Bacterial and fungal pneumonia Flashcards
what are the three categories of nosocomial pneumonia. Which has the most challenging bacteria?
HAP, VAP, HCAP (most challenging)
What is the most common pathogenesis of bacterial pneumonia? Less common ways?
Micro aspiration (of oropharyngeal pathogens) >inhalation>hematogenous
what are the most common early onset nosocomial pneumonia agents? Late Onset?
Enteric Gram (-) bacilli, H. influenzae, strep. spp; psuedomonas aeruginosa, MRSA
Difference in Rx of early and late onset nosocomial pnuem.
early=narrow spectrum antibiotics, late=broad spectrum
Typical vs atypical (walking) pneumonia
typic is sudden onset, productive cough, pleural symptoms. Atypic is gradual, dry cough, little pulm symptoms
what defines early vs late onset nosocomial pneumonia?
early=no risk factors, 4 days
Do vaccines prevent pneumonia?
No. they reduce mitigate
Three main contributers to CAP
S. peumoniae, H. influenzae, mycoplasma
What 3 fungi are associated with endemic pneumonia? With immunosuppression?
histo, blasto, coccidio. Aspergillosis, pneumocystosis
In what form are histo, blasto, coccidio, and P. jiroveci found?
Histo/blasto- hyphal in environment, yeast in tissue. Coccidio- hyphal and spherule. P jiroveci- cysts, sporozoites, trophozoites
What is the primary method of contracting endemic mycoses?
inhalation of conidia. No human-human transmission
Histoplama capsulatum: where? associations? characteristics? unique complications?
ohio and mississippi river valleys, associated with guano and excavation or construction. caseating and noncaseating granulomas, Ghon complex. Mediastinal fibrosis is unique.
what does the stain for Histo show?
narrow based budding yeast
When is a urine histoplasma antigen assay effective?
when disease is acute or disseminated
Blastomyces dermatitidis: where? associations? Unique aspects?
Great lakes region. Soil of wooded areas w/ decaying vegetation. Unique for clusters of PMNs and noncaseating granulomas, presence of PYOgranuloma
