Flashcards in Respiratory Tract Infection Deck (57):
What is optochain sensitive?
Streptococcus pneumonia is generally what-resistant?
Predisposing factors for nosocomial pneumonia
Surgery, intubation, antibiotics, intensive care unit, immunosuppression
E. coli and Klebsiella are what?
Organisms causing nosocomial pneumonia
Pseudomonas aeruginosa, coliforms (E.coli, Klebsiella)
Treatment of severe nosocomial pneumonia
IV amoxicillin, metronidazole and Gentamicin. Step down to oral co-amoxiclav (total 7-10 days treatment)
Treatment of non-severe nosocomial pneumonia
Amoxicillin and metronidazole for 7 days
Clinical features of legionella pneumophila
Flu-like illness, renal failure, GI symptoms, mental confusion
Diagnosis of legionella
Serology, legionella urinary antigen. (PCR test on sputum also available)
Treatment for legionnaires disease
Fluoroquinolones e.g levofloxacin
Treatment of PCP
You would use a bronchoalveolar lavage or identification of cysts in induced sputum to identify what?
PCP. Who gets PCP? AIDS.
Organism causing acute epiglottitis?
Haemophilus influenza (gram negative)
Chocolate culture with small translucent colonies/ X and V test used to confirm what?
Haemophilus influenza causing actue epiglottitis. H. influenza requires both factors X and V to grow. Diagnosis by blood culture.
Treatment for acute epiglottitis?
ITU and ceftriaxone
Haemophilus influenze, streptococcus pneumonia and moraxella catarrhalis can cause what?
Exacerbations of COPD (all 3 organisms are present in the normal upper respiratory tract flora)
Casual bacteria not good for cystic fibrosis
Haemophilus influenza, staphylococcus aureus, pseudomonas aureginosa, Burkholderia cepacia
What can Aspergillus fumigatus cause?
Severe pneumonia/systemic infection/aspergillus (in immunocompromised) Diagnosed by culture
What is I.V amphotericin B used to treat?
Acid alcohol fast bacilli?
What grows on Lowenstein-Jensen medium?
What grows on Bordet-Gengal medium?
Is tuberculosis transmissable between humans?
Yes. The mycobacterial species themselves are not directly transmissable
Drawback of Ziehl-Neisson stain
You cannot identify the species or tell what antibiotic they are resistant to. (Remember they appear as red rods on the stain). PCR provides information of species and some on sensitivity.
Direct immunofluorescence used for what?
Forms of respiratory infection spread?
Droplet spread, airborne precautions
Anti-virals used in treatment of flu
Lab confirmation of Flu
PCR (nasopharyngeal swab, throat swab)
antigen detector (near patient)
What does the killed influenza vaccine contain?
2 influenza A viruses, 1 influenza B virus
Other causes of community acquired pneumonia
Mycoplasma pneumonia, Coxiella burnetti, Chlamydia
Treatment of community acquired pneumonia
Tetracycline and macrolides (e.g. clarithromycin)
Who is affected by community acquired pneumonia?
Young children, old adults (person-person spread)
Coxiella burnetti (Q fever) causes what?
Complications of coxiella burnetti (Q fever) ?
Culture negative endocarditis
Chlamydia pstittici causes what?
Psittacosis (and this usually presents as pneumonia
Clinical presentation of severe bronchiolitis?
Grunting, sternal indrawing. Complications of bronchiolitis include respiratory/cardiac failure
Main cause of bronchiolitis?
Respiratory syncitial virus.
Bronchiolitis epidemics common in winter, no vaccine, nosocomial spread in hospitals. passive immunisation has poor efficacy
Metapneumovirus symptoms similar to those of?
RSV. (range of severity from mild to requiring ventilation)
What may be second only to RSV in bronchiolitis?
Laboratory confirmation of metapneumovirus?
What is chlamydia trachomatis?
STI which can cause infantile pneumoniae. (Diagnosis by PCR on urine of mother or by nasal swab of child)
What does chlamydia pneumonia cause?
Mostly mild respiratory infections. May be picked up by test for psittacosis.
Presentation of Pertussis
Acute tracheobronchitis is the clinical presentation of what?
Sinusitis and acute bronchitis complications of what?
Characteristic of diptheria?
Chest X-ray and examination in bronchitis?
Normal. May have transient wheeze
When are antibiotics indicated in bronchitis?
When they have underlying lung disease, otherwise they are not indicated.
Acute exacerbation of bronchitis symptoms
Wheeze, coarse crackles, may be cyanosed, breathless, ankle oedema (in advanced cases)
Treatment of acute exacerbation of chronic bronchitis
Antibiotics (e.g doxycycline or amoxicillin)
Short course of steroids in some cases
Will you hear crackles and rub in pneumonia?
Other severity markers of pneumonia:
Chest symptoms may be absent in which kind of pneumonia?
What is primary influenzal pneumonia?
Complication of influenza. Dry cough, bloody sputum and respiratory failure within 24 hours of initial fever
What is secondary bacterial pneumonia?
When you get a new fever on day 7 after your initial (flu) fever
Myositis (cardiac and skeletal), encephalitis and depression can be complications of what?