Pneumonia Flashcards
Two main classifications of pneumonia
Community acquired or hospital acquired
What is aspiration pneumonia
Pneumonia which develops as a result of inhaling a foreign body
What is hospital acquired pneumonia
Pneumonia which develops more than 48 hours after hospital admission
Presentation of pneumonia
SOB, cough with sputum, fever, haemoptysis, pleuritic chest pain, delirium, sepsis
Signs in pneumonia
Tachypnoea, tachycardia, hypoxia, hypotension, fever, confusio
Chest sounds in pneumonia
Bronchial breath sounds, focal course crackles, dullness to percussion
What is the CURB-65 score
Scoring system used in hospital to determine how severe the pneumonia is
What does the CURB-65 stand for
Confusion
Urea>7
Resp rate >30
BP <90 sys <60 dia
Age over 65
If someone has a score of 0/1 on CURB-65
Treatment at home
If someone has a score of >2 on CURB65
Consider intensive care admission
Two most common causes of pneumonia
Strep pneumoniae (50%)
Haemophilus influenza (20%)
Other causes of pneumonia
Moraxella catarrhalis
Pseudomonas aeruginosa
Staph aureus
Pneumonia associations of those with chronic pulmonary disease or immunocompromised
Moraxella catarrhalis
Pneumonia associated with cystic fibrosis
Staph aureus and pseudomonas aeruginosa
Pneumonia associated wiht bronchiectasis
pseudomonas aeruginosa
5 Atypical pneumonias
Legionella pneumophilia
Mycoplasma pneumoniae
Chlamydophilia pneumoniae
Coxiella burnetii
Chlamydia psittaci
Associations with Legionella pneumonphilia pneumonia
Typically caused by infected water supplies or air conditioning units, can cause hyponatraemia
Associations with mycoplasma pneumoniae
Can cause erythema multiforme and neurological symptoms in young patients
Associations with chlamydophilia pneumoniae
Can present in school aged child with chronic pneumonia and wheeze
Associations with Coxiella burnetii
AKA Q fever, linked to exposure to animals and their bodily fluids
Associations with Chlamydia psittaci
Typically contracted from contact with infected birds
Who do fungal pneumonias typically present in
Immunocompromised
Eg of fungal pneumonia
Pneumocystitis jiroveci (PCP)
Presentation of fungal pneumonia
Subtly with dry cough, SOB on exertion and night sweats
Treatment of fungal pneumonia
Co-trimoxazole (trimethoprim and sulfamethoxazole)
Minimum investigations required
CXR, FBC, U&Es and CRP
Investigations for more moderate to severe cases
Sputum and blood cultures, and legionella and pneumococcal urinary antigens
Complications of pneumonia
Sepsis, pleural effusion, empyema, lung abcess, death
Treatment of atypical pneumonias
Macrolides, fluoroquinolones or tetracyclines
Treatment of mild CAP
5 day course of oral ABx such as amoxicillin or macrolide
Treatment of moderate-severe CAP
7-10 day course of dual ABx such as amoxicillin and macrolide
Eg of macrolide
Clarithromycin
Eg of fluoroquinolone
Levofloxacin
Eg of tetracycline
Doxycycline
