Pneumonia Flashcards
What is the pathophysiology of pneumonia?
Inflammation of the alveoli and bronchioles caused by an infection or aspiration
What is the most deadly hospital acquired infection?
Pneumonia
What are the pathogens that can cause pneumonia?
Bacteria, viruses, and fungi
What is the most common pathogenic cause of bacteria pneumonia?
Strep pneumoniae
What is a common bacterial pneumonia that is associated with mechanical ventilation?
Pseudomonas
What are the viral causes of pneumonia?
Influenza
RSV
Parainfluenza
Adenovirus
COVID
Patients who are immunocompromised they are likely to be infected with these pathogens besides strep pneumoniae?
Staph Aureus
Aspergillus
Candida
gram-negative bacilli
What will be positive on physical exam in community acquired pneumonia?
Crackles or Absent lung sounds
+ Egophony and Bronchophony
Increased tactile fremitus
Lobar consolidation
What is the treatment of community acquired pneumonia in an outpatient
Azithromycin, Doxycycline, or Levofloxacin
What is a typical cause of community acquired pneumonia?
Aspiration
What is the characteristic of the presenting cough in typical community acquired pneumonia vs. atypical community acquired pneumonia?
Typical = productive cough
Atypical = dry cough
Where is the antibody against S. pneumonia created?
In the spleen
What is the typical treatment in children with community acquired pneumonia in the outpatient setting?
Amoxicillin 90mg/kg/day BID
What is the typical treatment in adults with community acquired pneumonia in the inpatient setting?
Ceftriaxone PLUS Azithromycin
Or Levofloxacin
What is the typical treatment in pediatrics with community acquired pneumonia in the inpatient setting?
Ampicillin (if fully immunized)
Ceftriaxone (if not fully immunized)
Why is Azithromycin the first line treatment in outpatient pneumonia treatment?
Only antibiotic that has been found to decrease lung inflammation
Atypical pneumonia is more common in what cohort?
Children
Damage is located where in atypical pneumonia?
Damage to the epithelium allowing bacteria to over grow
Who are the high risk groups of atypical pneumonia?
Children, young adults, college aged
What is the treatment for atypical pneumonia caused by Legionnaire’s disease?
Levofloxacin, any delay in abx increases risk of mortality
How is Legionaire’s disease transmitted?
Pathogen grows in water of ventilation symptoms, it is not transmitted human-to-human
To be classified as a hospital acquired pneumonia the presentation has to be at least how many hours after admission?
48
Who are at higher risk for hospital acquired pneumonia?
Intubation, tracheostomy, immunocompromised, chronic lung disease
What is the treatment for hospital acquired pneumonia?
No consensus on the best antibiotic treatment
What is the leading cause of death for people with HIV worldwide?
Pulmonary tuberculosis
For patients with HIV what should be the treatment for HIV associated pneumonia?
Ceftriaxone and Azithromycin
Why are patients with Sickle Cell Disease prone to S. pneumoniae pneumonia?
Poor spleen function
Why are patients with Cystic Fibrosis more prone to pneumonia?
Damaged ciliary bodies and thickened mucous
What is the typical pathogen infecting patients with cystic fibrosis causing pneumonia?
Pseudomonas aeruginosa
What is the treatment of cystic fibrosis pneumonia?
Should be treated aggessively inpatient with tobramycin and Pip-tazo
What is the treatment of viral pneumonia?
Trial albuterol and prednisone, if doesn’t improve or patient gets worse treat with antibiotics because viral infections of the lungs can pre-dispose to bacterial pneumonia
What is the cause and vector of fungal pneumonia caused by histoplasma capsulatum?
Fungus found in bird and bat droppings
What can be used to prevent pneumonia?
PCV-20 vaccine
Influenza vaccine