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Micro > pneumonia > Flashcards

pneumonia Flashcards

1
Q

bacillus anthracis

A

G+ rod, boxcar, aerobic spore former, polypeptid capsule

wool sorters, animal hides

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2
Q

actinomyces israelii

A

G+ rod, thin, branching filaments with clubbed ends, facul. anaerobe, EC bac
chronic/necrotizing pneumo
poor oral hygiene, etOH/malnourish.

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3
Q

corynebacterium diphtheria

A

G+, Clubbed-shaped rod, EC

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4
Q

staphylococcus aureus

A

G+ cocci in clusters, B-hemolytic, facult. anaerobe coagulase&catalase positive, EC, sens. to noboviocin, gold-yellow, EC (can be facult. IC) opportunist
** #2 HCAP/HAP ** also CAP
chronic/necrotizing pneumo
IV drub abuse, hematogenous dissemination, antecedent viral inf (flu), inhib. of escalator/gag/swallow reflex

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5
Q

streptococcus pneumoniae

A

G+ cocci in chains, aerotolerant anaerobes, encapsulated lancet shaped diplococci, a hemolytic, EC, coag. neg
** #1 CAP ** also HCAP/HAP
antecedent viral infection (flu), elderly, SCD, asplenics

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6
Q

streptococcus pyrogenes

A

G+ cocci in chains, aerotolerant anaerobes, Group A strep (GAS), B hemolytic, EC
lack of M-protein specific opsonizing abs, antecedent viral infection (flu)

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7
Q

croup (laryngotracheobronchitis):

more commonly viral or bac?

A

viral:
PIV
RSV, influenza, adenovirus, rhinovirus

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8
Q

agents of viral-like croup

A

Mycoplasma spp.

Chlamydia spp.

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9
Q

secondary bacterial tracheitis orgs (primary croup)

A

S. aureus
S. pneumo
H. flu
M. catarahalis

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10
Q

bronchitis in neonates: bac or viral?

A 
BACTERIAL
Strep. agalactiea
Streptococcus agalactiae.
Escherichia coli
Klebsiella pneumoniae
Ureaplasma urealyticum and U. parvum
Chlamydia trachomatis
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11
Q

bronchitis in infants/young kids: bac or viral?

A 
VIRAL
RSV
hMPV
influenza
parinfluenzavirus
adenovirus
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12
Q

bronchitis in infants/young kids may less commonly be caused by..

A

BAC:

B. pertussis, Mycoplasma pneumoniae, Chlamydia pneumoniae

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13
Q

acute bronchitis in adults: bac or viral?

A

VIRAL
influenza, any RT agent (RSV, parainfluenza)
bac less common: M. pneumo, C. pneumo, B. pertussis

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14
Q

AE-CB pathogens

A

H. flu (NTHi)
Moraxella catarrhalis
Strep pneumo
viral agents: influenza, others

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15
Q

pertussis (tracheobronchitis)

A

Bordetella pertussis (EC)
others:
other Bordetella spp., adenovirus, hPIV, RSV, hMPV, M. pneumo, C. pneumo

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16
Q

influenza agent

A

influenza virus !

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17
Q

consolidation pneumonia orgs

A 
Streptococcus pneumoniae.
Staphylococcus aureus.
Haemophilus influenzae (Hib) and (NTHi)
Pseudomonas aeruginosa.
Klebsiella pneumoniae.
Other G- bac, e.g., E.coli.
Legionellosis: Legionella pneumophila and other spp.
Burkholderia cepacia, pseudomallei, mallei
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18
Q

atypical pneumonia: walking pneumo

A

Mycoplasma pneumoniae

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19
Q

atypical pneumo: Psittacosis

A

chlamydia psittaci

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20
Q

atypical pneumo: Legionellosis

A

Legionella pneumophila and other spp.

