Pneumonia Flashcards
What is pneumonia?
Infection and inflammation of the alveoli
Pneumonia can be caused by various pathogens including bacteria, viruses, and fungi.
What does the acronym SALAMI stand for in pneumonia risk factors?
- S: Smoking
- A: Advanced age (over 60)
- L: Lung diseases or cancer
- A: Alcohol
- M: Malnutrition
- I: Immunocompromised
Immunocompromised individuals may include IV drug users and those with HIV or on antibiotic and cytotoxic drug use.
What are the most common bacterial infections associated with pneumonia?
- Strep pneumoniae
- Haemophilus influenzae b
These bacteria are often responsible for community-acquired pneumonia.
Which bacteria are associated with pneumonia in immunocompromised or chronic lung disease patients?
Moraxella
Moraxella is particularly noted in patients with weakened immune systems.
What bacteria are commonly found in cystic fibrosis patients with pneumonia?
- Pseudomonas aeruginosa
- Staphylococcus aureus
These pathogens can lead to severe lung infections in cystic fibrosis patients.
What is the primary bacterial cause of pneumonia in bronchiectasis patients?
Staphylococcus aureus
Staphylococcus aureus is often implicated in pneumonia for bronchiectasis patients.
What is the definition of hospital-acquired pneumonia?
Pneumonia that occurs 48 hours or more after hospital admission and is not present at the admission time
Hospital-acquired pneumonia is often more resistant to treatment due to the pathogens involved.
Define community-acquired pneumonia.
Pneumonia contracted in a community setting, not hospital or healthcare facility or nursing homes
This type of pneumonia is generally more common and may be less severe than hospital-acquired pneumonia.
What causes foreign body aspiration pneumonia?
Inhalation of a foreign object into the lungs
This type of pneumonia can occur in individuals of all ages, particularly in young children.
What is pneumocystis jiveci pneumonia?
A fungal infection that occurs in immunocompromised patients, e.g., poorly controlled HIV
This type of pneumonia is characterized by specific symptoms and requires antifungal treatment.
What are the three signs of pneumocystis jiveci pneumonia?
- Dry cough
- Shortness of breath on exertion
- Night sweats
These symptoms are indicative of the infection in immunocompromised individuals.
What is an atypical infection that causes pneumonia associated with infected water systems?
Legionella pneumophila
Example: AC systems
What is the hallmark feature of Legionella pneumophila infection?
Syndrome of Inappropriate ADH (SIADH) causing hyponatremia
Perform urine antigen test
What atypical infection is associated with infected birds?
Chlamydia psittaci
What is the hallmark feature of Mycoplasma pneumoniae infection?
Erythema multiforme and neurological symptoms
Occurs in approximately 43% of cases
What atypical infection is common in school-age children?
Chlamydia pneumoniae
What is Q fever caused by?
Coxiella burnetii
Transmitted through infected bodily fluids of animals, e.g., farmers
What are common pneumonia presentations?
Productive cough, fever, shortness of breath (SOB), malaise, acute confusion, haemoptysis, pleuritic chest pain
What are physical examination findings in pneumonia?
Bronchial breath sounds, focal coarse crackles, dullness to percussion
What are the complications of pneumonia represented by SLAP HER?
S: SIADH and hyponatremia
L: Lung abscess
A: ARDS
P: Parapneumonic effusion
H: Hypotension
E: Empyema
R: Respiratory or renal failure
What investigations are used for pneumonia?
CXR: Consolidation
FBC: Raised WBC count
CRP level: Raised
U&Es: Urea level and acute kidney injury
Microbiology: Sputum cultures, blood cultures
What does CURB-65 stand for in pneumonia scoring?
C: Confusion
U: Urea more than 7 mmol/L
R: Respiratory rate 30 or more
B: Blood pressure: systolic less than 90 OR diastolic equal to or less than 60
65: Age 65 or over
What is the total score range for CURB-65?
Ranges from 0-4
0/1: Low risk so can be treated at home
2: Moderate risk so should assess and consider hospital admission
3/4: High risk, give immediate hospital referral so should be admitted to intensive care
What is the management for hospital-acquired pneumonia?
PO doxycycline 200 mg on the first day then 100 mg once a day for 4 days (total course of 5 days)
