Respiratory infections

1. Indications
2. Medical thoracoscopy with biopsy: indications
3. Pleural fluid and pleural biopsy samples

1. Miliary TB pattern
2. Mediastinal lymph nodes
3. Lung cavities
4. Indirect findings of septic embolism
5. Septic emboli
6. Abscess
7. Hydatid cyst
8. Sequester
9. Signs of pleural infection/parapneumonic effusion
10. Atelectasis signs
11. Signs of bronchiectasis
12. Consolidation and air bronchogram sign
13. Ground glass opacities
14. Solitary nodule
15. Signs of cardiac pathologies
16. Parenchymal infiltrates
    1. linear
    2. reticular
    3. solitary
    4. nodulary
    5. consolidation
    6. homogeneous opacities
    7. nonhomogeneous opacities

1. Thoracic ultrasound to guide thoracentesis/aspiration
2. ICU patients that cannot be moved
3. Pneumonia diagnosis
4. Empyema diagnosis
5. Complicated parapneumonic effusion

1. Tree-in-bud sign
2. Bronchiectasis
3. Fungal respiratory infections
4. Pneumocystis Jiroveci Pneumonia (PJP)
5. Non-resolving pneumonia
6. Interstitial lung diseases
7. Empyema
8. Mediastinal lymph nodes
9. Bronchopleural fistula
10. Radiological signs of:
    1. Diseases associated with Aspergillus
    2. Non-tuberculous mycobacteria (NTM)
    3. Early (sub-clinical) tuberculosis
    4. COVID-19

Sample collection: spontaneous sputum (pro/con), induced sputum (pro/con) and interpretation of adequate sample.

1. Conventional microbiological methods such as Gram staining, culture and sensitivity testing for different pathogens, such as atypical bacteria, viruses and fungi, and for Pneumocytis pneumonia (PCP) due to Pneumocytsis jerovecii (previously carinii)
2. Indications for and collection of biological specimens, Gram staining, culture, molecular methods, IF and genetic testing
3. Common pathogens and their antibiotic sensitivities
4. Uncommon Respiratory pathogens and their meaning in clinical practice
5. Samples and specific pathogens
   1. Bacteria
   2. Fungi
   3. Mycobacteriae
   4. Other pathogenes (PJP, Nocardia, actinomyces, etc.)
6. Acid-fast bacilli: number (WHO and CDC USA), interpretation of quality, sputum induction indication and culture versus immunofluorescence (IF) versus PCR
7. Likelihood of a laboratory report being correct (e.g. Gram-negative pathogens or gonococcal pharyngitis); Nocardia as an acid-fast organism
8. Whole-genome sequencing (WGS) and targeted next-generation sequencing of Mycobacterium tuberculosis and other mycobacteria
9. Microbiologic diagnosis of TB (smear examination, liquid and solid culture media, molecular study of resistance and phenotypic/genotypic methods)
10. Interferon gamma release assay, interpretation of microbiological results provided by BAL, quantitative culture, particularities in immunocompromised patients, particularities in nosocomial infection and types of sputum harvest (spontaneous, induced and bronchial aspirate)
11. Airway microbiome in relation with/to epigenetic and transcriptomic profiles in lung tissue

1. Principles of inhaled therapy (understand drug delivery and dosing and the reasons to use inhaled antibiotics)
2. When to use inhaled drugs, e.g. nebulised amikacin in NTM disease, nebulised colistin in bronchiectasis for treatment of Pseudomonas aeruginosa
3. Delivery modes
4. Indications and challenges of application at an ICU
5. Adverse effects of inhaled therapy

1. Interpreting laboratory results and choosing treatment according to the category:
   1. Bacteria
   2. Fungi
   3. Mycobacteria
2. Methods of drug delivery
3. Use of antivirals (e.g. remdesivir) in epidemics (flu, COVID-19)
4. Use of antifungal drugs
5. Antibiotic stewardship and adherence to guidelines
6. Place of corticosteroids
7. Pharmacokinetics and pharmacodynamics

1. Role of physiotherapy in sputum induction
2. Airways clearance techniques in Bronchiectasis and other Chronic Respiratory conditions with hypersecretion
3. The role of aerobic exercise and muscle strengthening in airways clearance

1. Rehabilitation and airway clearance to help reduce exacerbations of chronic respiratory diseases such as COPD and bronchiectasis
2. Prevention of infections

1. Patient factors
   1. Vaccines
   2. Other preventive treatments
2. Environmental factors
   1. Segregation (segregation under infection control and relevance to CF and TB)
   2. Air pollution
   3. Occupational hazards and safety measures

1. Indications for and management of ICD
2. Empyema (including complicated parapneumonic effusion)
3. Intrapleural fibrinolytic therapy for empyema

1. Opportunistic infections after lung transplantation
2. Differentiation between organ rejection and infection
3. Antibiotic Prophylaxis
4. Post-transplant management
5. Graft versus host disease

1. CAP
2. Hospital-acquired pneumonia (HAP)
3. Ventilator-associated pneumonia (VAP)
4. NHAP
5. Sepsis
6. Bioterrorism
7. Epi/pandemics
8. Empiric antibiotic therapy – when and how to build the regimen
9. Use of oxygen (pneumonia versus COPD)

1. Differential diagnosis using clinical and radiological findings of infectious diseases (i.e. those caused by bacteria, viruses, fungi, mycobacteria and other difficult-to-treat microorganisms) in contrast with those of non-infectious disorders

1. Common upper respiratory tract syndromes (including acute infective rhinitis, sinusitis, pharyngitis, epiglottitis, laryngotracheitis and tonsillitis)

1. Pathophysiological mechanisms of exacerbation
2. Infectious management of exacerbation
3. Allergic bronchopulmonary aspergillosis
4. Infectious causes of eosinophilia

