Pneumonia Flashcards
Pneumonia
infection of the lung tissue
types of pneumonia
community acquired
hospital-acquired
aspiration
atypical
signs
fever productive cough dyspnoea general unwell confusion hypotension
dull percussion note
increase vocal resonance
crackles
community acquired
strep pneumonae is most common cause
rusty coloured sputum
hospital acquired
develop symptom 48hrs after stay in hospital
staph aureus common cause
aspiration
red jelly colour in sputum
difficult swallowing food/unsafe swallow
Klebsiella pneumoniae - gram negative anaerobic rod
common for alcoholics or diabetics
atypical causes
legionella:
common in air conditioned areas, urinary antigen test for diagnosis
hyponatraemia seen
mycoplasma:
bullseye target, cold autoimmune haemolytic anaemia
erythema multiform, raised LDH, unconjugated bilirubin, immune-mediated neuro signs
psittacosis:
explored to birds, fever, organmegaly, not responding to penicillin
investigations
FBC
ABG
CXR - consolidation on affected area
criteria used for primary and secondary care setting
primary care: Confusion - <8/10 RR - >30 B - <90/<60 >65
secondary care: Confusion - <8/10 Urea >7 RR - >30 B - <90/<60 >65
each one gets a point and determines course of action
0-1 - home treatment
2 - consider hospital admission
3-5 - urgent hospital admission
management
moderate:
prescribe amoxicillin/clarithromycin and monitor at home
severe:
send to hospital
administer oxygen
IV amoxicillin + clarithromycin
high severity:
IV co-amoxiclav and clarithromycin
what antibiotic is used in aspiration pneumonia
co-amoxiclav
what is present if there is recurring fever despite antibiotic treatment
empyema
chest drain should be done
what should happen post-treatment of pneumonia
6 week chest x-ray review
what organism causes it in patients with COPD
haemophilus influenzae
what organism causes it in patient previous infected with HIV
Pneumocystis jiroveci
