Module 5 Path Continued: Pneumonia Flashcards
Staphylococci infections are gram + cocci that normally colonize in human skin; entero, exo-, exfoliative -toxins. What are the common species?
S. aureus (most infections caused by this)
S. epidermidis
S. saprophyticus
Streptococci Infections are gram + cocci-diplo or strepto and produce hemolysis: classified into alpha and beta. Streptococcus pyogenes are streptococci infections, what are some feature of S. pyogenes?
Group A beta hemolytic; most important human pathogen
Direct damage: suppurative, cellulitis, abscess, pneumonia
Exotoxin
Indirect damage by immune response
ex: Post-Strep Glomerulonephritis, Rheumatic heart disease and scarlet fever
Lobular Bronchopneumonia is caused by what bacteria?
Klebsiella E. Coli Pseudomonas Staph Aureus (only gram positive) All are Aggressive KEPS
What is the pathogenesis of lobular bronchopneumonia?
URT infection —- acute bronchitis — spread of inflammatory exudate to adjacent alveoli —- destruction of bronchioles and alveoli
(so starts in bronchus)
—no macrophages in bronchioles to clean up the debris so this leads to scarring
What patients normally get Bronchopneumonia?
Children, elderly, bedridden and immunocompromised
What do patients present with that have bronchopneumonia?
Fever, pleuritic chest pain worse on inspiration, dyspnea, productive cough with bloody sputum
What is the best investigation as well as the first investigation for bronchopneumonia?
Best = Sputum culture Initial = X-ray (Shows patchy consolidation that is white on x-ray; remember that air is black on xray)
What are the complications of lobular bronchopneumonia?
- Empyema
- Lung abscess (liquificant)
- Pleural Thickening
- Septicemia (leads to DIC)
Patient who are immunocompromised with bronchopneumonia will they go through the same 4 stages of pathogenesis and lobar pneumonia
will go through the first three stages however they will never go through the 4th stage which is resolution
Lobar pneumonia is caused by what bacteria?
Streptococcal Pneumonia (Gram +)
Lobar pneumonia is likely to present in what kind of patients?
In healthy young adults exposed to cold, strain or exhaustion
What is the pathogenesis for lobar pneumonia? each card will go through the steps
- Acute Congestion: exudate rich in fibrin, RBC, Fibrin and a few PMNs in alveolar lumen
- -spreads throughout the pores of Kohn to involve entire lobe; alveolar walls not damaged or destroyed
what is the second step in pathogenesis of lobar pneumonia?
- Red Hepatization: exudate rich in RBCs, fibrin, and more PMNs – controlled infection
What is the third step in pathogenesis of lobar pneumonia?
- Grey Hepatization:Congestion and fibrin disappear, PMNs replaced by macrophages —- macrophages clear debris few days later with help of antibiotics
What is the final step in pathogenesis of lobar pneumonia?
Complete resolution without scaring: 10-14 days
will resolve with or without abx, just takes longer without ABX
What is the best investigation and initial investigation for lobar pneumonia?
Best: Sputum Culture
Initial: X-ray —consolidation
What are the signs and symptoms for lobar pneumonia?
Cough
Fever
Chest pain
Blood sputum
Diphtheria is caused by what bacteria?
Corynebacterium Diptheria — gram positive bacteria
–exotoxin