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21
Q

atypical pneumo: Q fever

A

Coxiella burnetti

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22
Q

atypical pneumo: PCP

A

pneumosystis jiroveci (aka pneumoxystis carinii)

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23
Q

atypical pneumo: cryptococcosis

A

cryptococcus neoformans

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24
Q

atypical pneumo: viral agents

A

RSV* (kids), PIV, hMPV, adenovirus, influenza* (A,B: adol/adult), hantavirus, rhinovirus, coronavirus, measles (kids), HSV-1, VZV (adults), CMV*
*pneumo in immunocompromised

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25
Q

chronic OR necrotizing pneumonia: TB

A

mycobacterium tuberculosis and bovis

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26
Q

chronic OR necrotizing pneumo: blastomycosis

A

blastomyces dermatitidis

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27
Q

chronic OR necrotizing pneumo: coccidioidomycosis

A

coccidioides immitis (and posadasii for necrotizing)

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28
Q

chronic OR necrotizing pneumo: histoplasmosis

A

histoplasma capsulatum

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29
Q

chronic OR necrotizing pneumo: nocardiosis

A

nocardia asteroides

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30
Q

chronic pneumo: others

A

abscesses +/- anaerobic bacteria
actinomyces israelii
brucella abortus, suis, melitensis

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31
Q

necrotizing pneumo

A 
Staphylococcus aureus.
Pseudomonas aeruginosa.
Klebsiella pneumoniae.
Other Gram-negative bacteria, e.g., Escherichia coli.
Abscesses + anaerobic bacteria.
Actinomyces israelii
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32
Q

necrotizing pneumo: aspegillosis

A

aspergillus fumigatus, niger, flavus

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33
Q

necrotizing pneumo: mucormycosis

A

absida spp.
mucor spp.
rhizormucor spp.
rhizopus spp.

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34
Q

other infectious diseases which may manifest pneumo

A

Cryptococcosis – Cryptococcus neoformans
Disseminated Mycobacterium avium and intracellular disease.
Pulmonary Anthrax: Bacillus anthracis.
Plague (pulmonary form): Yersinia pestis.
Tularemia: Francisella tularemia.
Complications of some viral diseases such as chicken pox, measles, CMV.
Vermis pneumonitis due to helminthes.
Pulmonary hydatid cysts, Cystic Echinococcosis – Echinococcus spp.
Malaria (Plasmodium vivax and ovale).
Chlamydia psittaci
Coxiella burnetii
Hantavirus
New World Arenavirus
Cryptococcus gattii.

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35
Q

pneumo complications

A

pneumo–>bacteremia–>distributive shock

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36
Q

pneumo complications: Guillain-Bare’s syndrome

A

mucosal infection by:

influenza virus, chlamydia spp.

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37
Q

CAP severity

A

6th leading COD in US

1/4 die w/in a year, (1/3 of >65)

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38
Q

most common way to get CAP?

agents

A

ASPIRATION
strep pneumo
klebsiella pneumo
oral anaerobes

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39
Q

CAP: aerosoled agents

A

M. tb, viruses, mycoplasma pneumo, chlamydia pneumo, fungi & legionella spp. from the environment

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40
Q

TYPICAL (lobar/consolidation) pneumo

A

extracellular bacteria or fungal
colonization of alveolar sac lining-PMN infil–>”white-out”
peripheral leukocytosis (el. WBC w/ band forms/left shift)

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41
Q

atypical (intersitial/patchy) pneumo

A

mycoplasma, chlamydia, viral, ureaplasma, legionella, pneumocystis
repl. in interstitium/lung parench.–>inflamm.–>”lacy”
mono/macro infil., leuko count normal or only bit elev.

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42
Q

chronic pneumo

A

anaerobes, M. tb, fungi, nocardiae, actinomycosis
(2-3 wks to mos)
pulmonary nodule (“coin-like”) OR abscess (PMNS) OR consolidation (lesions)
mono/macro infilt

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43
Q

what pneumonia has the highest severity?

A

VAP!

