WordNet

unrefined in character; "low comedy"
an air mass of lower pressure; often brings precipitation; "a low moved in over night bringing sleet and snow" (同)depression
a low level or position or degree; "the stock market fell to a new low"
used of sounds and voices; low in pitch or frequency (同)low-pitched
very low in volume; "a low murmur"; "the low-toned murmur of the surf" (同)low-toned
in a low position; near the ground; "the branches hung low"
less than normal in degree or intensity or amount; "low prices"; "the reservoir is low"
literal meanings; being at or having a relatively small elevation or upward extension; "low ceilings"; "low clouds"; "low hills"; "the sun is low"; "low furniture"; "a low bow"
move something or somebody to a lower position; "take down the vase from the shelf" (同)take_down, let down, get_down, bring_down
cause to drop or sink; "The lack of rain had depressed the water level in the reservoir" (同)depress
set lower; "lower a rating"; "lower expectations" (同)lour
(medicine) the invasion of the body by pathogenic microorganisms and their multiplication which can lead to tissue damage and disease
(phonetics) the alteration of a speech sound under the influence of a neighboring sound
the pathological state resulting from the invasion of the body by pathogenic microorganisms
(international law) illegality that taints or contaminates a ship or cargo rendering it liable to seizure
moral corruption or contamination; "ambitious men are led astray by an infection that is almost unavoidable"
an incident in which an infectious disease is transmitted (同)contagion, transmission
a brief treatise on a subject of interest; published in the form of a booklet (同)pamphlet
an extended area of land (同)piece of land, piece of ground, parcel of land, parcel
a system of body parts that together serve some particular purpose
a drawing created by superimposing a semitransparent sheet of paper on the original image and copying on it the lines of the original image (同)trace
the act of drawing a plan or diagram or outline
the discovery and description of the course of development of something; "the tracing of genealogies"

PrepTutorEJDIC

(高さ・位置が)『低い』,低い所にある / (価格・数量・程度などが)『低い』,少ない / (身分・地位などが)『低い』,卑しい / (人格・行為などが)『卑しい』,下劣な,下品な / 《補語にのみ用いて》(体が)『弱った』;元気のない,憂うつな / (供給が)不十分な;(…が)乏しい《+『in』(『on』)+『名』》 / (音・声が)低い,小さい / (生物が)下等な / 『低く』,低い所に / (価格・程度などが)『安く』,低く / 低い声(調子)で;静かに / 最低点,最低水準
(牛の)モーという鳴き声 / (牛が)モーと鳴く
(lowの比較級)『もっと低い』,(価格が)もっと安い / 《名詞の前にのみ用いて》『下級の』;低い(下の)ほうの / …‘を'『下げる』,降ろす / 〈価格・程度・量・調子など〉‘を'『下げる』,小さくする,低下させる / 〈人〉‘を'品位(品格)を落とす / 低くなる,下がる,滅る
(…に向かって)顔をしかめる,まゆをひそめる《+『at(on, upon)』+『名』》 / 〈空模様が〉険悪になる,〈雨などが〉降りそうな / しかめっつら / 険悪な空模様
〈U〉(病気の)伝染;感染 / 〈C〉伝染病
広大な土地(地域),(土地・海・空などの)広がり《+of+名》 / (器官の)管,(神経の)索
(おもに宗教・政治などの宣伝用の)小冊子,パンフレット
跡を追うこと,追跡;透写,複写 / 〈C〉 / 透写(複写)によってできたもの(地図・図案など),透写図

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/11/03 19:03:38」(JST)

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Lower respiratory tract infection, while often used as a synonym for pneumonia, can also be applied to other types of infection including lung abscess and acute bronchitis. Symptoms include shortness of breath, weakness, high fever, coughing and fatigue.

Lower respiratory tract infections place a considerable strain on the health budget and are generally more serious than upper respiratory infections. Since 1993 there has been a slight reduction in the total number of deaths from lower respiratory tract infection. However in 2002 they were still the leading cause of deaths among all infectious diseases, and they accounted for 3.9 million deaths worldwide and 6.9% of all deaths that year.^[1]

There are a number of acute and chronic infections that can affect the lower respiratory tract. The two most common infections are bronchitis and pneumonia.^[2] Influenza affects both the upper and lower respiratory tracts. Antibiotics are often thought to be the first line treatment in lower respiratory tract infections; however, these are not indicated in viral infections. It is important to use appropriate antibiotic selection based on the infecting organism and to ensure this therapy changes with the evolving nature of these infections and the emerging resistance to conventional therapies.^[3] H. influenzae and M. catarrhalis are of increasing importance in both community acquired pneumonia (CAP) and acute exacerbation of chronic bronchitis (AECB) while the importance of S. pneumoniae is declining. It has also become apparent the importance of atypical pathogens such as C. pneumoniae, M. pneumoniae and L. pneumophila, in CAP.^[3]

