Pneumonia Flashcards
What is hospital-acquired pneumonia?
HAP develops after more than 48 hours in hospital
What is the most common cause of CAP?
Streptococcus pneumoniae
What are the other causes of CAP?
Haemophilus influenzae
Moraxella catarrhalis (immunocompromised patients)
Pseudomonas aeruginosa (CF or bronchiectasis)
Staphylococcus aureus (CF)
What are the common bacterial causes of HAP?
Psueodomonas
E. coli
Stapyloccocus aureus
Klebsiella pneumoniae (aspiration pneumonia)
What are the causes of atypical pneumonia?
Legionella pneumophilia
Mycoplasma pneumonia
Chamydophilia pnuemoniae
What is the presentation of pneumonia?
Productive cough
Pleuritic chest pain
Dyspnoea
Fever
Reduced breath sounds
Coarse crepitations
Hypoxia
Tachycardia
What are the initial investigations for pneumonia?
CXR
FBC - raised white cells
U&E
ABG - respiratory failure
Sputum culture
CRP
What is CURB-65?
Confusion
Urea > 7mmol/L
Respiratory rate > 30
BP systolic < 90 OR diastolic < 60
> 65 years of age
Community based care is score is 0 or 1
Hospital based care for patients with a score of 2
Intensive care assessment if CURB65 is 3 or more
What is the management of mild CAP?
Oral amoxicillin - 5 days
Oral doxycycline/ clarithromycin if penicillin allergic
What is the management of moderate severity CAP?
Oral amoxicillin (5 days) + clarithromycin if atypical pathogen is suspected
What is the management of high severity CAP?
IV co-amoxiclav and clarithromycin
What are the complications of pneumonia?
Acute respiratory distress syndrome
Sepsis
Lung abscess
Pleural effusion
Empyema
What organism commonly causes bacterial pneumonia after influenza?
Staphylococcus aureus
What is the presentation of klebsiella pneumonia?
Red currant jelly sputum
Often affects upper lobes
Common after aspiration
How is legionella pneumonia diagnosed?
Urinary antigen test
What is the presentation of legionella?
Flu like symptoms including fever
Dry cough
Bradycardia
Confusion
Deranged LFTs
Hyponatraemia
What are the features of mycoplasma pneumonia?
Prolonged and gradual onset
Flu like symptoms precede pneumonia
Bilateral consolidation
What are the complications of mycoplasma pneumonia?
Haemolytic anaemia
Thrombocytopenia
Erythema multiforme and nodosum
GBS
Pericarditis
Hepatitis
Pancreatitis
How is mycoplasma pneumonia diagnosed?
Mycoplasma serology
What is the management of mycoplasma pneumonia?
Doxycycline or macrolide (erythromycin/clarithromycin)