Lower Respiratory Tract Infections Flashcards
What is the broad term for inflammation of the lung tissue
Pneumonia
What are the 4 types of pneumonia
Bacterial
Viral
Mycoplasma
Fungal
3 typical types of pneumonia
Streptococcus pneumoniae
Haemophilus influenza
Staph. Aureus
7 types of Aytipical pneumonia
Legionella
Mycoplasma pneumonia
Coxiella burneti
Chlamydia psittaci
Klebsiella
Pneumocystis jirovecii
Pseudomonas
Most common community aquired pneumoniae
Rust coloured sputum
Streptococcus
Pneumonia normally in elderly, those with COPD, or people who work with children
Green sputum
Haemophilis influenza
Pneumonia common in PWIDs often following influenza
Sepsis can develop
Staph aureus
Pneumonia normally caused by inhalation of contaminated water droplets
Not common in young patients
Common after travelling to foreign countries
Legionella
Pneumonia common in children and young adults
Peaks every 4 years
No cell wall
Causes cillial dysfunction
Can cause red ear problem at same time as lung issues
Mycoplasma pneumonia
Pneumonia commonly caught when farming
Coxiella burneti
Pneumonia commonly caught from birds
Chlamydia psittaci
Pneumonia commonly caused by aspiration
Red currant jelly sputum
Klebsiella
Pneumonia commonly caused by fungus
Especially in immunocompromised patients
Pneumocystis jirovecii
Green sputum
Mostly harmful to those who already have chronic lung infections
Pseudomonas
Two types of pneumonia pathophysiology
Lobar pneumonia
Bronchopneumonia
What is lobar pneumonia
Confluent consolidation involving a complete lung lobe
Commonly strep pneumonia, in healthy young adults
Bronchopneumonia
Infection starts in airways and spreads to adjacent alveolar lung
Most often seen in context of pre existing disease
Common symptoms of pneumonia
- Dyspnoea
- Pleuritic chest pain
Younger patients - typically productive cough and high fever
- darker sputum = more severe, neutrophils turn it green
Older patients - variety of aytipical symptoms, reduced mobility, diarrhoea (less cough)
- empyema normally forms
Main 3 signs of pneumonia
Rigors
Crackles and rub
Tachypnoea - rapid shallow breathing
What investigations are used for pneumonia
Not necessary for majority of community cases
In hospital
- FBCs, CRP, U+Es
- CXR
If severe
- sputum examination and culture,
- legionella and pneumococcal urinary antigens
Risk factors for pneumonia
CURB65 risk score
- Confusion - new onset
- Urea - > 7 mmol
- High respiration rate - >30
- Hypotension - <60/90
- Old - >65 years
Antibiotic Management of CURB 0-2 community acquired pneumonia
Amoxicillin - IV or oral
If penicillin allergic:
Doxycycline day one followed by course of doxycycline or IV clarithromycin
Antibiotic Management of CURB 3-5 community acquired pneumonia
Co-amoxiclav IV + doxycycline IV
Penicillin allergic:
Levofloxin PO/IV
Antibiotic management of community acquired pneumonia in ICU
Co-amoxiclav + clarithromycin IV
Penicillin allergic:
Levofloxin