1. Acute bacterial and viral bronchitis
2. Chronic bronchitis
3. Aspergillus tracheobronchitis
4. Treatment approach

1. Pathophysiological mechanisms of exacerbation
2. Infectious management of exacerbation, e. viral and bacterial
3. Immunomodulatory therapy
4. Risks associated with inhaled corticosteroids
5. Vaccination
6. Bacterial colonisation
7. Long-term macrolides

1. Respiratory syncytial virus
2. Other viruses and bacteria
3. Differential diagnosis
4. Treatment approach

1. Diagnostic and aetiological work-up
2. Management of exacerbation
3. Haemoptysis and management
4. Bacterial and non-bacterial surveillance
5. Eradication
6. Long-term antibiotic including nebulised antibiotics and immunomodulatory therapy
7. Long term management of bronchiectasis (ADD)
8. Respiratory physiotherapy
9. Rehabilitation
10. Classification severity
11. Vaccination

1. CAP (including NHAP and HCAP)
2. Nosocomial pneumonia
3. Non-responding pneumonia (CAP or nosocomial)

1. Diagnostic methods in radiology and ultrasound parapneumonic effusion and empyema pleuritis
2. Indication for large-bore pleural drainage
3. Indication for medical and surgical thoracoscopy
4. Evaluating the accuracy of microbiological methods

1. Choice and duration of antibiotic treatment in particular situations, such as intravenous drug users, and aspiration
2. Surgical intervention

1. Population groups with a worse prognosis
2. Infection control
3. Medical treatment
4. COVID-19

1. Pneumocystis jirovecii
2. Empirical antibiotic selection and treatment particularities in patients with acquired immunodeficiency, neutropenic patients, patients with solid organ malignancy, lung and other solid organ transplant recipients, haematopoietic cell transplant recipients, patients with other haematological conditions, patients with secondary immunodeficiency induced by drugs and biologicals and patients with primary immune deficiency syndromes
3. Antibiotic prophylaxis
4. Role of invasive diagnostic testing
5. Fungal infections
6. Pulmonary TB

1. Choice of antibiotics
2. Risk factors for aspiration pneumonitis
3. Prognosis
4. Supportive care
5. Preventative measures

1. Consideration of TB in the differential diagnosis of respiratory infections
2. Epidemiology, burden of disease and risk factors: know when to investigate and what tests to ask for
3. Indication for isolation and discontinuation of isolation
4. Risk factors for MDR/XDR TB
5. Diagnostic tests, molecular tests, whole genome sequencing (WGS)
6. Drug susceptibility and treatment
7. Directly observed therapy (DOT) / Video observed therapy (VOT)
8. Miliary TB
9. TB drugs-related adverse events (AEs)
10. How to increase compliance to treatment
11. The role of active TB drug safety monitoring – when and how
12. TB sequelae and pulmonary rehabilitation

1. Differential diagnosis
2. Diagnosis of adenitisTB TB and indication for EBUS
3. Rate of associations with pulmonary TB
4. Role of immunological tests for increasing the probability of diagnosis in patients with relevant risk factors and symptoms
5. Pleural TB
6. Specific extrapulmonary TB involvement: Liver, CNS, polyserositis, intestinal etc

1. Diagnosis
2. Contact investigation
3. Treatment
4. Surveillance of side effects
5. Alternative regimens in case of AEs
6. TBI management in immunocompromised patients
7. Selection of candidates to treat

1. Clinical presentation of NTM diseases
2. Diagnostic criteria
3. Indication for treatment
4. Treatment
5. Monitoring of drug responses including relapse, re-infection and cure
6. Epidemiology and risk factors for NTM
7. HIV co-infection
8. Immunosuppression

1. Differential diagnosis and testing
2. Treatment
3. Antibiotics
4. When to perform surgery
5. Oesophageal perforations
6. Transoesophageal fistulae

1. Patterns of pulmonary involvement in primary immunodeficiency disorders
2. Recognition, assessment and management of the severity of respiratory disease in patients with primary immunodeficiency disorders
3. Appropriate vaccination and prophylaxis regimens
4. Emphasise the most common primary immunodeficiency syndromes
5. Indications for immunoglobulin replacement therapy

1. Indications for screening and follow-up
2. Multidisciplinary approach to secondary immunodeficiency syndromes

1. Diagnosis and differential diagnosis
2. When and how to go for screening
3. Microbiological evaluation
4. Infection control and cross-infection
   1. Isolation and reverse isolation
   2. Infection surveillance
5. Antibiotic management for eradication
6. Suppression
7. Acute exacerbation
8. NTM infections in CF
9. Particularities in treatment (pharmacokinetics)
10. Immunomodulatory drugs
11. Physiotherapy
12. New CF transmembrane conductance regulator (CFTR)-specific medications
13. Multidisciplinary CF management
14. Non-respiratory management
15. CFTR modulators

1. Differential diagnosis and recognition of primary ciliary dyskinesia
2. Diagnostic testing
3. α1-antitrypsin

1. TB screening in HCWs
2. TB prevention in HCWs
3. TB infection control training for HCWs
4. Precautions for pregnant HCWs: measles, influenza and TB
5. Zoonosis
6. Influenza in exposed HCWs
7. COVID-19

1. General aspects of epidemiological and statistical methods for critical appraisal
2. Assessment of national TB programme
3. Approach to pandemics/epidemics data analysis

1. Alcohol abuse
2. Smoking including electronic cigarettes, marijuana and water pipes

1. Clinical evaluation of patient
2. Differential diagnosis
3. Treatment, intervention, mitigation
4. Disability, vocational considerations, Workers’ Compensation considerations
5. Public health approach