Bacterial pneumonia

Question 1

Strep pneumoniae patho

Answer 1

#1 CAP, 
#1 bact meningitis  in adults, 
#1 otitis media in children

Question 2

S. pneumoniae morpho

Answer 2

G+ lancet or diplococci
blood agar --> alpha hemolytic
lysed by bile
catalase -
optochin sensitive

Question 3

S. pneumoniae virulence

Answer 3

Polysaccharide capsule
IgA protease
Pneumolysin –> pore forming toxin sim to Strep O

Question 4

S. pneumoniae CP

Answer 4

acute chills, fever, SOB
rusty sputum with inflammatory cells (neutrophils) and organism
pleuritic chest pain with rales
will see lobar consolidation

Question 5

S. pneumoniae Dx and Tx

Answer 5

gram stain of smear
culture
latex agglutination of CSF
pos Quellung Rxn
host prod anti-capsular IgG --> activation of classical C'
Tx with PCN

Question 6

Klebsiella pneumoniae morpho

Answer 6

G- rod
oxidase -
lactose fermenter
pos Quelung test
pink colonies on MacCokney agar

Question 7

Klebsiella pneumonias vir and patho

Answer 7

antiphago polysacch capsule
endotoxin
necrotizing pneumonia --> currant jelly sputum
common in aspiration pneumonia
diabetics and alcoholics susceptible
nosocomial UTIs

Question 8

Peudomonas aeruginosa morpho

Answer 8

G- rod aerobic
motile
oxidase +
catalase +
nonlactose fermenter
sec blue-green  pyocyanin pigment
"fruity" odor

Question 9

P. aeruginosa vir

Answer 9

Exotoxin A –> ADP ribosylation of EF-2
endotoxin
proteolytic enzymes and capsular slime

Question 10

P. aeruginosa patho

Answer 10

nosocomial infections –>indwelling catheters and BURN victims
pneumonia in CF patients
osteomyelitis in diabetics

Question 11

Mycoplasma pneumoniae morpho

Answer 11

no cell wall ; triple layer of membrane with sterols
extracellular
fried egg appearance
grows on media with lipoprotein and sterols (Eaton’s agar)
completely resistant to cell wall synth inhib antibio

Question 12

Mycoplasma pneumoniae epid

Answer 12

droplet xsmission
primary atypical pneumonia –> “walking pneumonia”
teens and pre-teens and military recruits

Question 13

Mycoplasma pneumoniae patho

Answer 13

damages resp epith –> inflammation of bronchial, peribronch, and alveoli
insidious onset w/ non prod cough
patchy infiltrate with consolidation

Question 14

Mycoplasma pneumoniae Dx and Tx

Answer 14

serology is more efficient than culture
cold agglutinin titer
tx with doxy or erythromycin

Question 15

Legionella pneumophila morpho

Answer 15

G-; stains poorly
grow on charcoal yeast media with iron and cysteine (BCYE)
catalase +
oxidase +
facultative intracellular
silver stain

Question 16

Legionella pneumophila epid

Answer 16

warm and water sources
no PTP xsmission
can also live in biofilms
older men who smoke and drink at higher risk

Question 17

Legionella pneumophila patho

Answer 17

acute ulcerative bronchitis, bronchiolitis, and confluent pneumonia
may form abscesses
lesser form: Pontiac fever
worse form: Legionaire's dz
Dx via culture or serology (serotype 1)

Question 18

L. pneumophila Dx and Tx

Answer 18

Dx via culture or serology (serotype 1)

Tx with macrocodes and fluoroquinolones

Question 19

Chlamydophila pneumoniae

Answer 19

obligate intracellular
cell walls resemble G- but lack muramic acid
atypical pneumonia resembling mycoplasma
airborne xsmission

Question 20

Chlaydophila pneumoniae life cycle

Answer 20

elementary body (spore-like) –> reticulate body in cells –> divide by binary fission –> inclusion body
Tx with tetracycline and erythromycin
Dx with 1:16 titer

Question 21

Chlamydophila psittaci

Answer 21

psittacosis or ornithosis
obligate intracellular
cell walls resemble G- but lack muramic acid
non prod cough, rales, consolidation
get form BIRDS

Question 22

Coxiella Burnetii

Answer 22

Q fever --> febrile resp dz
rickettsia family --> but NOT xsmit by arthropods
obligate intracellular
no rash
neg Weil-Felix rxn
xsmit by cows