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Tegopen (Cloxacillin)

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CHEST INFECTION AS ONE OF THE CAUSES OF ACUTE CONFUSION

Chest infections occur more commonly in the winter, especially if the lungs are already diseased. Smoking is the main cause of lung damage and causes the conditions of chronic bronchitis and emphysema (breathing difficulties with shortness of breath, cough and phlegm) as well as lung cancer. People with these conditions get much worse when a chest infection occurs, so smoking should be stopped at any age no matter how few cigarettes are being smoked. An elderly person’s lungs may have been affected by their occupation, e.g. coal mining, or exposure to asbestos or other forms of dust. Lungs may be weakened by other chronic diseases, e.g. asthma, operations, complications of old tuberculosis (ТВ) infections, or after gassing in the First World War. Even fairly healthy lungs can become infected. In particular, influenza epidemics are very dangerous for the elderly, especially if there is already a chest problem.
Chest infections can be difficult to diagnose early. It becomes easier if the confusion is accompanied by a cough, especially a fruity one, and the person can cough up phlegm. Phlegm is often coughed up normally, especially in smokers, but it is then normally white in colour. In a chest infection it becomes green or yellow and may rarely contain some blood. The infection may be accompanied by some chest pains; when these occur on breathing deeply it is suggestive of pleurisy (an inflammation of the lining of the lungs and inner chest wall). The earliest sign that a chest infection is present is often breathlessness. This may not be complained of, but carers may notice that at the beginning of the illness the person sitting at rest is breathing quite fast and shallowly.
Chest infections are either caused by bacteria or viruses. In bacterial infections antibiotics are needed to kill the bugs. Smoking should be stopped. Sometimes the infection is accompanied by wheezing and then other drugs (often in an inhaler or vapour form) are given. Coughing helps bring up the phlegm and is therefore a good thing. However, it can sometimes become exhausting and painful and needs to be lessened. People with already damaged lungs may need the help of home oxygen during a new infection, but this is always supervised at the start by a doctor. Some areas of the country have physiotherapists (part of whose job is to help clear congested lungs by tapping the chest and draining the secretions by posture) who visit people at home.
Influenza is caused by a virus. Unlike bacteria, viruses are not killed by antibiotics, so antibiotics should not be prescribed, except where complications such as added bacterial pneumonia occur. Instead, treatment is supportive and along the lines stated above. It is possible to offer some protection against influenza by having vaccination injections from the GP, and these are especially recommended in the very frail and in those people with lung damage. As with urine infections, if the condition is very bad then admission to hospital is necessary.
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