FB: Complications of Pneumonia

Question 1

Complications (6)

Answer 1

Resp Failure
Hypotension
AF
Pleural effusion
Empyema
Lung Abscess

Question 2

Resp failure definition and management

Answer 2

􏰀 Type 1: PaO2 6kPa

􏰀 Mx: O2 therapy, ventilation

Question 3

Hypotension cause and management

Answer 3

􏰀 Cause: dehydration + septic vasodilatation
􏰀 Mx
􏰁 If SBP

Question 4

AF def and management

Answer 4

􏰀 Usually resolves ̄c Rx

􏰀 Mx: Digoxin or β-B for rate control

Question 5

Pleural effusion

Answer 5

􏰀 Exudate

􏰀 Mx: tap and send for MC+S, cytology and chemistry

Question 6

Empyema

Definition

Answer 6

􏰀 Pus in the pleural cavity
􏰀 Anaerobes, Staph, Gm-ve
􏰀 Assoc. ̄c recurrent aspiration
􏰀 Pt. ̄c resolving pneumonia develops recurrent fever

Question 7

Empyema tap and management

Answer 7

􏰀 Tap: turbid, pH

Question 8

Lung Abscess Causes

Answer 8

􏰀 Aspiration
􏰀 Bronchial obstruction: tumour, foreign body
􏰀 Septic emboli: sepsis, IVDU, RH endocarditis
􏰀 Pulmonary infarction
􏰀 Subphrenic / hepatic abscess

Question 9

Lung Abscess features

Answer 9

􏰀 Swinging fever
􏰀 Cough, foul purulent sputum, haemoptysis
􏰀 Malaise, wt. loss
􏰀 Pleuritic pain
􏰀 Clubbing
􏰀 Empyema

Question 10

Lung Abscess tests

Answer 10

s
􏰀 Blood: FBC, ESR, CRP, cultures
􏰀 Sputum: micro, culture, cytology
􏰀 CXR: cavity  ̄c fluid level
􏰀 Consider CT and bronchoscopy

Question 11

Lung Abscess Mx

Answer 11

􏰀 Abx according to sensitivities
􏰀 Aspiration
􏰀 Surgical excision

Question 12

Lung Abscess other complications

Answer 12

􏰀 Sepsis
􏰀 Pericarditis / myocarditis 􏰀 Jaundice
􏰁 Usually cholestatic
􏰁 Causes: sepsis, drugs (fluclox, Augmentin),
Mycoplasma, Legionella