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44
Q

VAP agents

A 
S. aureus
S. pneumoniae.
H. influenzae.
P. aeruginosa.
Acinetobacter spp.
enteric bacteria
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45
Q

HCAP factors

A
  • hospital >48 hrs in last 3 mod
  • nursing home, etc. in last 3 mod
  • outpt infusion tx or home wound care
  • hospital-based clinic or chronic hemodialysis center last 30 days
  • fam mem w. MDR pathogen
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46
Q

CAP orgs

A

Streptococcus pneumoniae
Mycoplasma, Chlamydia, Viruses
Staphylococcus aureus
Klebsiella pneumoniae
Haemophilus influenzae
Legionella pneumophila
other G- rods, unID’d orgs

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47
Q

HCAP/HAP orgs

A

Klebsiella pneumoniae
Staphylococcus aureus
Pseudomonas aeruginosa
Acinetobacter sp
Legionella pneumophila
Streptococcus pneumoniae
other G- rods, unID’d orgs

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48
Q

aspergillus sp.

A

fungi (EUK), opportunistic, phagocytic mycose
T cell compromise, neutropenia, Fe overload
cause of necrotizing pneumo: Aspergillosis: A. fumigatus, niger, flavus

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49
Q

anaerobes (prim. oral NF)

A

poor oral hygiene, etOH/malnourish.

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50
Q

blastomyces dermatitidis

A

fungi (EUK)
chronic/necrotizing pneumo
exposure to contam. soil in Ohio-Miss. River Valleys (wtf?)

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51
Q

brucella spp.

A

chronic pneumo
exposure to inf. animals, animal tissues, blood, bodily fluids (poultry world, farmer, vet, pet store (cat, cattle, sheep, goats))

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52
Q

coccidioides immitis

A

fungi (EUK)
chronic/necrotizing pneumo; produce sporangia, systemic mycoses
exposure to contaminated soil SW US

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53
Q

chlamydia pneumoniae

A

Gram-negative Cell Wall Architecture – obligate intracellular bacteria/pathogen- pleomorphic – without peptidoglycan, unique growth cycle: elem. and reticulate bodies
** #2 for CAP! **
viral-like croup, bronchitis in neonates (less so infants/y. kids)
atypical (walking) pneumonia, closed pops,
increased exposure due to crowding

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54
Q

chlamydia psittaci

A

G- cell wall arch., ob IC bac

exposure to birds, poultry worker/farmer/vet/pet store worker

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55
Q

cryptococcus neoformans

A

fungi (EUK), systemic mycoses
atypical (walking) pneumo
lymphoma, AIDS

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56
Q

coxiella burnetti

A

atypical pneumo: Q fever
ob. IC bac
exposure to contam. soil/infectious dust, exposure to inf. animals, animal tissues, blood, bodily fluids (poultry world, farmer, vet, pet store (cat, cattle, sheep, goats))

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57
Q

francisella tularensis

A

rabbit exposure

Tularemia

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58
Q

hantavirus

A

viral agent of atypical pneumo

exposure to contam. soil/infect. dust, exp. to infected rodents, tissues, blood, bodily fluids, droppings

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59
Q

Hib

A

G- rod, EC
secondary bacterial tracheitis, second. bac pneumo in flu pt
#1 AE-CB (and COPD), consolidation pneumo, VAP, CAP
antecedent/current viral LRT infection (esp. influenza)

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60
Q

histoplasma capsulatum

A

fungi (EUK), systemic mycoses
chronic/necrotizing pneumo
exposure to contam. soil in North-Central US
exp. to bats, bird droppings

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61
Q

klebsiella pneumoniae

A

G- rod, EC, oxidase neg, facult. anaerobe, among * most imp. hosp. pathogens, NF, opportunistic, currant jelly sputum
** #1 HCAP/HAP **
necrotizing, consolidation pneumo, CRKP
etOH, elderly, SCD, asplenics

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62
Q

legionella pneumophila

A

G- rod, facult. IC
HAP/HCAP and CAP
consolidation, atypical pneumo (Legionellosis), MDR
exp. to aerosolized water

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63
Q

mycoplasma pneumoniae

A

Cell Wall-less pleomorphic bacteria (Not Gram-positive or negative, bacteria which lack peptidoglycan, have a cytoskeleton) (mollicute), EC(EIA/ELISA)
prod. ADP-ribosylating, vacuolating cytotoxin, manif. w/ rash
viral-like croup, bronchitis in infant/y. kids, acute bronchitis, mycoplasma encephalitis
atypical (walking) pneumo
inc. exp. due to crowding, IMMUNODEFICIENCY

