Pneumonia Flashcards
Typical Pneumonia: common bugs
Strep pneumo H. Flu GAS Kleb M. Catarrhalis
Typical Pneumonia: onset?
Acute
Typical Pneumonia: SX
Fever, CHILLS, sweats, prod/nonproductive cough
Typical Pneumonia: Xray findings
lobar consolidations
Atypical Pneumonia: bugs
Mycoplasma
Chlamydia
Legionella
Atypical Pneumonia: onset?
Gradual, typically this is less serious
Atypical Pneumonia: Xray findings
diffuse interstitial infiltrates or patchy ground glass appearance
Atypical Pneumonia: Sx
fever, NO CHILLS, non-productive cough
What is the most deadly infectious disease in US?
CAP
What is the timing requirement that constitutes community acquired pneumonia from hospital acquired?
CAP- needs to be caused from outside of the hospital or withIN 48hrs of hospitalization
Hospital acquired- occurs more than 48 hours after admission to the hospital or other health care facility and excludes any infection present at the time of admissiont
What is the first line treatment for someone who has to be treated in the ICU for CAP?
Respiratory Flouroquinolone (Moxi-, Gemi- Levo- FLOXACIN)
What is the typical followup period after being treated for CAP?
about 6 weeks AFTER treatment
Hospital acquired PNA: SX
at least one: fever, leukocytosis and purulent sputum
Hospital acquired PNA: Xray findings
new or progressive opacity
Most common organisms in HAP
– Staphylococcus aureus (MSSA and MRSA)
– Pseudomonas aeruginosa
– Gram-negative rods including non-extended spectrum β-lactamase (ESBL) producing and ESBL-producing (Enterobacter species, Klebsiella pneumoniae, and Escherichia coli)
T/F: HAP is the leading cause of death due to infection with mortality rates ranging from 20% to 50%
TRUE
The most common cause of community-acquired pyogenic bacterial pneumonia is?
Strep Pneumo
Empiric tx for strep PNA as an OP? IP?
Outpatient: Amoxicillin
Inpatient: IV Pen G
complications of strep PNA?
empyema, endocarditis, pericarditis, meningitis
Who should get the pneumococcal vaccine?
– Patients at increased risk for developing severe pneumococcal disease (eg, asplenic patients, those with sickle cell disease)
– Chronic illnesses (eg, cardiopulmonary disease, alcoholism, renal disease, cancer)
– Persons OVER 65 years of age
– Elderly individuals with unknown immunization status should be immunized once
most common atypical PNA bug?
Mycoplasma
You see “ Red sputum currant jelly” you think?
Klebsiella
Pts PNA symptoms after being at a conference and staying in a hotel, you think?
Legionella!
Some who developed anaerobic PNA may have a predisposition to?
Aspiration
What are some findings of Anaerobic PNA?
poor dentition foul smelling sputum fever weight loss malaise
Do you treat viral PNA with ABX?
Heck no! You do some bed rest, pain management and antitussives
If you wanted to prescribe Zanamivir, when is the ideal timing for it?
You want to give antivirals within 48hrs of symptoms or else they are less effective after that window of time
Diagnostic evaluation for suspected nosocomial pneumonia includes:
blood cultures from at least 2 different sites!
T/F. You should wait until culture results are back before prescribing antibiotics for a nosocomial/hospital-acquired pneumonia.
FALSE - start empiric ASAP
Death from H1N1 is 4x greater in which race?
American Indians
