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Infectious Disease: Unit 2 > Pneumonia > Flashcards

Flashcards in Pneumonia Deck (19):
1

Pneumonia as "great neglected disease of mankind"

~*~DrAmA qUeEn AlErT~*~

  • Often misdiagnosed, mistreated, underestimated
  • Kills more children worldwide than any other illness
    • 2-4 million deaths/year 
    • Most young children in poor countries 
    • Accounts for 1/5 deaths in children < 5y/o
  • Kills more children than measles + malaria + HIV/AIDS combined
  • Community acquired pneumonia (CAP) in US:
    • 6th leading cause of death overall
    • Leading cause of ID deaths (~4 million cases, 600,000 hospitalizations/year)

2

Other causes of cough

  • Pharyngitis
  • Sinusitis
  • Bronchitis
  • COPD exacerbation

3

Features of pneumonia

  • Acute fever
  • Tachypnea
  • Cough
  • Purulent sputum
  • Lung consolidation
  • CXR infiltrates
  • S/S fewer in elderly (may just "feel bad")

4

Common risks for pneumonia

  • Elderly 
    • Waning immunity
  • Liver disease
  • Immunosuppression (especially HIV-1)
    • Can't kill the bugs
  • Alcoholism
    • Aspiration
  • Hematologic malignancy
  • Smoking
    • Cilia paralyzed by smoke
  • Infant not breast fed
    • No antibodies 

5

Common causes of CAP (4)

  • Mycoplasma
  • S. pneumoniae
  • M. tuberculosis
  • Pneumocystis jirovecii

6

Mycoplasma pneumonia: related risks

  • Young person

8

Mycoplasma pneumonia: syndrome (acute, subacute, or chronic?)

  • Acute

10

Mycoplasma pneumonia: treatment

  • Macrolides or tetracycline

12

S. pneumoniae pneumonia: related risks

  • Older person
  • HIV+ 

14

S. pneumoniae pneumonia: syndrome (acute, subacute, chronic?)

  • Acute

16

S. pneumoniae pneumonia: treatment

  • Macrolides or tetracycline

18

M. tuberculosis pneumonia: age group/related risks

  • Asian or African immigrant

20

M. tuberculosis pneumonia: syndrome (acute, subacute, chronic?)

  • Chronic

22

M. tuberculosis pneumonia: treatment

  • Isoniazid
  • Rifampin
  • Pyrazinamide
  • Ethambutol

24

Pneumocystis pneumonia: related risks

  • HIV positive

26

Pneumocystis pneumonia: syndrome (acute, subacute, chronic?)

  • Subacute

28

Pneumocystis pneumonia: treatment

  • Trimethoprin/sulfamethoxazole

29

Pneumococcal vaccine

  • 23-valent polysaccharide vaccine given to adults
    • Effective for bacteremia
    • Not effective for pneumonia
  • 7-valent conjugate vaccine (Prevnar) given to children
    • Reduces colonization in children
    • Reduces bacteremia > 90%
    • Reduces infection in older adults (indirect; herd immunity)
    • Reduces bacterial pneumonia < 37% in African children
    • Some reduction in serous otitis and meningitis

30

Influenza vaccine

  • Routine annual influenza vaccination recommended for all persons age > 6 months
  • Decreased illness 60-80% in children/young adults
  • Decreased serious illness and death:
    • 30% institutionalized elderly
    • 70% in general elderly