Diagnose PNA Flashcards
Bronchitis
Infection of airways with thick bronchial walls
PNA
More serious
Alveolar capillary is near airspace- inf can penetrate and become bloodborne
Also impairs gas exchange
Dx of PNA: 2 criteroa
Symptoms/signs of LRTI
Imaging
Not 100% specfic
Xray can be negative, CT not
Common PNA symptoms
Cough, fatigue, sputum, chills, sweats, rales
PNA & bronchitis
Cough, sputum, hemoptysis, dyspnea, rhonchi
PNA and not bronchitis
High fever, pleurisy, consolidation, hypoxemia
Influenza A
High fever, chills, myalgia, sore throat
Very rapid onset as compared to PNA
Strep pyogenes
PJP
Usually pharyngitis, rarely PNA
Requires immunocompromise/ rarley phlegm
UAT for strep pneumo
Most common pathogen
Rule in test (high specificity)
H influenza and epiglottitis
high fever, drooling, upright posture
Bacterial vs viral PNA
Elderly/immuno
Some has upper airway symptoms, others have chest symptoms
B- fever, phlegm, hemoptysis
V- dry cough
May not have normal presentation
Staph aureus
uncommon CAP (elderly, drug use, flu)
Skin/soft tissue infection (Cavities)
G+ cocci in clusters
H influenza PNA
G- short bacilli
Typical in chronic bronchitis pt
Lots of sputum
Legionella PNA
Risk
Early findings
Dx with
Not responding to typical antibiotics
Negative GS/culture
Elderly, smokers, IC, contaminated water
Ab pain/diarrhea/slow prodrome/dry cough/ hyponatremia/myalgia
UAT (Serogroup 1) and culture (use azithro)
Atypical PNA presentation
Usual bugs
Mild, protracted prodrome
Cough, UA symp, less fever
Dyspnea
Mycoplasma, chlamydia, legionella, viruses
Pseudomonas
CF pt is at risk
Recurrent hospital exposures
G- rods
Empyema
Presents as PNA
drain it + antibiotics
Strep pneumo
Diplococci, G+
Klebsiella
G - rods with capsule
Provisional
Confirmed
Pathologic
Dx
Risk-benefit favors AB tx
Pts condition improves with AB
Lung biopsy/autopsy confirms impression
