Clin Med: Pneumonia Flashcards
Pathophysiology of Pneumonia
Inflammation of the alveoli and bronchioles due to bacteria, viruses, fungi
1 cause of bacterial Pneumonia
Strep pneumoniae
Most common viral cause of pneumonia
Influenza
What is the meaning of community acquired pneumonia
Not inpatient - just acquired from the community
Community Acquired Pneumonia - Classifications
Typical
Atypical
Typical Community Acquired Pneumonia is caused by
Bacteria leading to alveolar inflammation and exudate (bacteria has entered the body and the immune system is causing the damage)
Atypical Community Acquired Pneumonia is when
Organisms invade and destroy interstitial of the lungs (the bacteria is doing the harm NOT the immune system)
Typical Community Acquired Pneumonia presents with
Productive cough
Lobar consolidations on CXR
High WBC count
Typical Community Acquired Pneumonia is usually caused by
S. Pneumoniae
Atypical Community Acquired Pneumonia is usually caused by
Mycoplasma, viral
Atypical Community Acquired Pneumonia presents with
Dry cough
Lack of alveolar exudate
Normal - Mildly elevated WBC count
Patchy infiltrate on CXR
Where is the antibody created in the body for Strep Pneumoniae
Spleen
Community Acquired Pneumonia - Typical treatment adults
Outpatient = azithromycin or doxycycline or levofloxacin
Inpatient = ceftriaxone plus azithromycin
Community Acquired Pneumonia - Typical treatment pediatrics
Outpatient = amoxicillin
Inpatient = ampicillin (fully immunized), ceftriaxone (if not fully immunized)
What pneumonia is more common in children and college aged pts
Community acquired pneumonia atypical - mycoplasma
What pneumonia is transmitted by water droplets of a poor ventilated buildings
Community acquired pneumonia - atypical - legionnaire’s
Treatment for legionnaire’s pneumonia
Levofloxacin
Community acquired pneumonia atypical - legionnaire’s presents with
Fever, chills, malaise, dry cough, diarrhea (very bad)
Hospital acquired pneumonia is
Any pneumonia that presents 48 hours after admission
Pathogens for Hospital acquired pneumonia
Pseudomonas, S. Aureus, Enterobacter, Klebsiella, E. Coli
Pts at risk for hospital acquired pneumonia
Intubation
Tracheotomy
Immunocompromised
Chronic lung disease
(ICU pts)
What is the most common type of pathogen in the ICU with the highest mortality rate
Pseudomonas
What pt population is prone to S. Pneumoniae due to poor spleen function from infarcts
Sickle cell disease
All children with sickle cell should receive prophylaxis when? and with what medication?
3 months - 5 years
Penicillin V daily
This pt population is prone to pneumonia due to damaged ciliary bodies and thickened mucosa
Cystic Fibrosis
What pt population is more prone to fungal pneumonia infections
HIV infection and suppressed immunity makes people more prone
Unlike bacteria there are no fungal toxins, instead fungi
Cause a hypersensitivity reaction and create granulomas similar to TB
Fungal Pneumonia Phases
- Acute
- Chronic pulmonary disease
- Disseminated infection
Fungal Pneumonia - Histoplasma Capsulatum is fungus found in
Bird and bat droppings
Disseminated histoplasmosis can be fatal within
6 weeks
Fungal Pneumonia - Histoplasma Capsulatum treatment
Intraconazole
Fungal Pneumonia - Coccidiomycosis is also known as
Valley Fever - Southwest U.S.
Fungal Pneumonia - Coccidiomycosis treatment
Usually self-limiting but can treat with 3-6 months of Fluconazole (Diflucan)
Fungal Pneumonia - Cryptococcus is found in
Bird droppings
Fungal Pneumonia - cryptococcus can cause _________ in HIV pts with CD4+ counts < 50
Meningitis