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64
Q

mycobacterium tuberculosis

A

acid fast bacilli, strict aerobe, facult. IC
chronic/necrotizing pneumo (TB) MDR
foreign-born minority in US, HC worker, low income pop/malnourished, T cell compromise, AIDs

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65
Q

mucormycoses

A

fungi (Absida spp., Mucor spp., Rhizormucor spp., Rhizopus spp)- opportunistic, phagocytic
necrotizing pneumo
neutropenia, DM, Fe overload

66
Q

nocardia asteroides

A

acid fast bacilli, strict aerobe, EC
chronic/necrotizing pneumo
exp. to soil and cancer

67
Q

pneumocystis jiroveci

A

fungi, EC, prod. sporangias
atypical (PCP), T cell opportunist
T cell compromise, AIDS

68
Q

pseudomonas aeruginosa

A

G- rod, EC, may be encapsulated, motile, grows BOTH aerob. and anaerobically, non-fermenter, oxidase +
*ubiquitous habitat (environment) and NF (moist sites)
HCAP/HAP, CR/MDR
consolidation, necrotizing pneumo (rapid, fulminant)
blue-green sputum, fruity odor
neutropenia, CF, Ca, burn pts, COPD, equipment (biofilms)
rarely causes pneumo, but HIGHEST MORTALITY RATE

69
Q

ureaplasma urealyticum

A

Cell Wall-less pleomorphic bacteria (Not Gram-positive or negative, bacteria which lack peptidoglycan) EC
bronchitis in neonates, atypical(walking) pneumo
vaginal infection in gravid female/passage through infected vaginal canal

70
Q

RT viral etiology

A

inc. exp. due to crowding

71
Q

acute bacterial (typical lobar) pneumonia onset

A

sudden onset and rapid
progress with fever, chills, productive, mucopurulent cough and chest pains (Pleuritic chest pain is chest pain that worsens with breathing, causing a sharp pain in the chest during deep inhalation but may also be triggered by coughing), lobar presentation, tachycardia, tachypnea, leukocytosis

72
Q

atypical pneumo

A

subacute onset, milder than lobar. Interstitial pulmonary involvement on Chest x-ray, minimal or absence of the following: high fever, pleuritic chest pain, rigors, mucopurulent cough, leukocytosis. (e.g., walking pneumonia –Mycoplasma)

73
Q

chronic pneumo

A

subacute onset of weeks to months – a cause of fever of unknown origin, manifestations vary with etiology.

74
Q

sputum

A

> 25 neutrophils,

75
Q

urinary Ag tests for

A

Legionella pneumophila

Streptococcus pneumonia

76
Q

antiviral tx

A 
neuraminidase inhibitors (oseltamivir, zanamivir)-->influenza virus 
ribavirin-->RSV
77
Q

influenza pt abx?

A

NO! will predispose to pneumonia, give neuraminidase inhibs instead

78
Q

aspiration pneumo: ppx abx?

A

NO! will inc. risk of occurrence

79
Q

vaccines: dec. incidence of pneumo

A

Hib, pertussis, invasive pneumococcal (strep pneumo)

80
Q

pure polysaccharide vaccines

A

(pure B-cell Ag) type II, T-independent Ag

S-pneumo: pneumovax/pnu-immune (23-valent)

81
Q

T-dependent Ag vaccines: prevent LRT disease bronchitis and/or pneumonia

A

diphtheria, Hib, pertussis, flu, S. pneumo (Prenevar, 13-valent), measles, M.tb (not in US)

82
Q

S. pneumo is a sig. cause of

A 
pneumonia.
meningitis.
conjunctivitis, otitis media, sinusitis, mastoiditis.
bacteremia.
pericarditis.
peritonitis
83
Q

virulence factors of strep pneumo

A

capsular polysaccharide: anti-phago, 23 serotypes: 90%

pneumolysin: cytotoxin

84
Q

strep pneumo risk factors

A

viral infec.
loss of mucocil. elevator/cough/gag reflex–>aspiration
innate/acq immune system defect
smoking, etOH
SCD, acute chest syndrome
elderly w. unreg. DM, chronic heart/lung disease

85
Q

strep pneumo clin manifest

A

patchy infiltrates > consolidation
productive cough (“rusty” sputum)
single bout of rigors (chills) several hrs before other symps.

