MI: Respiratory Tract Infections Pt.3 Flashcards
Describe the typical presentation of Pneumocystic jirovecii pneumonia.
- Dry cough
- Weight loss
- SOB
- Malaise
- Walk test - desaturation on exertion
How is PCP diagnosed?
- Blood PCR (early detection in HIV patients)
- Sputum staining with silver-based stains
- Bronchoalveolar lavage and immunofluorescence
What is the treatment for PCP?
Co-trimoxazole (septrin)
What are the main features of allergic bronchopulmonary aspergillosis?
- Chronic wheeze
- Eosinophilia
- Bronchiectasis
What is an aspergilloma?
- Fungal ball often forming within a pre-existing cavity
- May cause haemoptysis
Who is affected by invasive aspergillosis and how is it treated?
Affects immunocompromised individuals
Treated with IV voriconazole
Flowering spores?
Aspergillus
Which organisms cause pneumonia in the following subgroups of patients:
- HIV
- Neutropenia
- Bone marrow transplant
- Splenectomy
- HIV: PCP, TB, Atypical mycobacteria
- Neutropaenia: Fungal (e.g. Aspergillus)
- Bone marrow transplant: CMV
- Splenectomy: Encapsulated organisms (e.g. Streptococcus pnaeumoniae, Haemophilus influenzae)
What is the emprical treatment for mild-to-moderate CAP?
Amoxicillin
(macrolide if penicillin allergic)
What is the emprical treatment for moderate-to-severe CAP?
Moderate - amoxicillin AND clarithromycin
Severe - co-amoxiclav AND clarithromycin
What are the treatment options for moderate and severe HAP?
Check local guidelines
Mild = co-amoxiclav
Severe = tazocin (Piperocillin + tazobactam)
(glycopeptides if MRSA - vancomycin)
Which antibiotics are used to treat HAP caused by:
- MRSA
- Pseudomonas
- MRSA - Vancomycin
- Pseudomonas - Tazocin OR ciprofloxain +/- gentamicin
How can pneumonia be prevented
Vaccinations
Smoking advice
What causes red currant jelly sputum in smokers?
Klebsiella
What causes the halo sign?
Aspergillus
