Community Aquired Pneumonia Flashcards
what proportion of patients with pneumonia need admission?
1/3
men are affected twice as often as women. True/ False?
True. We don’t know why
Risk factors for pneumonia?
- smoking
- low BMI
- chronic illnesses (heart failure, diabetes, chronic lever disease, HIV)
- respiratory disease (COPD, asthma)
- influenze and other respiratory tract infections
Risks for aspiration?
- epilepsy
- stroke
- chronic neurological disease e.g. MS
- alcohol abuse
What are some treatments which can increase the risk of pneumonia?
- inhaled corticosteroids
- oral steroids
- proton pump inhibitors
What are some treatements which can decrease the risk of pneumonia?
- influenze vaccine
- pneumococcal vaccine
- statins
- ACE-I in Asian patients
What can cause pneumonia?
- bacteria
- viruses
- fungi
- other organisms
- eosinophilic pneumonia
- autoimmunity
most common causative organisms of pneumonia?
- Strep pneumonia
- mycoplasma pneumonia
- Chlamydophila pneumonia
- Haemophilus influenza
- Legionella pneumophila
- Moraxella pneumonia
- Staph aureus
- chlamydophila psittaci
- viruses
- no organism fond
symptoms of CAP?
malaise, anorexia, sweating, rigors, myalgia, arthralgia, headache, breathlessness, cough and sputum (often green), haemoptysis (rust coloured in pneumococcal pneumonia), pleuritic chest pain, confusion, (other signs are typical of particular organisms)
Signs of pneumonia (on examination)
- dull to percussion
- bronchial breathing
- crackles
- pleural rub
investigations of CAP?
- Bloods (WCC, CRP - may be normal)
- sputum and blood cultures
- atypical serology: mycoplasma IgM, legionella urinary antigen, respiratory viruses, chlamydia serology, other specific tests
how is the severity of CAP assessed?
CURB65
score of 3 or greater = severe pneumonia
Where should a patient with CURB65 = 0-1 be treated?
outpatient
Where should a patient with CURB65 = 2 be treated?
short inpatient stay
Where should a patient with CURB65 = 3 be treated?
admit to hospital
