pneumonia Flashcards
(20 cards)
pneumonia
inflammatory condition affecting the alveoli of the lungs
- most secondary to bacterial infection
(others = viral, fungal (pneumocystis jiroveci)
most common causative organism of pneumonia
strep pneumoniae
causative organism most commonly assoc with pneumonia in COPD patients
haemophilus influenzae
causative organism most commonly assoc with pneumonia in alcoholic patients
klebsiella pneumoniae
causative organism most commonly assoc with pneumonia in HIV patients
pneumocystis jiroveci
- dry cough
- exercise induced desaturations
- absence of chest signs
causative organism most commonly assoc with air conditioners in pneumonia
Legionella pneumophilia
- atypical organism
- hyponatraemia + lymphopenia common
- relative bradycardia
idiopathic interstitial pneumonia, what can cause it?
a group of non-infective causes on pneumonia
may develop as a complication of rheumatoid arthritis or amiodarone therapy
pneumonia on auscultation
reduced breath sounds
bronchial breathing
crepitations/crackles
(dullness on percussion)
pneumonia chest xray
consolidation
pneumonia scoring system
CURB65 (CRB65 inGP)
Confusion
urea >7
Resp rate >=30
BP <=90 / dia <=60
65 yrs
0 = treatment at home
2 = hospital assessment
3-4 = urgent admission
CRP levels in managing pneumonia
CRP <20 - no antibiotics
20-100 - delayed antibiotics
>100 - antibiotics
mx of low severity community acquired pneumonia
1st = amoxicillin
- if penicillin allergic - macrolide (erythromycin) or tetracycline
- 5 day course
mx of mod to high severity community acquired pneumonia
dual antibiotic therapy - amoxicillin + macrolide (erythromycin)
- 7-10days
follow up care of pneumonia
repeat chest xray 6 weeks after clinical resolution
- no consolidation
- no underlying secondary abnormalities (tumour)
classic presentation of pneumococcal pneumonia
rapid onset
high fever
pleuritic chest pain
herpes labialis (cold sores)
(streptococcus pneumoniae)
what conditions is mycoplasma pneumonia assoc with
- erythema multiforme
- cold autoimmune haemolytic anaemia
- guillain-barre
- pericarditis
(lots more ! inflammation of bits+bobs)
management of atypical pneumonias
legional / mycoplasma
- marcrolide ! (clarithro-/erythromycin)
- doxycycline
diagnostic test of choice for legionella pneumonia
urinary antigen
CXR - mid to lower zone predominance of patchy consolidation
mycoplasma pneumoniae
atypical pneumonia which often affects younger patients
- doesn’t respond to penicillins or cephalosporins (no peptidoglycan cell wall)
mycoplasma pneumoniae investigations
mycoplasma serology
positive cold agglutination test -> peripheral blood smear may shook red blood cell agglutination
