What is pneumonia?
Inflammation in the substance of the lung usually caused by bacteria
What are the most common agents of communities acquired pneumonia in the young and old, and middle aged respectivitely
Young/Old: Pneumococcus, Haemophilus influenzae
Middle aged: Mycoplasma pneumoniae, Chlamydophila
What are the most common agents of hospital acquired pneumonia? When does it occur?
Gram negative enterobacteria or Staph aureus, Pseudomonas, Klebsiella
48 hours post admission
What are some rarer causes of pneumonia?
What rarer type of pneumonia can occur in patients with animal exposure?
Q fever caused by Coxiella burnetii
What are some symptoms of pneumonia?
What are some signs that can be present with pneumonia?
Signs of consolidation (creps, dull percussion, bronchial breathing)
How might you Ix pneumonia?
Blood cultures, ABG
Bloods: FBE, LFT, UEC, CRP, ESR
Sputum: culture and micro
Urine: MCS, urine antigen (Legionella)
What is the CURB-65 index and what does it indicate?
BP: <90systolic or 60diastolic
>65 years old
If 0-1 manage at home, if 2 at hospital, if >3 = severe pneumonia
What are some potential complications of pneumonia?
Which antibiotics and doses are used to treat mild, community acquired pneumonia?
Oral amoxicillin 500mg-1g/8h (or benzyl penicillin)
Doxycycline 200mg loading then 100mg per day
Which antibiotics are used to treat hospital acquired pneumonia?
3rd Gen cephalosporin
When do you want to administer broad spectrum antibiotics by?
Within an hour
How do you approach a patient with ?CAP
- FBE, UEC, CRP
- Sputum/urine culture
- ?ABG/Blood cultures
- O2, aim sats >94%
- Empirical abx and convert to orals if required
- If T > 38 - blood cultures