86
Q

strep pneumo comps

A 
usually NO abscesses, NO nec. pneumo/perm. lung damage
Bacteremia *in 1/3, doubles mort. rate!*
Meningitis.
Septic shock, DIC.
Hemolytic Uremic Syndrome (HUS).
Rhabdomyolysis.
87
Q

invasive pneumococcal disease (IPD)

A

in kids w/ chronic diseases: cancer, chronic renal disease, splenectomy, transplant; otherwise: frail kids w/ repeat hosp. contact

88
Q

strep pneumo dx

A

G+ a-hemolytic diplococci colonies; + (to dif. from NF)

  1. optochin susceptibility 2. bile/deoxycholate solubility
    • Quellung test
89
Q

strep pneumo tx

A

Penicillin

resistance: PNSP, DRSP, MDRSP, Vancomycin tolerance

90
Q

strep pneumo: vaccine?

A

PPSV Pneumovax, Pnu-immune: 23-valent polysacc. vaccine

Prevenar 13: conj. to diphtheria CRM-197 protein (all kids, prev. IPD)

91
Q

Pneumovax (23) cons

A

pure B-cell, TII, T-ind. Ag, no mem cells, short term, only IgM produced, not recomm. for

92
Q

necrotizing pneumonia orgs

perm. lung damage

A 
most commonly: anaerobes
S. aureus
P. aeruginosa
K. pneumoniae
M. tb
(not always necrotizing)
93
Q

necrotizing pneumo dx

A

HAP/HCAP
no initial s/s diffs btw typical pneumo, pt history
dx: abscess or cavitation w. CXR/CT scan
tx. aggressively!

94
Q

staph epidermidis

A

catalase-positive, *coagulase-negative (CoNS)

sensitive to novobiocin, gamma hemolytic, white

95
Q

staph saprophyticus

A

catalase-positive, *CoNS

novobiocin resistant, gamma hemolytic, white/yellow

96
Q

staphyloslide test

A

determines if bac has fibrinogen receptor and protein A; will agglutinate if staph aureus

97
Q

staph aureus virulence factors

A

coagulase: antiphago, promotes abscess formation
degrad. enzymes: nuclease
exotoxins: PVL (CAP MRSA): can lyse leukos–>necrosis
alpha-hemolysin: cytolytic (pneumo, skin/ST inf)
cell wall + teichoic acid polymer: shock prod.
quorum sensing: exotoxins prod–>spreading

98
Q

staph aureus: severity

A

Most common cause of skin and soft tissue infections and invasive infections acquired in hospitals in the US

99
Q

staph aureus: bacteremia/hematog. dissem to

A

pneumonia
endocarditis (A patient with two positive S. aureus blood
cultures has a 50% risk of Acute Infectious Endocarditis
[AIE] with a 100% mortality if not treated!!)
soft tissue abscesses
bone (osteolitis)
joint infections
(can occlude BVs–>necrosis–>painful black eschar (pyoderma, ecthyma gangrenous, P. aeruginosa)

100
Q

staph aureus primary infection

A

skin
pneumo (prim or sec)
bacteremia (prim or sec)

101
Q

staph aureus clin manifest

A
  • acute pneumonia +/- permanent lung damage, cavitation can occur with PVL production
  • chronic lung infections (abscess) with permanent lung damage
  • secondary bacteremia
102
Q

dx staph aureus

A

Cx, phage type to ID strains

103
Q

MSSA

A

abx-sens (RARE)
PCN-resistant (B-lactamase prod), sens to methicillin
actually oxacillin and nafcillin used, not methicillin

