Community Acquired penumonia Flashcards
typical causes of CAP
Strep pneumoniae, haemophilus influenzae, moraxella catharralis
Atypical causes of CAP
Mycoplasma pneumonia, legionella pneumophilia, chlamydophila pneumoniae, chlamydophilia psittaci
Risk factors for developing Strep pneumoniae CAP
Alcohol abuse, Cancer, asthma/COPD, Immunosuppresion, smoking, elderly, use of PPIs
Clinical features of typical CAP
fever, a productive cough with purulent sputum, dyspnoea, and pleuritic chest pain
how would you treat strep pneumoniae CAP
penicillin (in UK)
If allergic to penicllins - use macrolides e.g. clarithromycin or tetracycline e.g. doxycycline
how would you treat a H. influenzae CAP
Co-amoxiclav.
Can use macrolides or tetracycline if needed
Describe an atypical presentation
lethargy, achy, headache, fever, cough of some kind (often dry and persistent)
Name a rare complication of mycoplasma pneumonia CAP
Haemolysis due to cold agglutinins
what antibiotics do you use to treat an atypical?
macrolides, tetracyclines and quinolones
how is legionella pneumoniae most commonly diagnosed
urinary antigen test
how is mycoplasma pneumoniae diagnosed
PCR (throat swab or sputum sample) or serology
Describe CURB65
C- COnfused U - Urea >7 R - RR >30/minute B - Systolic <90, diastolic <60 65 - >65 years of age
how many of curb 65 would indicate a severe pneumonia
a score of 2 or more
Describe the qSOFA score
bedside indicator of sepsis BP - Systolic <100 mm Hg Altered metal status (GCS<15) RR >22.minute. having 2 or more of these increases your chances of death
name two things that definitely indicate a severe pneumonia (regardless of the CURB 65
multi-lobular consolidation on CXR
patient hypoxic on room air
