Microbiology: Respiratory Tract Infections (From pathguide)

Question 1

Fever, cough, chest pain, SOB. Onset of 2 weeks. Abnormal CXR. Most likely diagnosis?

Answer 1

Pneumonia

Question 2

Fever, cough, chest pain, SOB. Onset of 2 weeks. Abnormal CXR. Management?

Answer 2

Supportive:

• O2
• IV fluids
• Antibiotics (IV if severe)
• Asses severity using CURB-65

Question 4

Fever, cough, chest pain, SOB. Onset of 2 weeks. Coughing up rusty coloured sputum. Abnormal CXR (Lobar consolidation on right side).

What is the most likely causative organism?

Answer 4

S. Pneumonia

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Causing Pneumonia

rusty coloured sputum

Question 5

Fever, cough, chest pain, SOB. Onset of 2 weeks. Abnormal CXR (Lobar consolidation on right side). Blood cultures reveal a gram +ve diplococci.

What is the most likely causative organism?

Answer 5

S. Pneumonia

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Causing Pneumonia

+ve diplococci

Lobar consolidation is a clue

Question 6

Fever, cough, chest pain, SOB. Onset of 2 weeks. Abnormal CXR. Patient smokes. Blood cultures reveal a gram -ve cocco-bacilli

What is the most likely causative organism?

Answer 6

H. Influenza

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gram -ve cocco-bacilli

Smoking association

Question 7

Fever, cough, chest pain, SOB. Onset of 2 weeks. Abnormal CXR. Patient smokes. Blood cultures reveal a gram -ve coccus

What is the most likely causative organism?

Answer 7

M. Catarrhalis

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-ve coccus

Question 8

Fever, cough, chest pain, SOB. Onset of 2 weeks. Abnormal CXR, shows consolidation with some cavitation. patient had recently recovered from the flu.

What is the most likely causative organism?

Answer 8

S. Aureus

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Cavitation

Just got over flu

Question 9

Fever, cough, chest pain, SOB. Onset of 2 weeks. Abnormal CXR. Blood cultures reveal a gram +ve cocci in grape bunch clusters.

What is the most likely causative organism?

Answer 9

S. Aureus

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gram +ve cocci in grape bunch clusters.

Question 10

Fever, cough, chest pain, SOB. Onset of 2 weeks. Abnormal CXR. Patient is elderly and admits to excessive alcohol consumption.

What is the most likely causative organism?

Answer 10

K. Pneumonia

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Elderly and excess alcohol

(Also Haemoptysis)

Question 11

Fever, cough, chest pain, SOB. Onset of 2 weeks. Abnormal CXR. Blood cultures reveal gram -ve rods.

What is the most likely causative organism?

Answer 11

K. Pneumonia

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gram -ve rods

Question 12

Management of atypical pneumonias?

Answer 12

Macrolides and tetracyclines