Pneumonia Flashcards
Clinical manifestations of pneumonia
Fever, cough, sputum production, pleurtic chest pain, SOB, tachypnoea, tachycardia.
HAP
Occurs within 48hrs or more of admission to hospital
Complications of pneumonia
Pleurisy Pleural effusion Atelectasis Delayed resolution Abscess Empyemea Endocarditis/pericarditis Arthritis Meningitis
Management of pneumonia
Adhere to infection control Adequate fluid intake O2 therapy Minimise risk of aspiration Deep breathing and coughing (Physio) Appropriate AB’s Amoxicillin Antipyretic Analgesia
Diagnosis of HAP
New progressive infiltrate on chest X-ray plus one of the following:
Fever of 38 or above
Total WCC above or below normal range
Presence or increased amount of purulent sputum or lower respiratory tract secretions
Worsening gas exchange - desaturation, increased o2 requirement
Pneumonia prevention
Immunisation against influenza and streptococcus pneumoniae Smoking cessation Exercise and management of obesity Medication review Reduce the risk of aspiration
CAP -
Acquired outside of hospital
Most common cause of HAP
Streptococcus pneumoniae
Management for HAP
Low to moderate severity: amoxicillin+clavulanate 875/125 BD
Moderate to severe: oral if tolerated
Ceftriaxone 1g daily
High severity: Piptaz 4+0.5 q6hly
Most common causative agents for CAP
Pneumoniae Haemophilus influenza
Chlamydia pneumoniae
CAP management
For moderate to severe CAP: inpatient management + combination therapy of
Benzylpenicillin 1.2g IV 6hrly plus doxycycline 100mg BD or clarithromycin 500mg Oral (azithromycin if unable to take oral)
Once the pt has improved- switch to oral therapy
Amoxicillin 1g 8hrly plus doxycycline 100mg bd
What is the criteria for moderate to severe CAP
Low severity : low risk complications and are suitable for management in the community
High severity : are associated with a risk of acute organ failure.
Most pts cannot be categorised as either low severity or high. These pts are classified as having moderate-severe CAP
Risk factors for CAP
Elderly Co morbidities Smoking Alcohol abuse Immunosuppression Failure to contain infection
