Microbiology 14 - Respiratory Tract Infection Flashcards
What pattern of pneumonia is usually produced by streptococcus pneumoniae?
Neatly lobar pneumonia
What pattern of haemolyisis does S. pneumonia show?
Alpha haemolysis
What are the top 2 organisms that can cause CAP?
S. pneumoniae
H. influenzae
What are the 3 most likely organisms to cause CAP in neonates?
E coli
Group B strep
Listeria
What are the 3 most likely organisms to cause CAP in 1-6 month olds?
Chlamydia
S. aureus
RSV
What are the 2 most likely organisms to cause CAP in 6 month - 5 year olds?
Mycoplasma
Influenza
Recall the CURB 65 criteria
Confusion Urea > 7 Resp rate > 30 BP <90 systolic/ <60 diastolic Age > 65
How will a CXR appear in bronchitis?
Normal
How should bronchitis be managed?
Bronchodilators and antibiotics IF bacterial cause (usually viral)
In which patient group is H. influenzae most likely to cause CAP?
Those with a pre-existing lung condition
Which cause of CAP is associated with confusion?
Legionella
What are the typical symptoms and signs of legionella pneumonia?
Confusion
Abdominal pain
Diarrhoea
Hyponatraemia
Why are penicillins ineffective in atypical pneumonia?
Organisms that can cause atypical pneumonia don’t have a cell wall
What are the possible extrapulmonary features of atypical pneumonia?
Hepatitis
Hyponatraemia
What is the biggest risk factor for coxiella burnetti pneumonia?
Exposure to domestic/ farm animals
How is coxiella pneumonia diagnosed?
Serology
Which type of atypial pneumonia is spread by birds?
Chlamydia psittaci
What imaging is needed to diagnose empyema?
CT
How can empyema be treated?
Large chest drain
Which type of pneumonia might cause a mild anaemia?
M. tuberculosis
What is a hospital-acquired pneumonia?
Pneumonia that develops within 48 hours of being in hospital
How can upper and lower respiratory flora be identified and distinguished in HAP?
Bronchial lavage
Which organism is the most common cause of HAP?
Enterobactericiae
What is the typical CXR appearance of PCP pneumonia?
Bat wing
What antibiotic is used to treat PCP pneumonia?
Co-trimoxazole
Which patient population is most at-risk of aspergillus pneumonia?
Immunosuppressed (eg prolonged chemo/ HIV)
What is the treatment for aspergillus pneumonia?
Amphotericin B
Which 2 pneumonia-causing organisms can be tested for in urine?
S. pneumoniae
Legionella
NOTE: only useful in PAIRED samples
What is the antibiotic of choice to treat MRSA pneumonia?
Vancomycin
What is the antibiotic of choice to treat pseudomonas pneumonia?
Piptazobactam
What are the 1st and 2nd line antibiotic therapies for HAP?
1st line: Ceftazidine/ciprofloxacin +/- vancomycin
2nd line: Piptazobactam and vancomycin
