community acquired pneumonia Flashcards
pneumonia is more common in who?
older,males, Af Am
aspiration pneumonia, lung abscess, anaerobic organisms, difficulty swallowing, alcohol
anaerobic organisms pneumonia
what is the most commonly identified cause of community acquired pneumonia?
strep pneumoniae
In pneumonia cases post influenza, after previous antibiotics , or with lung disease, consider? (3)
Staph aureus, Enterobacteriaceae, Pseudomonas
what pathogen is often seen in older patients & those with underlying lung disease (COPD or CF)
H. infleunza
name that pathogen: pneumonia cases with close person-person contact (schools, military)
Mycoplasma pnuemoniae or chlamyophilia
name that pathogen: pneumonia outbreaks assc;d with cooling towers, showers, hot tubs
legionella
name that pathogen: pneumonia seen in elderly or very young after previous influenza
staph aureus
name that pathogen: fulminant disease w/ early empyema
grp A streptococcus
how commonly are gram negative bacili causes of CAP ?
uncommon, really only seend with patients required ICU tx
sx of pneumonia
cough, fever, pleuritic chest pain, dyspnea, sputum production
does cough assc’d with pneumonia have sputum production?
not always, depends on pathogen
____ and _____ can sometimes also present wtih pneumonia
chest pain and chills
___is less common in the elderly, while _____is the most sensitive sign in elderly
fever, tachypnea
what is the gold standard for dx of pneumonia?
CXR
do you have to identify the pathogen before tx’ing pneumonia?
not required - empiric tx is very successful
which situations is idenification of pathogen critical? (5)
- legionella
- influenza A/B
- MERS
- Community acquired MRSA
- agents of bioterrorism
is sputum gram stain & culture recommended for outpatient or inpatient?
ICU admission
when is is sputum gram stain & culture recommended? (6)
- ICU admission
- failure of antibiotic tx
- cavitary changes on imaging
- immunocompromised host
- alcoholism
- suspecteddrug resistance
in those with preexisting pulm issues, when is is sputum gram stain & culture recommended? (3)
- severe COPD
- pleural effusion
- epidemic pneumonia
what type of testing is more sensitive/specific than sputum for legionella and S. pneumoniae?
urinary testing
can urinary testing be used if the patient has already started antibiotics?
yes, still valid
can urine tell you antibioitic sensitivity?
NOO
how to tx pneumonia in a previously healthy patient with no comorbidities?
oral macrolide
how to tx pneumonia in In patients with comorbidities such as cardiac/pulmonary/renal/liver disease, diabetes, asplenia, immunosuppression, or antibiotic in previous 3 months
oral macrolide + beta lactam or just oral respiratory quinolone
treatment for pneumonia should be given for a minimum of _____ days
5