104
Q

MRSA

A

not via B-lactamase (may still be produced)
mutation of mec gene: mecA–>prod. resistant PBP2a
oxacillin, nafcillin used in abx susc. testing
**marker for resistance to other drugs (MDR)
mecR does NOT confer MDR to S. aureus

105
Q

MRSA hospital acquired infection (HAI)

A

HA-HOI or HA-COI

tx w. VANCOMYCIN (>50% are true MDR)

106
Q

community acq. infection: CAI-MRSA

A

resistant to B-lactam abx (PCN, oxacillin, cephalosporins)
sometimes others, typ. MDS can tx w. other abx, no need for vancomycin
exception: now CAI-MRSA (true MDR cases) are on the uprise; skin/ST inf. (less necrotizing) these strains are more virulent

107
Q

VISA (vanco intermediate resistant S. aureus) resist. mech

A

mutations in PBP genes
thickened PTG cell wall–>seq. vancomycin from PBPs
(NOT due to alt in pentapeptide side chain (like VRE)

108
Q

VRSA resist mech

A

alt in pentapeptide side chain (VREnterococci) via HGT

Linezolid for tx

109
Q

Burkholderia cepacia

A

G- rod, pseudomonad
consolidation pneumo, necrotizing pneumo
opportunistic pathogen: CF pts, HAI in immunecomp pts
complex (bcc)–>cepacia syndrome (bacteremia)

110
Q

Burkholderia cenocepacia

A

subcat. of B. cepacia, opportunistic MDR bac, damp/wet places, causes pneumo in CF pt–>cepacia syndrome

111
Q

Burkholderia pseudomallei

A

CAI in tropical regions

112
Q

Burkholderia mallei

A

stable, Glanders dis. in livestock, pot. human germ warfare agent

113
Q

P. aeruginosa pigment production

A

pyocyanin and 1-hydroxyphenazine: blue-green, iron siderophore, antiphago
pyoverden (fluorescein): yellow (wood’s lamp), iron siderophore

114
Q

P. aeruginosa virulence factors

A
  • pigments
  • exotoxins: Exotoxin A- heat labile, ADP-ribosyltransferase, like DT: inact of EF-2 (kills host cells), local and systemic disease
  • degrad. enz: proteases, elastases/alk proteases
  • mucoid exopolysacch/slime layer: in bronchial tree of CF pts–>biofilm formation, antiphago
  • quorum sensing: exotoxins prod, biofilm initiated-chr inf
115
Q

P. aeruginosa drug resistance/tx

A

-lim. perm of OM, abx efflux pump
CR/MDR PA: cephalosporins, cipro (FQ), imipenem, piperacillin
susc only to AMINOGLYCOSIDES (tobramycin) in combo tx
pts must be in resp. isolation

116
Q

Kleb pneumo virulence factor

A

polysacch capsule: antiphage, mucoid colony form, K1 and K2 serotypes most virulent

117
Q

Kleb pneumo 2nd to E. coli in nosocomial G- bac

A 
pneumonia (esp. HAI)
UTI (DM pts)
bacteremia-->meningitis (neonates)
*pyogenic liver abscess w/ comps of septic/pyog mening/endophthalmitis*
(50% immunecomp)
118
Q

kleb pneumo resist/tx

A

panresistant: KPC-1 (prod. carbapenemase): resistant to ALL!
CRKP: susc. only to cefepim, imipenem
pt must be placed in resp. isolation

119
Q

moraxella catarrhalis

A

G- diplococci (kidney bean) (flatten abbutting sides
resists destain, nonencap, ox +
no exotoxin prod, but produce B-lactamases
3rd for: OM, acute sinusitis, bac cause of AE-CB/COPD
*imp. agent of LRTI (tracheitis–>pneumonia) esp hosp. setting and immunosuppr.