Classification

Bronchitis

Main article: Bronchitis

Bronchitis can be classified as either acute or chronic. Acute bronchitis can be defined as acute bacterial or viral infection of the larger airways in healthy patients with no history of recurrent disease.^[2] It affects over 40 adults per 1000 each year and consists of transient inflammation of the major bronchi and trachea.^[4] Most often it is caused by viral infection and hence antibiotic therapy is not indicated in immunocompetent individuals.^[5]^[6] There are no effective therapies for viral bronchitis.^[6]^[7] Treatment of acute bronchitis with antibiotics is common but controversial as their use has only moderate benefit weighted against potential side effects (nausea and vomiting), increased resistance, and cost of treatment in a self-limiting condition.^[4]^[8] Beta2 agonists are sometimes used to relieve the cough associated with acute bronchitis. In a recent systematic review it was found there was no evidence to support their use.^[6]

Acute Exacerbations of Chronic Bronchitis (AECB) are frequently due to non-infective causes along with viral ones. 50% of patients are colonised with Haemophilus influenzae, Streptococcus pneumoniae or Moraxella catarrhalis.^[2] Antibiotics have only been shown to be effective if all three of the following symptoms are present:- increased dyspnoea, increased sputum volume and purulence. In these cases 500 mg of Amoxycillin orally, every 8 hours for 5 days or 100 mg doxycycline orally for 5 days should be used.^[2]

Pneumonia

Main article: Pneumonia

Pneumonia occurs in a variety of situations and treatment must vary according to the situation.^[7] It is classified as either community or hospital acquired depending on where the patient contracted the infection. It is life-threatening in the elderly or those who are immunocompromised.^[9]^[10] The most common treatment is antibiotics and these vary in their adverse effects and their effectiveness.^[9] Pneumonia is also the leading cause of death in children less than five years of age.^[11] The most common cause of pneumonia is pneumococcal bacteria, Streptococcus pneumoniae accounts for 2/3 of bacteremic pneumonias.^[12] This is a dangerous type of lung infection with a mortality rate of around 25%.^[10] For optimal management of a pneumonia patient the following must be assessed;- pneumonia severity (including where to treat e.g. Home, hospital or intensive care), identification of causative organism, analgesia of chest pain, the need for supplemental oxygen, physiotherapy, Hydration, bronchodilators and possible complications of emphysema or lung abscess.^[13]

Treatment

Treatment depends on the cause thus see the appropriate page above.

Epidemiology

The following map shows lower respiratory infections per 100,000 inhabitants in year 2002.

Disability-adjusted life year for lower respiratory infections per 100,000 inhabitants in 2002.^[14]

no data

less than 100

100–700

700–1,400

1,400–2,100

2,100–2,800

2,800–3,500

3,500–4,200

4,200–4,900

4,900–5,600

5,600–6,300

6,300–7,000

more than 7,000

References

^ Robert Beaglehole...et al. (2004) (PDF). The World Health Report 2004 - Changing History. World Health Organization. pp. 120–4. ISBN 92-4-156265-X. http://www.who.int/entity/whr/2004/en/report04_en.pdf.
^ ^a ^b ^c ^d Antibiotic Expert Group. Therapeutic guidelines: Antibiotic. 13th ed. North Melbourne: Therapeutic Guidelines; 2006.
^ ^a ^b Guthrie R (2001). "Community-acquired lower respiratory tract infections: etiology and treatment". Chest 120 (6): 2021–34. doi:10.1378/chest.120.6.2021. PMID 11742937. http://www.chestjournal.org/cgi/pmidlookup?view=long&pmid=11742937.
^ ^a ^b BJM Clinical evidence: London, United Kingdom: BMJ, 1999-2007 : Accessed 29/3/7 at : http://0-www.clinicalevidence.com.library.newcastle.edu.au/ceweb/index.jsp.
^ Therapeutic guidelines : respiratory. 2nd ed ed: North Melbourne : Therapeutic Guidelines Limited, 2000.
^ ^a ^b ^c Smucny J BL, Glazier R. . Beta2-agonists for acute bronchitis. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD001726. doi:10.1002/14651858.CD001726.pub3.
^ ^a ^b Integrated pharmacology / Clive Page ... [et al.]. 2nd ed ed: Edinburgh : Mosby, 2002.
^ Fahey T SJ, Becker L, Glazier R. . Antibiotics for acute bronchitis. Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No.: CD000245. doi:10.1002/14651858.CD000245.pub2.
^ ^a ^b Bjerre LM VT, Kochen MM. . Antibiotics for community acquired pneumonia in adult outpatients. Cochrane Database of Systematic Reviews 2004, Issue 2. Art. No.: CD002109. doi:10.1002/14651858.CD002109.pub2.
^ ^a ^b Dear KB G AR, Holden J, Tatham DP. . Vaccines for preventing pneumococcal infection in adults. Cochrane Database of Systematic Reviews 2003, Issue 4. Art. No.: CD000422. doi:10.1002/14651858.CD000422.
^ Kabra SK LR, Pandey RM. . Antibiotics for community acquired pneumonia in children. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD004874. doi:10.1002/14651858.CD004874.pub2.
^ The Merck manual of diagnosis and therapy. 17th ed / Mark H. Beers and Robert Berkow ed: Whitehouse Station, N.J. : Merck Research Laboratories, 1999.
^ eTG complete [electronic resource] "?". http://0-www.etg.hcn.net.au.library.newcastle.edu.au/.
^ "Mortality and Burden of Disease Estimates for WHO Member States in 2002" (xls). World Health Organization. 2002. http://www.who.int/entity/healthinfo/statistics/bodgbddeathdalyestimates.xls.

