Lung infections Flashcards
What are the components of the CURB65 score?
Confusion Urea >7mmol/L Respiratory Rate > 30 Systolic BP < 90 mmHg Over 65 years old
0-2 CURB 65
CAP treatment?
Amoxicillin PO 1 g
0-2 CURB 65
Penicillin Allergic
CAP treatment?
Doxycycline PO 200mg on day 1 then 100mg
3-5 CURB65 CAP Treatment?
Co-Amoxiclav IV 1.2gs + Doxycycline PO 100mg
ICU CAP treatment?
Co amoxiclav IV 1.2gs + Clarithromycin IV 500mg
INTIAL treatment for severe hospital aquired pneumonia or aspiration pneumonia?
IV Amoxicilllin + Metronidazole + Gentamicin
INTIAL treatment for severe hospital aquired pneumonia or aspiration pneumonia with PENICILLIN allergy?
IV Co-trimoxazole + Metronidazole +/- Gentamicin
STEP DOWN treatment for severe hospital aquired pneumonia or aspiration pneumonia?
PO Co-trimoxazole + Metronidazole for 7 days
INTIAL treatment for non-severe hospital aquired pneumonia?
PO Amoxicillin + Metronidazole for 5 days
STEP DOWN treatment for ALL patients with community aquired pneumonia?
Doxycycline 100mg for 7 days
Treatment for PENICILLIN ALLERGIC severe or ICU Community aquired pneumonia?
IV Levofloxacin 500mg
Which organisms commonly cause mild community aquired pneumonia?
Streptococcus pneumoniae, followed by Haemophilus influenzae
Which organism commonly causes pneumonia in the community following viral influenza infection?
Staphylococcus aureus
Which organisms commonly cause exacerbation of COPD?
Streptococcus pneumoniae, followed by Haemophilus influenzae
How useful is blood culture in pneumonia?
Not useful in community aquired pneumonia (only +ve in 5-15%)
Most useful in severe disease - aim to get cultures BEFORE giving antibiotic in severe pneumonia.
Which bacteria groups can cause false positives in blood cultures?
Skin commensals such as staphyloccus epidermidis, corynebacterium species and bacillus species.
What are the features of Heamophilus Influenza?
- gram negative (stains pink)
- coccibacillus
- aerobic
- will generally NOT grow on blood agar and requires chocolate agar media
Mycoplasma pneumoniae generally infects?
Children and young adults
How is mycoplasma pneumoniae spread?
person to person
Which skin condition is characteristic of mycoplasma pneumoniae infection?
Erythema multiforme
How is Coxiella burnetti spread?
Sheep and goats
How is chlamydia pstiacci spread?
Infected birds
Which organism can be detected via urine?
Legionella, by finding legionella antigen in the urine.
When is urine culture indicated?
If complicated infection is suspected?
Within what time frame should you aim for urine samples to reach the lab?
One hour
