Lower Respiratory Tract Infection Flashcards
What is pneumonia?
acute infection of alveoli causing inflammation & fluid or pus accumulation
LRTI Signs and Symptoms
Sputum production
Tachycardia
Tachypnea
Hemoptysis
Pleuritic chest pain
Increased WBC
Diminished Breath Sounds
Dyspnea
Gram +ve diplococci
S. pneumoniae
Cluster of gram +ve cocci
S. aureus
Tiny gram -ve coccobacilli
H. influenzae
gram -ve diplococci
M. catarrhalis
plump gram -ve rods
Klebsiella
Gram -ve rods
P. aeruginosa
Diagnosis of LRTI
Sputum Culture in severe hospitalized
***obtain before ABx
Other LRTI Diagnostic
- Bronchoalveolar Lavage (BAL)
CURB - 65
Confusion = 1
Uremia (BUN>20)
Resp Rate (>30/min) = 1
SBP <90/DBP <60
Age >65 yrs = 1
CURB-65 ratings
0-1 = outpatient
2 = inpatient
>3 = ICU
HAP
48 hrs after admission
community pts w/ IV ABx within 90 days of admission
VAP
> 48 hrs after endotracheal intubation
CAP
no exposure to healthcare system
Most common CAP pathogens?
S. pneumoniae
CAP pathogens covered empirically>
S. pneumoniae
H. influenzae
Atypicals
Typical Pneumonia (primary pulmonary symptoms)
Abrupt onset
Unilateral infiltrate
Significant fever, chills
Purulent sputum production
Atypical Pneumonia (extrapulmonary symptoms)
Gradual onset
Dry cough
Diffuse infiltrates
CAP Outpatient Treatment in Healthy Patients
PO Amoxicillin
PO Doxycycline
PO Macrolides (Azithro/Clarithro)
CAP Outpatient Treatment in ppl with comorbidities
PO Augumentin
Cephalosporin + Macrolide (A/C)
Respiratory Fluoroquinolone (Levo/Moxi)
CAP Inpatient Treatment Non-Severe
IV B-Lactam + Macrolide
IV B-Lactam + Respiratory Fluoroquinolone
CAP Inpatient Treatment Severe
IV B-Lactam + Macrolide
IV B-Lactam +Respiratory Fluroquinolone
IV B-Lactam used in CAP
Ampicillin/Sulbactam (Unasyn)
Ceftriaxone
