Lower Respiratory Tract Infections Flashcards
Bronchitis
What is the causitive pathogens of bronchitis?
- VIRUSES! > 90% of cases
- bacteria (atypical organisms)= mycoplasma pneumoniae, chlamydia pneumoniae, bordatella pertussis (whopping cough)
Bronchitis
When is acute bronchitis treated?
if the infection is caused by bordatella pertussis (whopping cough)
Bronchitis
What antibiotics are used to treat Bordatella pertussis?
- macrolide
- sulfamethoxazole/trimethoprim
Pneumonia
What is the diagnosis criteria of pneumonia?
new lung inflitrate + clinical evidence for an infectious origin (fever, purulent sputum, leukocytosis, decreased oxygenation)
Pneumonia
What is the cause of pneumonia?
- aspiration (suble aspiration common in all indivuals, but risk factors may predispose pt)
- inhalation
- hematogenous
Pneumonia
What are the risk factors for pneumonia?
- viral infections predispose pt to secondary bacterial pneumonia (commonly seen in elderly)
- hospitalization
- mechanical ventilation
- smoking
- alcoholism
- elderly
- immunosuppresion
Pneumonia
How is hospital acquired pneumonia (HAP) classified?
pneumonia that occurs > 48 hours after admission to the hospital and was not incubated at the time of admission
Pneumonia
How is ventilator acquired pneumonia (VAP) classified?
pneumonia that occurs > 48 hours after endotracheal intubation
~9-27% incidence rate of intubated patient, risk increases with time
Pneumonia
What is the cause of aspiration pneumonia?
large inoculum of less virulent pathogens (anaerobes- normal flora)
Pneumonia
What are the risk factors for aspiration pneumonia?
- drugs
- altered mental status
- impaired host defenses (cough/gag reflex)
- neuromuscular disease
- dysphagia (history of stroke)
- mechanical ventilation, bronchoscopy, nasogastric feeding
Pneumonia
What is the clinical presentation of pneumonia?
- cough
- dyspnea
- sputum production
- pleuritic chest pain
- signs of systemic infection (fever, chills, hypoxemia, tachycardia, tachypnea)
peds: grunting, retractions, nasal flaring
Pneumonia
What labs and diagnostic tests can be used to diagnosis pneumonia?
- chest Xray
- sputum culture
- blood culture
- pulse oximetry
- WBCs
- urine antigen testing
- rapid influenza molecular assay (especially during the season in the elderly)
Pneumonia
What are the common pathogens that are respondsible for community acquired pneumonia (CAP)?
- streptococcus pneumoniae
- haemophilus influenzae
- staphylococcus aureus
- mycoplasma pneumoniae
- legionella species (serious illness)
- chlamydia pneumoniae
- moraxella catarrhalis
Pneumonia
What are the common pathogens that are respondsible for hospital acquired pneumonia (HAP)?
- escherichia coli
- staphylococcus aureus
- klebsiella pneumoniae
- acinetobacter spp.
- pseudomonas aeruginosa
- enterobacter spp.
Pneumonia
What is the most common bacterial pathogen that causes pneumonia in ages birth- 3 weeks?
group B strep