Empyema (not a condition either, I know) Flashcards
1
Q
What is empyema?
A
Pus in the pleural space
2
Q
Empyema is a common complication of?
A
Pneumonia (43% of pneumonia patients develop it)
3
Q
Which type of bacteria is it most commonly associated with?
A
Anaerobic bacteria
4
Q
Which gram positive aerobes?
A
Strep milleri Staph aureus (post-op)
5
Q
Which gram negative aerobes?
A
E. coli
Pseudomonas
H. influenza
Klebsiella
6
Q
What are clinical signs of empyema?
A
Slow to resolve pneumonia
Persisting effusion on CXR - D-sign
7
Q
What investigations?
A
CT
USS
CXR
8
Q
What treatment?
A
Chest drain
IV or oral antibiotics
9
Q
Which IV antibiotics would you give?
A
Broad spectrum
Amoxicillin and metronidazole initially
10
Q
Which oral antibiotic would you give?
A
Directed words the cultured bacteria
11
Q
What predisposes to chronic pulmonary infections?
A
Immunodeficiency (antibody deficiencies / hypo-splenism / immune paresis) Immunosuppression Defective Innate Host defence Repeated Insult (recurrent aspiration / indwelling material)
