Pneumonia Flashcards
Define pneumonia
Defined as any inflammatory condition affecting the alveoli of the lungs
Pneumonia refers to any inflammatory condition affecting which parts of the lungs
Alveoli
What is the most common causative organism for community acquired pneumonia
Streptococcus pneumonia
Most common causative organism for community acquired pneumonia is Streptococcus pneumonia, followed by?
Haemophilus influenzae and Mycoplasma pneumoniae
Define Community acquired pneumonia
Refers to a pneumonia that is contracted in the community
Define Hospital acquired pneumonia
Pneumonia that develops more than 48 hours after hospital admission
What are the 3 most common causative organisms of hospital acquired pneumonia
Pseudomonas aeruginosa
Staphylococcus aureus
Legionella pneumophila
Which organism that causes community acquired pneumonia is particularly common in patients with COPD
Haemophilus influenzae
Pneumonia can be divided into 3 categories.
Name them
Community acquired pneumonia
Hospital acquired pneumonia
Aspiration pneumonia
Define aspiration pneumonia
Develops as a result of aspiration i.e. inhalation of foreign material e.g. food
What is the most common causative organisms in aspiration pneumonia
Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, and Pseudomonas aeruginosa
Community acquired pneumonia is a type of pneumonia.
It can be subdivided into two groups. Name them
Atypical organisms
Typical organisms
Which organisms is classically the cause of community acquired pneumonia in alcoholics
Klebsiella pneumoniae
Typicals are a group of community acquired pneumonia organisms.
Define the term typicals
Called because of the classical rapid onset of symptoms, including high fever and productive cough;
Typicals are a group of community acquired pneumonia organisms.
Define the term atypicals
Called because of the more gradual onset of symptoms, which may be non-specific initially (fever, myalgia, dry cough). The organisms are also intracellular;
Give an example of a typical community acquired pneumonia organism
Streptococcus pneumoniae (gram +ve cocci found in pairs)
Staphylococcus aureus
Haemophilus influenzae (gram -ve rod, potent beta-lactamase producer)
Moraxella catarrhalis (gram -coccus, potent beta-lactamase producer)
Give an example of an atypical community acquired pneumonia organism
Mycoplasma pneumoniae
Chlamydia pneumoniae
Legionella pneumophila
(Coxiella burnettii
Chlamydia psittaci)
In the vast majority of patients pneumonia is secondary to which kind of an infection.
Bacterial
What are the 3 classic symptoms of pneumonia
Cough
SOB
Signs of consolidation
What are the 4 signs indiactive of sepsis secondary to pneumonia
Tachypnoea (raised respiratory rate)
Tachycardia (raised heart rate)
Hypoxia (low oxygen)
Hypotension (shock)
How is pneumonia diagnosed in the hospital setting
CXR - showing consolidation
How is pneumonia diagnosed in the community setting
Clinical diagnosis
Chest x-ray is not routinely used for patients managed in the community
What is the scoring system used to aid clinical judgement in assessing whether the patient with pneumonia should be managed in hospital or at home
CURB-65
CURB-65 is a scoring system used for what?
Pneumonia - to assess whether a patient should be managed in the hospital or at home
What are the components of the CURB-65 score
(1 point for each if present)
C - new onset Confusion
U - Urea (> 7)
R - Respiratory Rate (>30)
B - Blood Pressure (< 90 / < 60)
65 - Age > 65
At what CURB-65 score is it recommended that the patient be admitted for pneumonia
Score 2 or more
At what CURB-65 score is it recommended that a patient with pneumonia should be managed in the ICU setting
Score 3 or more
What is the mainstay of treatment for pneumonia
Antibiotics as per local guidelines
What are potential complications of pneumonia
Pulmonary complications:
- Parapneumonic effusion
- Pneumothorax
- Abscess
- Empyema
Extrapulmonary complications:
- Sepsis
- Atrial fibrillation
What is the scoring system for pneumonia in the community
CRB-65 due to the inability to get a serum urea result (urea is the ‘U’ in CURB-65).
What generally is the first line antibiotics for pneumonia
Amoxicillin
Define sepsis
Infection with evidence of organ hypoperfusion (confusion, low GCS, high RR or low systolic pressure)
What are the 3 routes in which a bacteria can reach the lungs
Inhalation
Aspiration
Haematogenous
Define Bronchitis
Lower respiratory tract infection of the large airways.
What are the two types of bronchitis
Acute and chronic
Define Acute bronchitis
An acute infection of the lower airways without evidence of pneumonia (infection of the lung tissue)
Define Chronic bronchitis
Subtype of chronic obstructive pulmonary disease
Characterised by a chronic productive cough for ≥3 months over two consecutive years
What usually causes Acute bronchitis
Viral infection
Investigations should not delay antibiotic treatment for hospital acquired pneumonia.
How long after diagnosis should a patient be started on treatment?
Within 4 hours
What supportive management options are there for hospital acquired pneumonia
Oxygen titrated to saturations
IV fluids
Appropriate analgesia
