Respiratory Infections Flashcards Preview

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Flashcards in Respiratory Infections Deck (17):
1

H. influenzae

Gram neg rod on chocolate agar (X)B (vaccine) = MENINGITIS, EPIGLOTTITIS, cellulitis, arthritis PRP (makes up the capsule) detectable in blood, CSF, urine, even after bacteria no longer present (culture negative)Non-typeable = otitis (2nd MCC), sinusitis, bronchitis Tx = Amp/Amox (75%) or Macrolide, Quinolone, Ceftriazone, TMP-SMXRifampin chemoprophylaxis if exposed

2

B. pertussis

Gm neg coccobacilli: Bordet-gengou or buffered charcoal yeast extract (BCYE)Extremely infectiousNon-invasive (toxin-mediated - pertussis toxin, adenylate cyclase toxin, tracheal cytotoxin); destroy ciliated cells in URT3 stages = Catarrhal (1-2wks, most communicable), Paroxysmal (whoop), Convalescent*organisms often not present by paroxysmalTx = Macrolide: only effective in catarrhal DTaP/Tdap, PXP

3

Mycoplasma pneumoniae

No cell wall, so can’t treat w/ beta-lactam Cell membrane contains sterols Most common cause pneumonia in 5-20yo: 15-20% of CAP“Walking pneumonia:” CXR much more impressive than SxDx = cold agluttinin serology (usually just clinical)Tx = Macrolides, Fluoroquinolones

4

Legionella pneumophila

MC = serotype 1: Intracellular pathogenNot seen on GM stains: need silver stain, Buffered charcoal yeast extract (needs L-cysteine)Symptoms more impressive than CXR (opposite of Mycoplasma)Assoc w/ cruise ships, faulty air conditioning At risk pts = T cell immune deficiency (steroids, transplant, smokers, etc)Diarrhea, hyponatremia, multilobular pneumonia Dx = urine Legionella Ag Tx = Macrolides, resp quinolones

5

Chlamydia

Pneumoniaenot acutely illhealthy college studentsHoarse voice, assoc w/ atherosclerosis Tx = Macrolide or QuinolonePsittaciParrots, headache, fever, pneumonia, mild rash (Horder’s spots)Tx = Macrolide or tetracyclines

6

Pnuemonia in CAP

MycoplasmaResp virusesStrep pneumoLegionella and Chlamydia are close behindLegionella and Strep pneumo make you very sick!

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Pneumonia in HAP

Strep pneumomycoplasma

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Pneumonia in ICU

Strep pneumoLegionella

9

Pneumonia in smoker, COPD

H. influenzaKlebsiella pneumo

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Pneumonia in alcoholic

Klebsiella pneumo

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Pneumonia in pt w/ Bronchiectasis or CF

Pseudomonas(this is someone who comes from the community with infection and is hospitalized, they usually have underlying lung problem)

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Aspiration Pneumonia cause

anaerobes

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Pneumonia in diabetics

Klebisiella

14

Pneumonia in those living in close quarters or young

GAS

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Risk Factors for Drug Resistant Strep pneumo

1 - Age > 652 - use of macrolides, fluoroquinolones or beta-lactams in past 3 months3 - alcoholism4 - medical comorbidities5 - immunocompromised (illness or therapy)6 - Day center

16

Most likely causes acute exacerbation COPD bronchitis

H. influenzaeS. pneumoniaeM. catarrhalis

17

Most likely cause acute bronchitis

B. pertussisMycoplasma pneumoniaeChlamydia pneumoniae