Pneumonia Flashcards
what is the scoring system for community-acquired pneumonia?
CURB-65
what does CURB-65 indiciate?
severity and risk of mortality
what are the common causes of pneumonia?
- steptococcus pneumonia
- haemophilus influenzae
- mycoplasma pneumoniae
what are the typical symptoms for pneumonia?
- fever
- malaise
- rigors
- cough
- purulent sputum
- pleuritic chest pain
- haemoptysis
what are the features of hospital-acquired pneumonia?
develops >48 hours after hospital admission
what are the common organisms in hospital-acquired pneumonia?
- pseudomonas aeruginosa
- staph aureas
- enterobacteria
what are the features of aspiration pneumonia?
- occurs in patients with an unsafe swallow
- more commonly affects the right lung (as the right bronchus is wider and more vertical)
what are the risk factors for aspiration pneumonia?
- stroke
- myasthenia gravis
- bulbar palsy
- alcoholism
- achalasia
what are the featurs of staphylococcal pneumonia?
bilateral cavitating bronchopneumonia due to staph aureas (gram +ve cocci found in clusters)
what are the risk factors for staphylococcal pneumonia?
- IV drug users
- elderly patients
- patients who already have an influenza infection
what are the features of klebsiella pneumonia?
- primarily affects the upper lobes resulting in a cavitating pneumonia
- presents with ‘red-current sputum
- caused by gram -ve anaerobic rod
what are the complications of pneumonia?
- empyema
- lung abscesses
- pleural adhesions (more common in klebsiella pneumonia)
what are the risk factors for developing klebsiella pneumonia?
- weakened immune system (e.g. elderly, alcoholics, diabetics)
- malignancy
- COPD
- long-term steroid use
- renal failure
what are the features of mycoplasma pneumonia?
- presents with flu-like symptoms (flu, arthralgia, myalgia, dry cough, headache)
- can present with erythema multiforme (multiple erythematous papules with deeply erythematous borders)
- primarily affects younger patients
- auto-immune manifestations due to cold agglutinins - causes autoimmune haemolytic anaemia
what complications are associated with mycoplasma pneumonia?
- erythema multiforme
- stevens-johnson syndrome
- guillian-barre syndrome
- meningoencephalitis
what are the features of legionella pneumonia?
- fever, myalgia, malaise
- followed by dyspnoea and dry cough
- associated wiht legionnaires disease - patients who have been exposed to poor hotel air conditioning
what positive investigation findings are found in legionella pneumonia?
- hyponatraemia
- derranged LFTs
- legionella antigen in urine
what are the features of chlamydophila psittaci pneumonia?
- acquired from contact with infected birds (e.g. parrots, cattle, horse, sheep)
- lethary, headache, anorexia, dry cough, fever
- additional features = hepatitis, splenomegaly, nephritis, infective endocarditis, meningoencephalitis, rash
what is chlamydophila psittaci?
intracellular bacteria that results in psittacosis (infected disease from bird)
what are the features of pneumocystis pneumonia?
- associated with patients who are immunocompromised (malignancy, chemotherapy and HIV +ve)
- exertional dyspnoea, dry cough, fever
what is the causative agent in pneumocystis pneumonia?
pneumocystis jiroveci (fungus)
what is the best investigation to obtain a definitive diagnosis in legionella pneumonia?
urinary antigen enzyme immunoassay test
what antibiotic is most appropriate for staphylococcal pneumonia?
flucoxacillin
what is the normal antibiotic management in pneumonia?
oral or IV amoxicillin and clarithromycin
check antibiotic person
