Microbiology Flashcards
Symptoms
fever productive cough SoB hypoxia High RR Confusion
What is CAP
Clinical lower respiratory tract infection + new pneumonic changes on CXR + onset of symptoms in the community or within 48 hours of hospital admission
What increases chances of CAP
COPD
Diabetes
CV disease
Immunosuppression
what is seen in CAP
peak age 50-70
Seasonal- winter and early spring
COmmon causes of CAP
Streptococcus pneumoniae – most common
Haemophilus influenzae
Moraxella catarrhalis
Staphylococcus aureus/MRSA – common after a viral pneumonia as a secondary bacterial infection
Group A streptococcus species
Atypical causes of CAP
Mycoplasma pneumonia
Legionella
Chlamydia
Investigations if suspect pneumonia
CXR Bloods- FBC/U&E/CRP/LFT Blood cultures Sputum sample Urinary antigens (if suspect atypical cause)
How to decide how sever pneumonia is
CURB 65 (new onset confusion, urea>7, RR>20, BP <90/60, Age>65
What does the CURB 65 score help you decide
Where to manage
Antibiotic choice
Hospital acquired pneumonia definition
Clinical lower respiratory tract infection + new pneumonic changes on CXR + onset of symptoms > 48 hours after admission OR admission in the last 7 days
Risk factors for HAP
Age >70, severe underlying disease, poor mobility
Common organisms HAP
Enteric gram negative bacilli- includes enterobacteriacia and pseudomonas species
Strep pneumoniae
Haemophilus influenza
Staphylococcus aureus
Is there HAP severity guidelines
No. Only CAP
What is HAP severity dependent on
Clinical decision -New confusion -High respiratory rate Hypoxia Severity of CXR (bilateral or multilobular) HYpotension -Need for ventilatory support
What is aspiration pneumonia
- Does it show on CXR
- When to suspect
- What to do If suspected
Aspiration of gastric contents leading to chemical inflammation and infection
- Does not always show on CXR.
- Suspect who has a low GCS and evidence of vomiting
- Add metronidazole for HAP or CAP
