "Viruses or bacteria: Antibiotics - necessary yes ..... but when?", Which you will find at the symposium ( in exhibition tent 3 at stand 1) free of charge.