Flashcards in Pneumonia Deck (11):
Where in the lungs does pneumonia start?
Complications of pneumonia
• parapneumonic effusion
• lung abscess
• necrotising pneumonia
Symptoms found in pneumonia
• persistent fever
• tachypnoea at rest
• Cough +/- chest pain
○ Remember - cough not necessary - alveoli don't have cough receptors!
• Vomiting +/- abdo pain
• increased work of breathing/respiratory distress
• lethargy/ unwell appearance / irritability
• Reduced appetite and dehydration
Exam findings in pneumonia
• hypoxaemia ( <92%) on pulse oximetry
• crackles and bronchial breathing on auscultation
• elevated respiratory rate for age
• chest wall indrawing, retractions, grunting, nasal flaring
• absent breath sounds and a dull percussion note suggest a pleural effusion
What Ix could you do in pneumonia?
Ix are not recommended for routine use in Dx CAP - esp. in mild disease:
- UEC: hyponatraemia vs SIADH
- microbio Ix
Severe pneumonia - criteria
Clinical features of pneumonia and 2 or more of the following:
• Severe respiratory distress
• Severe hypoxaemia or cyanosis
• Marked tachycardia
• Altered mental state
When to admit and d/c pneumonia?
○ <1 yo
○ Nil by mouth + dehydration
○ Pleural effusion
○ Extensive consolidation
○ Severe breathing problems
- D/C when can maintain adequate oxygenation and oral intake
When O2 for pneumonia?
What abx for bacterial pneumonia?
○ Non-severe pneumonia: oral amoxicillin (7-10days) or IV benpen
- We don't really use augmentin, that would be if you think staph is likely
○ Severe: ceftriaxone or cefotxaime AND flucloxacillin
- Consider addition of vancomycin for MRSA
- If mycoplasma - roxythromycin 10 days
○ Consider neuraminidase inhibitors (oseltamivir) i.e. tamiflu if suspect to be complicated by/will be by influenza e.g. IC
- exam findings
- stony dullness and pleuritic pain
- chest drain and fibrinolytics