UpToDate Contents

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1. 成人における急性気管支炎 acute bronchitis in adults
2. RSウイルス感染：臨床的特徴および診断 respiratory syncytial virus infection clinical features and diagnosis
3. Upper respiratory tract infections: Considerations in adolescent and adult athletes
4. 成人における感冒：診断と臨床的特徴 the common cold in adults diagnosis and clinical features
5. 成人における市中肺炎の疫学、病因、および微生物学 epidemiology pathogenesis and microbiology of community acquired pneumonia in adults

English Journal

Rhinovirus load and disease severity in children with lower respiratory tract infections.

Takeyama A, Hashimoto K, Sato M, Sato T, Kanno S, Takano K, Ito M, Katayose M, Nishimura H, Kawasaki Y, Hosoya M.SourceDepartment of Pediatrics, Soma General Hospital, Fukushima, Japan; Department of Pediatrics, Fukushima Medical University, School of Medicine, Fukushima, Japan. ayatake@rondo.ocn.ne.jp.
Journal of medical virology.J Med Virol.2012 Jul;84(7):1135-42. doi: 10.1002/jmv.23306.
It has not been clarified if there is a correlation between rhinovirus (RV) load and disease severity in the lower respiratory tract infections of hospitalized children. This study was undertaken to elucidate the contribution of the viral load to the development of disease severity in 412 children �
PMID 22585733

Viral infections of the lower respiratory tract.

Ren L, Xiang Z, Guo L, Wang J.SourceMOH Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, IPB, CAMS-Fondation Mérieux, Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, 9# Dong Dan San Tiao, Dongcheng District, Beijing, 100730, People's Republic of China.
Current infectious disease reports.Curr Infect Dis Rep.2012 Jun;14(3):284-91.
Lower respiratory tract infections (LRTIs) are a global burden to public health and are frequently caused by respiratory viruses. Advances in molecular diagnostic techniques have allowed the identification of previously undetected viral pathogens and have improved our understanding of respiratory vi
PMID 22456860

Japanese Journal

Assessment of Olfactory Nerve by SPECT-MRI Image with Nasal Thallium-201 Administration in Patients with Olfactory Impairments in Comparison to Healthy Volunteers

Shiga Hideaki,Taki Junichi,Washiyama Kohshin,Yamamoto Junpei,Kinase Sakae,Okuda Koichi,Kinuya Seigo,Watanabe Naoto,Tonami Hisao,Koshida Kichiro,Amano Ryohei,Furukawa Mitsuru,Miwa Takaki
PLoS ONE 8(2), e57671, 2013-02-02
… The causes of olfactory dysfunction in the patients were head trauma (n = 7), upper respiratory tract infection (n = 7), and chronic rhinosinusitis (n = 7). … Results: Nasal201Tl migration to the olfactory bulb was significantly lower in the olfactory-impaired patients than in healthy volunteers. …
NAID 120005253903

The Immunomodulatory Effects of Garenoxacin on Interleukin-8 Produced by Human Tonsillar Lymphocytes with Lipopolysaccharide Stimulation

林正樹,保富宗城,山中昇
耳鼻咽喉科臨床 106(3), 279-284, 2013
… Garenoxacin (GRNX), a recently developed fluoroquinolone, has been reported to show strong antimicrobial activity against respiratory pathogens such as Streptococcus pneumoniae and Haemophilus influenzae and high treatment efficacy for acute infectious diseases of the upper and lower respiratory tracts. …
NAID 130003374037