1. Chest (Infection) Flashcards
Strep. Pneumoniae (imaging)
Lobar consolidation
Strep. Pneumoniae (trivia) (3)
Favours lower lobe.
Severe in sickle cell pts post splenectomy.
Commonest pneumonia in AIDS pts.
Staph aureus pneumonia (imaging)
Bronchopneumonia - patchy opacities
Staph Aureus pneumonia (trivia) (3)
Often bilateral,
Can make abscesses,
Can spread via blood in endocarditis
Anthrax pneumonia - imaging (3)
Haemorrhagic lymphadenitis,
Mediastinitis,
Haemothorax
Anthrax pneumonia - classic look (2)
Mediastinal widening with pleural effusion,
Setting of bio-terrorism
Klebsiella pneumonia - imaging (2)
“Bulging fissure” from inflammation.
More likely to have pleural effusions, empyema and cavity than conventional pneumonia
Klebsiella - Trivia (2)
Alcoholics and nursing home pts.
Current jelly sputum
Haemophilus - imaging (2)
Usually bronchitis.
Can get bilateral lower lobe bronchopneumonia
Haemophilus - trivia (2)
Seen in COPD and people without spleen
Pseudomonas - imaging (2)
Patchy opacities with abscess formation.
Pleural effusions are common but usually small
Pseudomonas - trivia (2)
ICU pts (or CF/primary cilliary dyskinesia)
Legionella - imaging (3)
Peripheral and sublobar airspace opacity.
Imaging lags behind resolution of symptoms.
Cavitates only if immunosuppressed.
Legionella - trivia (2)
COPD pts.
Seen around bad air conditioners.
Aspiration - imaging (2)
Anaerobes with airspace opacity.
Can cavitate and form abscess.
Aspiration - trivia (4)
Posterior lobes if supine while swallowing.
Basal lower lobes if upright.
May favour right side, like ET tube.
Commonest complication is empyema, which may lead to bronchopulmonary fistula.
Actinomycosis - imaging (2)
Airspace opacity in peripheral lobes.
Can be aggressive and cause rib osteomyelitis or invade chest wall
Actinomycosis - trivia
Commonly dental procedure gone wrong, leading to mandible osteomyelitis and aspiration.
Mycoplasma - imaging (2)
Fine, reticular pattern on CXR.
Patchy airspace opacity with tree-in-bud
Commonest cause of death post bone marrow transplant
Pneumonia, occurs in almost 50% of people after BMT
Graft vs Host disease post BMT (types) (4)
Acute:
- 20-100 days
- Favours extrapulmonary systems (Liver, skin, GI)
Chronic:
- >100 days
- Lymphocytic infiltration of airways and obliterative bronchiolitis.
Post BMT Pulmonary findings (types) (3)
Early neutropenic (0-30 days),
Early (30-90 days),
Late (>90 days)
Early neutropenic post BMT findings (lung) (4)
Pulmonary oedema,
Haemorrhage,
Drug induced lung injury,
Fungal pneumonia (invasive aspergillosis)
Early post BMT findings (lung) (2)
PCP, CMV
Late post BMT findings (lung) (2)
Bronchiolitis obliterans,
Cryptogenic organising Pneumonia
AIDS infections - CD4 >200 (2)
Bacterial infections,
TB
AIDS infections - CD4 <200 (2)
PCP,
Atypical mycobacterial
AIDS infections - CD4 <100 (3)
CMV,
Disseminated fungal,
Mycobacterial
AIDS - focal airspace opacity - DDx (3)
Bacterial infection (strep most common),
Consider TB if low CD4,
Consider lymphoma or kaposi sarcoma if chronic