Microbio - Pneumonia Flashcards
What is pneumonia?
An infection resulting in inflammation of lung alveoli
Pneumonia Ix (8)
- Observations
- Bloods
- FBC, CRP, U&E
- CURB65
- Cultures
- Blood & sputum
- ±Atypical screen
- CXR
Typical pneumonia syx
Fever, productive cough, SOB, pleuritic chest pain
Pneumonia Initial Mx
ABCDE if unwell
Oxygen if needed
CURB-65 -> antibiotics
Difference between typical and atypical pneumonia
Atypical - different presentation, CXR and do not respond to penicillins (due to lack of cell wall) -> treat w Macrolides
When is pneumonia considered HAP?
after >48hrs of hospital admission
Most common HAP (4)
S. aureus, Klebsiella, Pseudomonas, Haemophilus
Most common typical pneumonia (5)
- Strep pneumoniae (pneumococcus)
- Haemophilus influenzae
- Moraxella catarrhalis
- Staph aureus
- Klebsiella pneumoniae
*What is the typical presentation of strep pneumoniae?
Rusty-coloured sputum
Lobar on CXR
What is the typical presentation of haemophilus influenzae?
Smoking, COPD
What is the typical presentation of moraxella catarrhalis?
Smoking
What is the typical presentation of staph aureus?
Post-influenza infection
Cavitation on CXR
*What is the typical presentation of klebsiella pneumoniae?
Alcoholism
Haemoptysis
Elderly
Ix: patchy consolidation + cavitating lesion
Most common atypical pneumonia (3)
Legionella pneumophilia
Mycoplasma pneumonia
Chlamydia psittaci
*What is the typical presentation of legionella pneumophila?
Travel / hotels, air conditioning, water
Hyponatraemia, hepatitis
*What is the typical presentation of Mycoplasma pneumonia?
Flu-like symptoms: cough, arthralgia
Universities, boarding schools
AIHA: cold agglutinins +ve
Erythema multiforme
What is the typical presentation of Chlamydia psittaci?
Birds
What are the components of CURB65?
Confusion
Urea >7
Resp rate >30
BP <90systolic/ <60diastolic
>65 y/o
What is the severity scoring for CURB65?
0-1 - Mild
2-3 Moderate
4-5 Severe
*What is the management for mild pneumonia?
Amoxicillin PO 5d
Outpatient treatment
Pen allergy= macrolide
What is the management for moderate pneumonia?
Amoxicillin PO 5-7d +
Clarithromycin PO 5-7d
Consider admission
What is the management for severe pneumonia?
Co-amoxiclav IV 7d +
Clarithromycin IV 7d
Admit +/- ITU
What is the management for HAP?
hospital guidelines (e.g. vanc, taz)
What is used to treat Legionella?
Macrolides
What Ix can be seen in Legionella?
Lobar consolidation, gram - rods
*Which atypical pneumonia presents with bilateral ground glass opacities on CT?
Pneumocystis jiroveci
*Transplant patient on immunosuppressives has pneumonia - halo sign (multiple)?
Aspergillosis
*Which pneumonia cause is most common in HIV pts?
Pneumocystis jiroveci (PCP)
*Urinary antigen tests are useful in the diagnosis of community acquired pneumonia. State one organism that the commonly available tests can detect.
Strep pneumonia
