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Pulm > Bacterial Pneumonia > Flashcards

Bacterial Pneumonia Flashcards

1
Q

Type of pneumonia caused by Pseudomonas aeruginosa?

A
  1. HCAP
  2. HAP
  3. Ventilator associated Pneumonia (VAP)
  4. Pneumonia in Cystic Fibrosis
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2
Q

Characteristics of Staph. aureus

A
  1. Gram positive
  2. Cocci in clusters
  3. Catalase positive
  4. Coagulase positive
  5. Bronchopneumonia on CXT
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3
Q

Tx of Strep Pneumonia

A
  1. Penicillin (1st choice if suseptible)
  2. Vancomycin (severe)
  3. Ceftriaxone
  4. Flouroquinolones*
  5. Azithromycin*
  • for less severe
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4
Q

Dx of Strep Pneumonia

A
  1. Gram stain and Culture of Sputum
  2. Blood cultures (positive in 15-20%)
  3. Rapid urinary antigen test
  4. CXR shows lobar consolidation
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5
Q

Those commonly affected by Legionella pneumoniae?

A
  • elderly
  • smokers
  • alcoholics
  • those with comorbidities
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6
Q

Name the organisms that cause Atypical pneumonia

A
  1. Mycoplasma pneumoniae
  2. Chlamydia pneumoniae
  3. Legionella pneumophila
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7
Q

Who is recommended for the Prevnar strep. Pneumo vaccine?

A

Children and infants

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8
Q

Tx of Legionella pneumoniae infection

A
  1. Macrolide (azithromycin)

2. Flouroquinolone (Levofloxacin)

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9
Q

How to Dx pneumonia?

A
  1. CXR
  2. Gram stain/cultures of sputum
  3. special test for certain organisms
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10
Q

Strep. pneumoniae’s virulence factors:

A
  1. Capsule - prevents phagocytosis
  2. IgA protease - enhances ability to colonize URT
  3. Lipoteichoic acid - activates complement and induces cytokines
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11
Q

Complications of Staph. aureus pneumonia?

A
  1. Necrotizing pneumonia

2. Lung abscesses

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12
Q

Who is commonly infected with Moraxella catarrhalis (risk factors)

A
  • Elderly

- COPD pts

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13
Q

Tx of mycoplasma pneumoniae infections

A
  1. Macrolide (Azithromycin)
  2. Doxycycline
  3. Flouroquinolone (Levofloxacin)
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14
Q

Diseases caused by Legionella pneumoniae

A
  1. Legionnarire’s disease

2. Pontiac fever

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15
Q

Tx of pneumonia caused by Haemophilus influenzae?

A
  • Amoxicillin (Mild infections)

- Ceftriaxone (serious infections)

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16
Q

Name the organisms that cause Typical pneumonia (7)

A
  1. Streptococcus Pneumoniae
  2. Staph. Aureus
  3. Pseudomonas aeruginosa
  4. Haemophilus influenzae
  5. Klebsiella pneumoniae
  6. Moraxella cararrhalis
  7. Acinetobacter baumanii
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17
Q

Characteristics of Legionella pneumoniae?

A
  1. Gram neg rod

2. Facultative intracellular organism

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18
Q

Tx of Pseudomonas aeruginosa

A
  • Cefepime (4th gen ceph._
  • Meropenem or imipenem
  • Ciprofloxacin (flouro)
  • Piper/Tazobactam
  • Gentamicin (aminogylcoside)
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19
Q

Clinical presentation of Strep. Pneumoniae

A
  1. Sudden onset of
    - Fever, chills
    - cough w/ RUSTY sputum
    - SOB
    - Pleuritic pain (pain on breathing)
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20
Q

Describe the result of a catalase test on staph vs. strep

A
  • Strep. = Catalase negative

* Staph = Catalase positive

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21
Q

Unique symptoms that characterize Legionaries disease?

A

Severe pneumonia with:

  1. Dry cough
  2. Fever
  3. Diarrhea
  4. Confusion
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22
Q

Risk factors for strep. pneumoniae? (6)

A
  1. Alcohol/drug intox
  2. Abnormal resp. tract
  3. Abnormal circulatory dynamics (pulm congestion heart failure)
  4. Splenectomy
  5. Sickle cell disease
  6. HIV infection
23
Q

Other diseases caused by Strep Pneumonia?

A
  1. meningitis
  2. Otitis media
  3. Sinusitis
24
Q

Characteristics of atypical pneumonia

A
  1. Symptoms and CXR atypical compared to step. pneumo

2. Organisms cannot be cultured on routine media

25
Q

Characteristics of Streptococcus pneumoniae

A
  1. Gram postive
  2. Lancet shaped
  3. Encapsulated
  4. Diplococcus
  5. Alpha Hemolysis on blood agar
  6. Optochin positive
  7. Catalase negative
  8. Quellung rxn - capsules swell
26
Q

Who typically get pneumonia from Klebsiella Pneumoniae?

A
  1. Alcoholics
  2. Malnourished
  3. Diabetics

*one of most frequent causes of gram neg bacterial pneumonia

27
Q

Virulence factors of Pseudomonas aeruginosa?

A
  1. Endotoxin
  2. Exotoxin A
  3. Elastase
  4. Leucocidin
  5. Hemolysins
  6. Proteases
28
Q

Most common bacteria that causes (C-A) Pneumonia worldwide?

