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Week 120 - Pneumonia > Infectious causes of Pneumonia > Flashcards

Infectious causes of Pneumonia Flashcards

1
Q

What would a patient with a typical pathogen pneumonia present like?

A

Increased fever, usually:
- high with rigors (cold, shivering, hot, copious sweating)

Productive cough
- sputum / sputum change
[] volume, freq, colour, consistency, blood, smell

Dyspnoea

Pleuritic pain - localised

Focal chest signs

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2
Q

What are the typical pathogens of pneumonia?

A 
Streptococcus penumoniae (Pneumococcus)
 - gram +ve (>50%)

Haemophilus influenza
- gram -ve (5%)

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3
Q

What type of bacteria is Streptococcus pneumoniae (pneumococcus)?

A

Gram +ve

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4
Q

Describe the distinct characteristics of Haemophilus influenza?

A

Gram -ve bacillus

Common cause of bronchiectasis exacerbations

Can be diffuse or contained to one lobe

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5
Q

What would a patient with an atypical pathogen pneumonia present like?

A

More systemic symptoms

Often less focal chest signs

Associated with milder pneumonias in immunocompetent, except for Legionella (severe atypical pneumonia)

Hard to detect since difficult to culture
- but may cause ~30% of CAP

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6
Q

What are the atypical pathogens of pneumonia?

A

Mycoplasma pneumoniae

Chlamydia pneumoniae

Legionella Pneumophila

Coxiella burnetti

Chlamydia psitacci

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7
Q

What type of bacteria is Mycoplasma pneumoniae?

A

Atypical bacterial with no cell wall

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8
Q

What type of bacteria is Chlamydia pneumoniae?

A

Obligate intracellular bacterium

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9
Q

What type of bacteria is Legionella pneumophila?

A

Gram -ve bacteria

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10
Q

What type of bacteria is Coxiella burnetti?

A

Gram -ve bacteria (small)

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11
Q

What type of bacteria is Chlamidiya psittaci?

A

Obligate intracellular bacterium

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12
Q

Describe the distinct characteristics Chalmydia psitacci

A

An obligate intracellular bacterium

Often transmitted from birds

Prefers lower lobes

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13
Q

Describe what is meant by a hospital acquired pneumonia (HAP)?

A

Pneumonias that occur after >=2 days of admission, or in patients who have been in healthcare environment in last 3 months (e.g. nursing home)

However, may be caused by typical pathogens also

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14
Q

What three things can increase the risk of aquiring a HAP?

A

Immunocompromised

Previous viral infection

Ventilated

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15
Q

What are the most common HAP organisms?

A

Bacteria

  • Stapylococcus aureus (Gram +ve)
  • Klebsiella (Gram -ve enterobacteria)
  • E-coli (Gram -ve enterobacteria)
  • Pseudomonas aeriginosa (Gram -ve enterobacteria)

Viruses
- Influenza virus ~ 8%

Fungi
- Pneumocystis (rare)

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16
Q

Describe the distinct characteristics Staphylococcus aureus

A

Usually a HAP

Often follows influenza infection
- presents with pneumonia, pleuritic chest pain +/- haemoptysis

Produces cavitation - empyema and abcess develop

17
Q

Describe the distinct characteristics klebsiella

A

Usually affects hospitalised or immunocompromised
- e.g. alcoholics - may follow aspiration

Prefers upper lobes

Causes cavitation/abcess
- haemoptysis with a currant jelly sputum is classical

18
Q

Describe the distinct characteristics E-coli

A

Usually affects immunocompromised
- often develops from aspiration or UTI

Lower lobes usually

19
Q

Describe the distinct characteristics Pseudomonas aeriginosa

A

Usually affects hospitalised or immunocompromised

Gradual onset with copious green sputum

20
Q

Describe who pneumocystis normally affects?

A

Immunocompromised

  • AIDS sufferers
  • rare infection
21
Q

Where does streptococcus pneumoniae live?

A

Respiratory tract and multiplies rapidly

22
Q

Is streptococcus a lobar or diffuse pneumonia?

A

Lobar pneumoniae

23
Q

Describe the sputum of a Streptococcus pneumoniae?

A

Rusty coloured sputum - classically

24
Q

What virus is associated with Streptococcus pneumoniae?

A

Herpes Labialis - cold sores

25
Q

How sudden and severe can Mycoplasma pneumoniae present?

A

Slow progressiong

Mild-moderate pneumonia
Flu-like symptoms followed by a dry cough

26
Q

What can Mycoplasma pneumoniae also cause?

A

Haemolytic anaemia

Eyrthema multiforme

27
Q

Which pneumonia initiates as Q fever (flu-like fever)?

A

Coxiella burnetti

28
Q

Which pneumonia is often transmitter from birds?

A

Chlamydia psitacci

29
Q

How is Legionella pneumophila normally acquired?

A

Those who are immunocompromised

Due to air conditioning/stagnant water in health patients

30
Q

What are the symptoms and effects of Legionella pneumophilla?

A

Produce flu like symptoms, i.e. dry cough, fever, diarrhoea

May cause:

  • lymphopaenia
  • derranged LFT
  • hyponatraemia
31
Q

Where is Coxiella burnetti normally acquired from?

A

Animals

32
Q

What are the symptoms of Q fever?

A

A flu like fever

  • malaise
  • headache
  • joint pain
  • GI symptoms
33
Q

What can Coxiella burnetti progress to?

A

Atypical pneumonia

Hepatitis

Chronic endocarditis

34
Q

What can result from a pneumonia that causes cavitation?

A

Empyema

Abcess

35
Q

What organism is likely for a pneumonia following infleunzae infection?

A

Staphylococcus aureus

36
Q

Which pneumonia organism presents with a currant jelly like sputum?

A

Klebsiella

37
Q

Which pneumonia organism presents with a copious green sputum?

A

Pseudomonas aeriginosa

38
Q

Which lobes is Chalmydia psitacci normally associated with?

A

Lower lobes

39
Q

Which lobes is E.coli normally associated with?

A

Lower lobes

Week 120 - Pneumonia (4 decks)

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