PCAP Flashcards
What is pneumonia?
Inflammation in the lung caused by an infectious agent that stimulates a response resulting in damage to lung tissue.
What is community-acquired pneumonia (CAP)?
One of the most important health problems affecting children worldwide and the leading single cause of mortality in children younger than 5 years of age, especially in low- and middle-income countries.
What is the most prevalent cause of pneumonia throughout childhood?
Viruses.
Which bacterium is the most prevalent cause of community-acquired pneumonia (CAP)?
S. pneumoniae.
What are the coinfection rates for pneumonia?
Up to 75%.
What infectious agents are most common from birth to 28 days?
- Group B streptococci
- Gram-negative enteric bacteria
- RSV
What infectious agents are common beyond the neonatal period?
- RSV
- Streptococcus pneumoniae
- H. Influenza
- S. aureus
- Moraxella catarhallis
What are the common pathogens in school-age children and adolescence?
- Viruses
- Mycoplasma pneumoniae
- Streptococcus pneumoniae
- Chlamydia pneumoniae
What pathogens are notably present in the first 6 months of life?
- Chlamydia trachomatis
- Bordetella pertussis
- Ureaplasma urealyticum
What are the secondary causes of Staphylococcus aureus pneumonia?
- Inhalation of the pathogen
- Rarely, bacteremic spread
What are the radiologic findings associated with Staphylococcus aureus pneumonia?
- Bronchopneumonia with alveolar infiltrates, mostly unilateral
- Consolidation
- Cavitation
- Air trapping
- Pneumatocele formation (30%)
What complications can arise from Staphylococcus aureus pneumonia?
- Pneumothorax
- Pyopneumothorax
What is CA-MRSA?
Community-acquired Methicillin-resistant Staphylococcus aureus that usually affects younger patients and often susceptible to clindamycin, trimethoprim-sulfamethoxazole, and tetracyclines.
What is the main symptom of pneumonia?
Fever, chills, tachypnea, productive cough, lower chest indrawing, abdominal pain, and chest pain.
What are the danger signs of severe pneumonia?
- Inability to drink
- Persistent vomiting
- Convulsions
- Lethargy
- Impaired level of consciousness
- Stridor
- Severe malnutrition
What laboratory tests are used for pneumonia diagnosis?
- High WBC
- CRP
- Procalcitonin (bacterial)
- Lung puncture specimen or bronchoalveolar lavage
- Sputum examination
- Blood cultures
- Pleural fluid culture
What is the gold standard for etiologic diagnosis in pneumonia?
Lung puncture specimen or bronchoalveolar lavage.
What are the typical radiologic findings in pneumonia?
- Consolidation
- Pleural effusion
What is the recommended management for children with CAP without danger signs?
Can be safely cared for at home and child reexamined within 48 hours.
What are the indications for hospital admission for infants <2 months?
- SaO2 of 90%–92% or less
- Cyanosis
- RR > than 70 bpm
- Difficulty of breathing
- Intermittent apnea
- Grunting
- Inability to feed
- Failure after oral therapy
- Severe malnutrition
- Family incapable of providing appropriate care
What is the first choice antibiotic for pneumonia in children?
Oral amoxicillin.
What is the management for smaller pleural effusions?
Can usually be managed with antibiotics alone.
What is necrotizing pneumonia?
Necrosis and liquefaction of consolidated lung tissue, usually secondary to pneumococcus, S. aureus, CA-MRSA, or Pseudomonas aeruginosa infections.
What are the symptoms of pleural effusion?
- Persistent fever
- Persistent respiratory distress
- Pleuritic pain
- Abdominal pain
