Bacterial pneumonia Flashcards
Pneumonia
is an acute infection of lung parenchyma, usually caused by bacteria.
Pneumonia is classified into:
- CAP: community-acquired
pneumonia - HAP: hospital-acquired
pneumonia - VAP: ventilator-associated
pneumonia - Aspiration pneumonia
predisposing condition for pneumonia
- Very young or old age
- Other concomitant disease
- Malnutrition
- HIV infection
management guided by?
Age
* Co-morbidities
* Severity of pneumonia
symptoms of pneumonia
Fever
chest pain
coughing
Dyspnea
malaise
severe: shock nd respiratory failure
signs of pneumonia when examaning a patient ?
fever> than 38 degrees
crackles sound
tachypnoea
bronchial breath sounds
most commmon pneumonic pathogens causing Community aquired pneumonia
S. pneumoniae
S. aureus
Atypicals
(Legionella
pneumoniae, Mycoplasma
pneumoniae, Chlamydia
pneumoniae)
H. influenzae
most common pneumonic pathogens causing hospital acquired pneumonia
Staphylococcus
aureus
G- enterics
(Klebsiella
pneumoniae)
G- nonenterics
(P. aeruginosa,
H. influenzae
M. catarrhalis
most common pneumonic pathogens causing ventilated acquired pneumonia
S. pneumoniae
S. aureus
Haemophilus
influenzae
Aspiration P
B. Melaninogenicus
Fusobacteria
anaerobic streptococci
Polymicrobial infections
with
S. aureus,
S. pneumoniae
gram-negative bacilli
CAP treatment considerations
for less than 65 years:
amoxicillin
ampicillin
Co-amoxiclav or cefuroxime
above the age 65:
co-amoxiclav
An alternative drug for CAP treatment?
Moxifloxacin
or luvoflaxacin
Adjuvant treatment of severe CAP requiring ICU
Addition of macrolide (azithromycin)
Systemic corticosteroids
IN CAP what bacteria’s mostly causes severe pneumonia in children?
Bacterial * Non-typical H. influenza & S. aureus leading bacterial causes of
severe pneumonia in children
respiratory viruses causing severe pneumonia in children - CAP
Resp. syncytial virus
for severe pneumonia plus chest indrawing.
Give ceftriaxone.
HAP (Hospital Acquired Pneumonia) pathogens causing it ?
Gram Positive staphylococci * S. aureus
Gram Negative enterics
* K. pneumoniae
Gram Negative nonenterics
* P. aeruginosa
* H. influenzae
* M. catarrhalis
what are risk factors Of HAP
Hospitalized > 5 days
* Hospitalized > 2 days in past 3 months
* Immunocompromised with poor functional status
* Developed pneumonia after admission to ICU
* Mechanical ventilation
What is HAP normally diagnosed on?
New infiltrate on CXR
* Fever * Worsening respiratory status
* Thick secretions (neutrophil-containing
VAP (Ventilator- associated pneumonia)
- S. pneumoniae
- S. aureus
- H. influenzae
Standard treatment and medicine for VAP
Piperacillin/tazobactam, IV
Amikacin, IV
Cefepime
Carbapenem with activity against Pseudomonas.-DRUG?
imipenem-IV
(Except CNS infections or known epileptics)
Aspiration pneumonia
inhalation or abnormal entry of large inoculum of exogenous substance or endogenous secretions into the lower airways. causes inflammation leading to pneumonia.
Anaerobic bacteria
- B. melaninogenicus, Fusobacteria, and anaerobic streptococci.
