Atypical infections and Tb Flashcards
List the 3 organisms that commonly cause atypical pneumonia.
Mycoplasma pneumoniae
Legionella pneumophila
Chlamydophila pneumoniae
How do you treat atypical pneumonia?
Macrolides, Tetracyclins or Fluoroquinolones
Why can’t you do a gram stain for atypical pneumonia infections?
The organisms have little to no peptidoglycan
How is chlamydophila pneumoniae transmitted?
Human - human
How do you diagnose mycoplasma pneumoniae?
PCR
What does mycoplasma pneumoniae cause?
Upper, lower URTI in children and teens
How do you diagnose Legionella Pneumophilia?
Urine antigen test
What is legionella pneumoniae associated with and what is legionaries disease?
Water environment (ac units or showers)
Severe pneumonia
What is the nature of chlamydia trachomatis
Obligate intracellular pathogen
What are the 4 clinical manifestations of chlamydia trachomatis and their clinical presentations?
Trachoma = recurrent eye infection causing corneal scarring and clouding from in turn eyelids and damage, resulting in blindness
STI = urethritis, conjunctivitis, reactive arthritis (+cervicitis in women leading to PID)
Extragenital = proctitis
Neonatal = conjunctivitis and pneumonia
How is chlamydia trachomatis transmitted?
Sexual, eye, vertical
What is the organism responsible for Tb?
Mycobacterium Tb
What is the character of mycobacterium Tb?
Aerobic fast-acid bacilli
How is Tb transmitted?
Inhalation of droplet nuclei, aerosolised in coughing, talking, sneezing
What are the risk factors of Tb?
Nutrition (malnourished)
Age (very young and old)
Immunocompromised
Social (homeless)
Environment (prison inmates)
What is the pathophysiology of Tb?
MTb is engulfed by alveolar macrophages
Infected macrophages die from MTb multiplication, attracting more macrophages
Infected macrophages spread by lymphohematogenous dissemination to regional lymph nodes and extra pulmonary organs
Followed by unrestrained MTb multiplication
Cell immunity and hypersensitivity develops within 3-9 weeks, forming granulomas
What are the symptoms of latent and active Tb?
Latent Tb is asymptomatic
Active Tb = Weight loss, Bloody cough, Chest pain, Night sweats, Fever
How do you diagnose Tb?
Latent = Tb skin test, IFN G release assay
Active = Sputum smear and culture, PCR
What is the preventive treatment for Tb and when is it used?
Latent Tb
Isoniazid and rifapentine
What is the curative treatment for Tb and when is it used?
Active Tb
Rifampin, Isoniazid, Pyraziramide, Ethambutol
How long should RIPE and RI treatment last?
RIPE for 4 months
RI for 2 months
What does pyrzinamide cause?
Gout like symptoms
What does isoniazid cause?
vitamin B6 deficiency
Who is rifampicin safe to use in and who is it not safe to use in?
Safe for renal impairment
Not safe for liver disease
