pneumonia Flashcards
test you can do to confirm etiology of Mycoplasma pneumonia
cold agglutination
Haemophilus influenzae gram stain
gram-negative rod
which set of individuals typically get Klebsiella as the cause of their CAP
impaired host defenses (alcoholics, DM, severe COPD)
Klebsiella stain
sputum stains gram negative rods
which bacteria is commonly associated as a superimposed infection after viral infection
s. aureaus
S. aureus sputum gram stain
gram positive cocci in clusters
which pneumonia is most commonly caused by anaerobes
aspiration pneumonia
- most common in RL lobe
- associated w/ foul-smelling sputum (rotten egg smell)
aspiration pneumonia
list 6 extrapulmonary sx seen in atypical pneumonia
- HA
- sore throat
- earache
- wheeze
- malaise
- confusion
which type of pneumonia commonly has a normal pulmonary exam
atypical pneumonia
which pneumonia commonly has signs of consolidation (bronchial breath sounds, dullness to percussion, tactile fremitus, egophony, inspiratory rales)
typical pneumonia
which type of pneumonia does NOT respond to beta lactams or sulfonamides
atypical pneumonia
4 etiologies of typical pneumonia
strep pneumonia
H. influenza
Moraxella catarrhalis
Klebsiella pneumonia
3 etiologies of atypical pneumonia
- mycoplasma pneumonia
- legionella pneumonia
- chlamydia pneumonia
- homogenous fibrinosupparative consolidation
this is used to describe what type of pneumonia
typical or lobar pneumonia
exposure to overcrowded institutions is associated with risk of what 4 bacterias
- S. pneumoniae
- mycobacteria
- mycoPLASMA
- chlamydia
what bacteria has presentation of
* one time chills & rigors
* blood-tinged (rusty) sputum
strep pneumonia
which bacteria has GI sx in additin to fever, chills, cough, dyspnea
Legionella
which bacteria
- bilateral nodular infiltrates
- empyema or abscess formation
- pts w IV durg use or post influenza typically affected
staph aureus
which bacteria
- bullous myringitis (blisters on tympanic membrane)
- cobweb infiltrates
- low grade fever and cough
mycoplasma pneumoniae
which bacteria
- productive cough with green sputum
- typically affects COPD, post splenectomy and decreased immunities
H. influenza
which bacteria
- current jelly sputum
- bulging fissure sign
- lung necrosis possible
- typically affects alcoholcs, chronic illnesses and aspiration patients
klebsiella
which bacteria
- green sputum with abscess formation
- mostly affects ventilator patients and CF patients
pseudomonas (typical)
outpatient empiric tx of pneumonia in healthy person w/ no antimicrobial in past 3 months (3)
amoxicillin 1G PO TID x 7 days
doxycycline 100mg PO BID x 5-7days
azithromycin 250mg tablets; 2 PO today and 1 PO daily x 4 days
outpatient empiric tx of pneumonia if they have comorbidities or used immunosuppresive or antimicrobials in past 3 months (2)
- Resp. fluoroquinolone (levo-, moxi-, gemi-)
- betalactam + macrolide (augmentin)
inpatient (non-ICU) empiric tx for CAP (2)
- respiratory fluoroquinolone
- b-lactam + macrolide
ICU tx for CAP
- b-lactam + azithromycin
- resp. fluoroquinolone
- if PCN allergic, resp. fluoroquinolone and aztreonam
pseudomonas tx
cipro or levofloxacin
what is curb 65
admission criteria– admit if over two of:
* confusion
* uremia over 30
* RR over 30
* SBP under 90 or DBP under 60
* age over 65
tx for legionella pneumoniae (if healthy & no abx vs comorbidies)
- healthy: azithromycin
- comorbidies: fluoroquinolone
tx for staph aureus pneumonia
beta-lactam + macrolide
mycoplasma pneumoniae tx
macrolide
klebsiella tx
3rd or 4th gen cephalosporin
OR
quinolone
tx for anaerobic pneumonia
beta lactam + beta lactamase inhibitor (augmentin) OR clindamycin
