Micro - Resp Infections Flashcards
Pneumonia
Rust coloured sputum, Gram +ve diplococci
Strep or Staph
Strep
Associated with smoking and COPD, gram -ve cocco-bacilli
Hib OR Moraxella catarrhalis
Hib
Associated with smoking, gram -ve coccus
Hib OR Moraxella catarrhalis
Moraxella
Recent flu infection. +ve cocci grape bunched clusters
Staph
Alcohol, haemoptysis, -ve rod, enterobacter
Klebsiella
Generally quite resistant - 3rd gen ceph or better
Hepatitis, Confusion, recent travel
Legionella
Commonly causes hyponatraemia, hence the confusion. Treat with macrolide and rifampicin
No culture results, silver stain shows crushed ping pong ball look. Ground glass appearance on CXR
PCP
Treat with co-trimoxazole
Very severe pneumonia, what test to identify organism?
Urine Rapid Antigen
Can be used to identiy Strep and Legionella
Cystic Fibrosis
Pseudomonas and Burkholderia
Both gram -ve gammaproteo/proteobacteria, elastase +ve
Burkholderia
rod shaped, mutiple flagella, bio weapon potential
Immunocompromised, india ink left ‘halos’
Cryptococcus
Immunocompromised, neutropenic, on every antiobiotic under the sun
Aspergillus
Rx
Amphotericin B
Had BMT
CMV
Not improving on treatment, developed pleural effusion which is seen on X Ray,
Fluid pH = 7.15, blood pH is 7.38
Empyema
Bacteria invaded pleural space, can culture but not necessarily same organism. Very hard to treat with Abx therefore drainage is often the way forward.
If pH < 7.2, chest drain
60 yr old Pt comes into hospital with a kidney stone. 1 day later, develops a pneumonia.
Not confused
Urea = 4.6
Resp rate = 32
BP = 100/70
Management?
CAP as only in hospital for 1 day.
CURB65 = 1 - therefore mild
Rx
Amoxicillin or Macrolide for 1 week
68 yr old Pt comes into hospital with a kidney stone. 3 days later, develops a pneumonia.
Confused
Urea = 4.6
Resp rate = 32
BP = 80/58
Management?
HAP
CURB65 = 4
ITU
Rx
1st line: Cipro+Vanc
2nd line: Taz+Vanc
Aspiration: Cef + Met
