Infection Flashcards
What is the M/C type of pheumonia?
Streptococcus pneumonia (40%)
What is the M/C community acquired infection?
steptococcus pneumonia
What location does streptococcus pneumonia like to affect?
lower lobes
True or false: cavitations are common in streptococcus pneumonia.
False – they are rare!
Where does streptococcus pyogens like to occur in the chest?
lower lobes
What is the M/C type of bronchopneumonia?
Staphylococcus aureus
What pop’n is more likely to get staphylococcus aureus pneumonia?
Hospitalized & debilitated patients, spread from endocarditis and intravenous drug users.
True or false: air bronchograms are rare in staphylococcus aureus.
True. Remember this is a BRONCHOpneumonia so airways are filled.
Which organism is acquired through contact with infected goats/meat & decaying soil/organic matter and can present with hemorrhagic pneumonia?
Bacillus anthracis
What is a key radiographic feature of bacillus anthracis pneumonia?
Mediastinal widening from lymphadenopathy – they get enlarged lymphnodes.
Bulging interlobar fissures and current jelly sputum are M/C seen in which chest infection?
Klebsiella (Friedlander’s) pneumonia
What pop’n is most commonly infected by Klebsiella pneumonia?
Older, alcoholic men & debilitated hospitalized patients
What is the M/C location for Klebsiella pneumonia?
Unilateral, posterior aspect of upper lobe or superior portion of lower lobe.
Which pneumonia causes round pneumonia in kids?
Streptococcal pneumonia
Mycotic aneurysms of abdominal aorta are M/C found with which organism?
Salmonella
Haemophilus influenza M/C affects which population?
Kids btwn age 2 months and 3 years.
Where within the chest does haemophilus influenza affect?
Bilateral & lower lobes
Pneumonia from which organism has a high mortality rate?
Pseudomonas aeruginosa
Where does pneumonia from pseudomonas aeruginosa most commonly affect and how does it present on CT?
Bilateral & lower lobes
Tree-in-bud or centrilobular nodules.
Which chest infection presents with a shaggy heart sign?
Pertussis (bordetella pertussis)
What is the pathomechanism of pertussis?
Abundant intraluminal mucus production causing partial or complete airway obstruction.
What is the differential for a shaggy heart sign?
1) Asbestosis (eg. interstitial lung disease)
2) Pertussis
3) Pleural thickening (benign or malignant)
Which chest condition is the “steeple sign” affiliated with?
Pertussis or croup
What is aspiration pneumonia?
Aspiration of foreign bodies producing airway obstruction –> leads to atelectasis, air trapping, distal pneumonitis or bronchiectasis
What are the predisposing risk factors for aspiration pneumonia?
alcohol intoxication, altered consciousness, dysphagia, neuromuscular disorder
True or False: Non-tuberculous mycobacterium is less indolent than M tuberculosis?
False - it is more
Atypical mycobacterial infection M/C affects what part of the lungs?
Upper lobe
What are the radiographic features of non-tb mycobacterium?
Similar to TB (eg. nodular opacities, focal consolidation, cavitaion, fibrosis etc.)
What is the difference from how you acquire an atypical mycobacterial infection vs TB?
Atypical –> From the natural environment (eg. water, soil and dust)
TB –> Airborne respiratory disease
What are the 2 stages of pulmonary tuberculosis?
Primary & postprimary
Which pop’n of patients are most likely to get lymph node involvement with primary pulmonary TB?
Children & immuno-compromised adults
What is a renke complex?
lymphadenopathy with Ghon focus
How common is it to see mediastinal lymph node calcification in primary TB?
33%
What is postprimary TB?
Reactivation of infected regions when host defenses are impaired.
What is the cause of bronchogenic spread of postprimary TB?
Spillage of caseous material from cavities into bronchus
What does the presence of cavitation in postprimary TB indicate?
Worsening infection
Parenchymal involvement in primary TB calcifies in what % of cases?
20%
What historical procedure involved the removal of the ribs as a form to treat TB?
Thoracoplasty
What historical procedure involved creating a cavity and then stuffing golf balls etc. in the thorax to forcefully collapse the lung as a treatment for TB?
Plombage
Which infection is endemic to The San Joaquin Valley?
Coccidioidomycosis
What is the prognosis of pulmonary coccidioidomycosis? What is a clinical presentation of this condition?
It is usually self-limiting (~3 weeks).
Clinical:
- mostly asymptomatic (60%)
- erythmatous rash
What are the 4 types of pulmonary coccidioidomycosis?
a) Primary/Acute
b) Persistent
c) Chronic progressive
d) Disseminated (<1%)
What are some of the obvious differences btwn acute and persistent (or even chronic) coccidioidomycosis?
Acute = calcified; rarely cavitates
Persistent and chronic = rarely calcifies; cavitates quickly
What is valley fever?
When coccidioidomycosis presents with erythema nodosum and arthralgia.
What areas are endemic to histoplasmosis?
Ohio, Mississippi, St. Lawrence River valleys
What are the clinical features of pulmonary histoplasmosis?
Asymptomatic (95-99%)
What are the radiographic features of histoplasmosis and where does it commonly occur?
- Multiple, well-defined calcified nodules resembling miliary TB
- occurs in lower lobes
What is fibrosing mediastinitis and what are the top 3 common causes for it?
Extension of granulomatous disease to involve the mediastinal tissues causing extensive fibrosis.
M/C/C = histoplasmosis, TB and sarcoidiosis
Moniliasis (candidiasis) pneumonia M/C occur in which pop’n?
Immuno-compromised patients (particularly lymphoma or leukemia)
Invasive aspergillosis M/C invades which anatomy?
Invasion of pulmonary vasculature (aka Angioinvasive aspergillosis)
“Finger-in-glove” appearance occurs in which conditions?
Asthma, allergic aspergillosis (usually with a hx of asthma) & cystic fibrosis
What is the M/C/C of aspergilloma? What is the 2nd M/C/C?
1st = cavitary disease from prior TB 2nd = sarcoidosis
Actinomycosis normally exists where in the respiratory system?
Oropharynx
AIDS and transplate patients are risk patients for developing which pneumonia?
Pneumocystic jiroveci
Which infection can cause mandibular osteomyelitis following dental extraction?
Actinomycosis
Which bacterial organisms are gram positive?
- streptococcus pneumonia
- streptococcus pyogens
- straphylococcus aureus
- bacillus anthracis
Which bacterial organisms are gram negative?
- Friedlander’s (klebsiella) pneumonia
- escherichia coli
- salmonella
- proteus
- haemophilus influenzae
- pseudomonas aeruginosa
- bordetella pertussis
- aspiration pneumonia
Infants with congenital heart disease or pulmonary brochodysplasia are “at risk” patients for which type of respiratory virus?
Respiratory syncytial virus (RSV)
Giant cell (multinucleated giant cells) pneumonia can be see in which pulmonary infections?
- Measles virus
- parainfluenza
- RSV infections
Echinococcosis can be asymptomatic unless______
They rupture – then sx occur.
What is the sign of camalote?
aka. Water lily sign = ruptured echinococcal cyst into bronchial tree.
Which chest infection affects cystic fibrosis patients and patients on mechanical respirators?
Pseudomonas aeruginosa
