4.1 Pneumonia part 2 (classifications and complications)

Question 1

What is the most common pneumonia?

Who typically gets it?

Answer 1

Pneumococcal pneumonia

All ages, common in elderly, alcoholics, immunosupressed

Question 2

What is staphycoccal pneumonia?

Answer 2

May complicate after the flu or be a primary pathogen in the young, elderly, Iv drug users or those who are neutropenic.

Consider vancomycin if suspected MRSA

Question 3

Describe Klebsiella pneumonia

How do you treat it

Answer 3

Rare, only occurs in elderly, diabetics and alcoholics
Red jelly sputum

cefotaxime or imipenem

Question 4

Describe pseudomonas pneumonia

How is it treated

Answer 4

Occurs in bronchiecstasis/CF causes walled off cavities of infection. Can also occur in ITU

Treatment with meropenem and aminoglycoside (dual therapy reduces resistance

Question 5

Describe mycoplasma pneumonia

What complications may it cause?

Answer 5

Occurs in epidemics every 4 years, presents seriously with flu like symptoms

cold agglutins- heamolytic aneamia
steven johnsons syndrome
Menigocephalitis
gullian barre syndrome

Question 6

What is chlamydphila pneumoniae

Answer 6

pharyngitis, hoarseness, otittis and pneumonia

Question 7

What is chlamydophila psiittaci

Answer 7

Pneumonia acquired from infected birds

Question 8

What type of infection is pneumocystis jiroecii?

Answer 8

A fungi

Question 9

What are some complications of pneumonia?

Answer 9

Respiratory failure
Atrial fibrilation
Pleural effusion
Empyema
Lung abscess
Sepsis (hypotension)
Pericarditis and myocarditis
Jaundice

Question 10

What is the difference between type 1 and type 2 respiratory failure?

Answer 10

Type 1- low oxygen, normal CO2 (pneumonia, ARDS)

Type 2- low oxygen, high CO2 (COPD, heroin)

Question 11

How do you treat atrial fibrilation caused by penumonia?

Answer 11

Treat the pneumonia

B blocker or digoxin may be needed short term to slow ventricular rate

Question 12

What is empyema?

How is it treated?

Answer 12

Pus in the pleural space. Comes on as pneumonia and a fever

Needs a chest drain

Question 13

What is a lung abscess and what causes it?

Answer 13

Cavitating region of localised supparative infection within the lung.

Causes include- Poorly treated pneumonia, aspiration, bronchial obstruction, septic emboli

Question 14

What are the clinical features of a lung abscess?

Answer 14

Swinging fever, cough, purulent sputum, pleuretic chest pain, haemoptysis, malaise, weight loss

look for finger clubbing, anaemia, crepitiations

Question 15

What tests can be done if a lung abscess is indicated?

Answer 15

Bloods, ESR, CRP, blood cultures, sputum cytology, CXR, bronchoscopy/CT for better look and obtain specimens

Question 16

What is the treatment of a lung abscess?

Answer 16

Antibiotics for 4-6 weeks as sensitivities indicate.
postural drainage
repeated aspiration, antibiotics or surgical excision

Question 17

Describe the relation between sepsis and pneumonia?

Answer 17

May occur if bacteria spreads from lungs into the bloodstream. May cause hypotension, metastatic infections.

Treat with sepsis 6 and antibiotics specific to causative organism.

Question 18

How can jaundice be caused by pneumonia?

Answer 18

Due to sepsis or secondary to antibiotic therapy