Pneumonia Flashcards
What are some symptoms of pneumonia?
SOB Fever Headache Myalgia Green sputum
Risk factors?
Prolonged hospital stays Recent surgery Smoking Alcohol excess Travel abroad Immunosuppression Underlying lung disease
Differential diagnosis?
Asthma COPD Pneumothorax Pulmonary emboli Cardiac disease
What scoring system is used to identify marks of increased severity of disease associated with increased mortality?
What are the categories of this scoring system?
CURB-65
Confusion Urea >7 mmol/L RR >= 30 SBP<90 or DBP<60 Age >65
What treatment do each of the scores for the severity marking system indicate?
CURB-65
0-1 - Low risk, home treatment
2 - Admission or close outpatient management
3-5 - Admission, manage as severe
What organism is the most common cause of CAP in adults?
What are other causative organisms?
Streptococcus pneumoniae
Staphylococcus aureus Haemophlilus influenzae Legionella pneumophila Mycoplasma pneumoniae Viral causes
What organism should be considered in patients with COPD?
Psudomonas aeruginosa
What signs may be seen in atypical pneumonias?
Low sodium & deranged liver function tests.
What organism should be considered in those with a recent travel history?
Legionella pneumonia
What laboratory tests might be done to help confirm a diangosis of atypical pneumonia?
Urine legionella antigen (hard to grow on culture)
Sputum for routine culture and PCR
What is the treatment of pneumonia determined by?
CURB-65 score
What would be the treatment of a patient with a **- score of 0-2?
1st Line: PO Amoxicillin +/- Clarithromycin (if mycoplasma suspected) 2nd Line (if 1st CI): PO doxycycline of levofloxaxin
What would be the treatment of a patient with a **- score of 3-5?
1st Line: IV co-amoxiclav + PO/IV Clarithromycin
2nd Line: Teicoplanin + PO/IV Levofloxacin
What would be the treatment of a patient with legionella pneumophilia pneumona?
1st Line: PO/IV Levofloxacin or Clarithromycin
2nd Line: PO Azithromycin
If unsure, go for IV co-amoxiclav + PO/IV Clarithromycin as for severe disease.
What are the potential complications of pneumonia?
Pulmonary effusion Empyema Pneumothorax Pulmoary embolism Lung abscess ARDS Sepsis with multiorgan failure
