16 Pneumonias Flashcards
What is pneumonia? Outline its typical course of infection.
Inflammation of lung tissue due to infection
Common feature: cellular exudate in alveolar spaces
What is pneumonitis?
Inflammation of lung tissue due to non-infective causes eg physical/chemical damage
Whats the difference between lobar pneumonia and bronchopneumonia?
Lobar= confined to a lobe of lung
Bronchopneumonia= patchier, diffuse
How are pneumonias classified?
Classified by: source of infection
- Community acquired pneumonia
- Hospital acquired pneumonia
- Aspiration pneumonia
- Pneumonia in immunocompromised patients
What are the causative organisms for Community acquired pneumonia?
What is classed as a Hospital acquired (nosocomial pneumonia)?
Infection in lower respiratory tract in hospitalised patients
Occurs >48hrs after admission and was not incubating at time of admission
assoicated with impaired defences
What are some of the causative organisms for Hospital acquired (nosocomial) pneumonia?
Gram negative bacteria
Staphylococcus aureus
How is aspiration pneumonia caused? What might predispose someone to acquiring this? What are the causative organisms?
How?
Aspiring food, drink, saliva or vomit into lungs
Why?
Individuals:
- whose concious level in altered
- Anaesthesia
- Alcohol abuse
- Drug abuse
Causative organism?
Oral flora
Anaerobes
Give some examples of causative organisms for pneumonia in immunocompromised patients.
- Pneumocystis jiroveci
- Aspergillus species
- Cytomegalovirus
How does pneumonia present?
- Malaise
- Fever
- Cough
- productive sputum (purulent, rusty coloured- blood, blood stained)
- Pleuritic chest pain
- Dyspnoea
To assess the severity of pneumonia, the CURB 65 score is used. Outline how this is used.
Hospital treatment required - Presence of 2+ features
ICU treatment- High score
Give an example of an organism that causes rapid onset of pneumonia and an example of one that has a more prolonged onset?
Pneumococcal and Staphylococcal = rapid onset
Mycoplasma pneumonia and other atypical pneumonias = prolonged
What will the chest x-ray and the microbiology show if a patient has pneumonia?
Pneumococcal pneumonia in previously well patients has a mortality of 5%. In which patients is the mortality likely to be higher?
Older patients
High CURB score
High or low white cell count
Absense of fever
Significant hypoxia
Rise in blood urea
Extensive x-ray shadowing
How is pneumonia managed?