Community Acquired Pneumonia Flashcards
1 cause of death from infections in those >65 yr old
CAP
CAP risk factors
Alcoholism, asthma, immune suppression, institutionalization, >70 yrs old
Most common CAP organism
Strep pneumonia
Viruses responsible for CAP
Influenza, parainfluenza, RSC
How does MRSA become a CAP
MRSA spreads from hospital setting to community and can infect healthy individuals
Risk factors for pneumococcal pneumonia CAP
Dementia, seizures, CHF, CVA, alcoholism, smoking, COPD
Risk factors for MRSA CAP
Skin colonization or current infection
Enterobacteriaceae CAP risk factors
Recent hospitalization, ABX therapy, alcoholism, HF, renal failure
Risk factors for pseudomonas aeruginosa CAP
Bronchiectasis, cystic fibrosis, severe COPD
Risk factors for Legionella CAP
Diabetes, malignancy, renal disease, HIV, smoking, male, recent hotel or ship cruise
Risk factors for early deterioration in CAP
Multilobular infiltrates, hypoxemia, acidosis, mental confusion, tachypnea, hypoalbuminemia, neutropenia, thrombocytopenia, hyponatremia, hypoglycemia
Complications of CAP
Septic shock, organ failure, cardiovascular compromise, AMI, CHF, arrhythmias
Diagnostic tests and imaging for CAP
CXR
Sputum cx with gram stain
Blood cultures
Urinary test for legionella and pneumococcal
PCR for atypicals
CRP
PCT
CURB-65 diagnostic and scoring
C-confusion
U- urea >7mmol/l
R- RR>30
B- SBP <90 or DBP <60
65- age >65
0-1: low risk, consider outpatient treatment
2: Probable admission vs close outpatient monitoring
3-5: Admission, manage as severe
Non-ICU CAP treatment
Moxifloxacin or levofloxacin
Rocephin (beta lactam coverage) PLUS Azithromycin