A

Streptococcus Pneumoniae

29
Q

Clinical manifestations of atypical pneumonia

A

Insidious onset of:

  1. Dry cough*
  2. headache*
  3. Low-grade fever
  4. Myalgias*
  5. Sore throat
  6. CXR looks way worse than PT
30
Q

Characteristics of Chlamydia (Chlamydophilia) pneumoniae?

A
  1. Obligate intracellular organism
  2. 2nd most common cause of atypical pneumonia
  3. Clinically similar to M. pneumoniae
    - usually affect older adults
31
Q

Extrapulmonary manifestations of Mycoplasma pneumoniae

A
  1. Hemolysis
  2. Rash
  3. CNS involvement (encephalitis)
  4. Cardiac involvment (Rhythm disturbance, CHF, myocarditis, conduction abnormalities)
32
Q

Pathogenesis of atypical pneumonia caused by mycoplasma pneumoniae

A

Adhesin binds to ciliated epithelial cells and causes reduced ciliary clearance

33
Q

Staph. aureus causes what kinds of pneumonia?

A
  1. Post-influenza
  2. CAP
  3. HAP/HCAP
34
Q

Characteristics of Moraxella catarrhalis:

A
  1. Gram neg coccobacillary rod
35
Q

Characteristics of Haemophilus influenzae

A
  1. Gram neg coccobacillary rods
  2. Pleomorphic
  3. 6 serotypes, encapsulated and nonencapsulated
  4. Facultative anaerobes
  5. nonmotile
  6. Culture on chocolate agar. (factors V - NAD+ and X - hematin for growth)
36
Q

The optochin sensitivity distinguishes Strep. pneumoiae from what other organism?

A

Streptococcus viridans

37
Q

Dx and Tx of Chlamydia (Chlamydophilia) pneumoniae?

A
  • Dx: No good test

- Tx: Doxycycline

38
Q

Diseases caused by Haemophilus influenzae

A
  1. Pneumonia
  2. otitis media
  3. epiglottitis
  4. Meningitis
39
Q

Dx of Mycoplasma pneumoniae infection

A
  1. PCR on resp. secretion/nasopharynx
  2. Serology
  3. Cold Agglutinins: IgM auto-abs against type O RBCs (50% pts)
  4. Grows on Eaton agar
40
Q

Diseases caused by Acinetobacter baumanii

A
  1. VAP/HAP
  2. Sepsis
  3. Line infections
  4. UTIs
41
Q

Who is recommended for the polyvalent strep. pneumo vaccine (Pneumovax) ?

A
  • All 65yrs and up

- ages 19-64 at inc. risk and or serious complications of infection

42
Q

Complications of pneumonia infections with Klebsiella Pneumoniae

A
  • abscess and necrotizing pneumonia
43
Q

Who is commonly affected by atypical pnuemonia caused by Mycoplasma pneumoniae?

A
  1. Most common cause of pneumonia in school-aged children

2. Also those in close quarters: Military recruits and prisoners

44
Q

Characteristics of Klebsiella pneumoniae

A
  1. Gram neg. bacillus
  2. Encapsulated
  3. Ferments lactose
  4. Indole negative
  5. Cant grow @ 10 degrees C
  6. Red “currant-jelly” sputum
45
Q

What are the gram positive organisms that cause typical pneumonia?

A
  1. Strep pneumoniae
  2. Staph aureus
  • Differentiated by gram stain and catalase test
46
Q

Characteristics of Acinetobacter baumanii

A
  1. Gram neg coccabacillary rod
  2. Oppertunistic pathogen
  3. found in water and soil
  4. Strongly associated with respiratory equipment
47
Q

Complications of Pseudomonas aeruginosa infection

A

Focal hemorrhage and necrosis

  • due to virulence factors
48
Q

Who is recommended for both the pneumovax and Prevnar vaccines?

A

High Risk adults

49
Q

Dx features of Legionella pneumoniae infection

A
  1. CXR- shows multiple types of infiltrates
  2. Gram stain shows macrophages and neutrophils but no organisms. Must use Silver stain
  3. Grows on Charcoal year extract culture wih iron and cysteine!
  4. Labs show hyponatremia
  5. Urine antigen used for Dx clinically
50
Q

Characteristics of mycoplasma pneumoniae

A
  1. NO CELL WALL
51
Q

Diseases caused by mycoplasma pneumoniae?

A
  1. Atypical “walking pneumonia” - the most common type of atypical pneumonia
52
Q

Characterisitics of Pseudomonas aeruginosa

A
  1. Aerobic Gram Neg bacilli
  2. Cant ferment lactose!
  3. Oxidase positive
  4. Blue-green pigment
  5. Fruity odor
  6. From water source (also soil and plants)
53
Q

Pathogenesis of Legionella pneumoniae?

A
  • Intracellular avoids phagolysosome fusuon
  • Endotoxin
  • Aerosol transmission from environmental habitat
54
Q

Other disease caused by Pseudomonas aeruginosa

A
  • Wound infections in burn victims
  • Sepsis in hospitalized patients
  • external otitis (esp. in DM Pts)
  • UTIs
  • Hot tub folliculitis

Pulm (14 decks)

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