Pneumonia Flashcards
Presentation of pneumonia (7)
SOB Cough productive of sputum Fever Haemoptysis Pleuritic chest pain Delirium SEPSIS
Signs of pneumonia (6)
Tachypnoea Tachycardia Hypoxia Hypotension (shock) Fever Confusion
Chest signs in pneumonia
Bronchial breathing
Focal coarse crackles
Dullness to percussion
Score to assess severity
CURB65 C - Confusion (new) U - Urea (>7) R - Respiratory rate (>30) B - BP (<90 sys or ≤60 dias) 65 - Age >65
Score >2 hospital admission
Score >3 consider ITU
Common causes of pneumonia
Streptoccoccus pneumoniae (50%) Haemophilus influenzae (20%)
Causes of pneumonia associated with specific patient groups
Moraxella Catarrhalis - immunocompromised patients or with chronic pulmonary disease
Pseudomonas aeruginosa - CF or bronchiectasis
Staphylococcus aureus - CF
Klebsiella - alcoholics, diabetics, elderly
Atypical pneumonias
Legions of psittaci MCQs
Legionella (infected water/air conditioning units) can cause SIADH
Chlamydia psittaci (infected birds)
M - Mycoplasma (rash/neuro symptoms)
C - chlamydophila pnemoniae (school child with chronic mild/moderate pneumonia)
C - Q fever - Coxiella burnetti (exposure to animals and bodily fluids)
What causes fungal pneumomnia in which patients?
PCP - Pneumocystis jiroveci
In patients that are immunocompromised - HIV with low CD4
Presents with:
Dry cough without sputum
SOB on exertion
Night Sweats
Treatment of fungal pneumonia
Co-trimoxazole (Septrin)
Prescribed prophylactially for patients with low CD4
Investigations in pneumonia
CXR
FBC (raised WCC)
U&Es (raised Urea)
CRP
Moderate/Severe
Sputum culture
Blood culture
Legionella/Pneumococcal urinary antigens
Treatment course for pneumonia
Mild CAP: 5 day course of oral antibiotics (amoxicillin or macrolide)
Moderate to severe CAP: 7-10 day course of dual antibiotics (amoxicillin and macrolide)
Complications of pneumonia
Sepsis Pleural effusion Empyema Lung abscess Death