120
Q

acinetobacter baumanii

A

G- coccobacilli (rod), non-motile, MacConkey agar, MDR (1/3) tx: CARBAPENEMS (shows some resist.)
VAP

121
Q

acinetobacter baumanii inf

A 
pneumonia
endocarditis
meningitis
peritonitis
osteomyelitis
endopthalmitis
urinary tract infections
skin and wound infections
122
Q

Bordatella pertussis

A

G- rod
LRT disease, bronchitis (kids/adults), pertussis pneumo
pertussis w/ second. bac pneumo

123
Q

atypical pneumo orgs

A

Mycoplasma pneumoniae
Ureaplasma urealyticum, U. parvum
Chlamydia pneumoniae, C. trachomatis

124
Q

hallmarks of atypical pneumo

A

subacute-slow progression over days (milder than lobar)
flu-like disease (no exudate/cerv lymph/coryza)
SOB OE, no rigors, sed rate/CRP often inc., “lacy” CXR
lymphocytosis if viral etiology, prolong. convalescence

125
Q

atypical pneumo tx

A

NOT tx w/ PCNs or cephs

126
Q

viral causes of atypical pneumo

A

RSV, parainfluenzavirus, adenovirus, human metapneumovirus, influenza virus

127
Q

bacterial pneumonia caused by G+ agents

A

strep pneumo and staph aureus

128
Q

necrotizing pneumonia caused by G+ agents

A

staph aureus

129
Q

necrotizing pneumonia caused by G- agents

A

pseudomonas aeruginosa
burkholderia cepacia, etc.
klebsiella pneumonia, k. oxytoca

130
Q

pneumonia caused by G- agents

A

moraxella catarrhalis
acinetobacter baumanii
Hib, NTHi, B. pertussis
Legionella pneumophila

131
Q

agents that cause atypical pneumonia

A

mycoplasma pneumoniae, chlamydia spp., ureaplasma spp.

viral agents

132
Q

why mycoplasma pneumo, u. urealyticum, u. parvum, m. haemofelis, m. spp. are not observed on Gs

A

they are mollicutes: proc. grp of smallest free-living cell orgs., smallest genome

133
Q

mycoplasma pneumonia seasonality

A

late summer, fall, early winter (july-jan) when other pneumos are less common!
(ureaplasma has no seasonality)
IMMUNODEFICIENCY

134
Q

comps of m. pneumo RT disease (esp. pneumo)

A

multiple organ involvement with increased mortality
immunodeficients (hypogam.glob.) may develop joint inf.
CNS-PNS infection (peds enceph)
induction/exacerb. of asthma

135
Q

m. pneumo tx

A

macrolides: erythromycin, azithromycin$$
tetracyclines
quinolones
(some ab resist)

136
Q

ureaplasma urealyticum produces

A

resp. inf. from perinatal period–>3 yo

chronic lung disease in premies

137
Q

u. urea manifest.

A

bronchiolitis, resp. distress (pneumo, ARDS)
neonate, infant, y. kid have cough and wheeze
dx. w/ throat/vag swab in special broth–>Cx

138
Q

u. urea txq

A

clarithromycin

139
Q

chlamydia spp. deets

A

slow growing, alt. btw 2 cell forms:
elementary body (EB, EC infectious form- inert)
reticulate body (RB, IC parasitic form- active)
forms large intracytoplasmic inclusions, not visible by Gs
lytic infection
C. psittaci (parrot fever), C. trachomatis (Tric), C. pneumo (TWAR)

140
Q

chlamydia spp. may cause

A

RT inf (bronchitis, pneumo), conjunctival inf (dev. countries), UG infections (#1 for STDs in US!)

141
Q

c. trachomatis (Tric) causes

A

cervicitis (STDs) in women, vert. transmission to child:
conjunctivitis, pneumo, both
rare agent of pneumo in adults

142
Q

c. pneumoniae (TWAR) causes in who

A 
human RT disease
adult males, reinfection in elderly (also mycoplasma)
smokers
coinfect. (50%) w/ 
strep pneumo
sycoplasma pneumo
legionella pneumophila 
influenza virus type A
143
Q

comps of c. pneumo

A

heart, CNS, septic arthritis, exacerbation of asthma, induction of asthma/atherosclerotic lesions?

144
Q

how to dx c. pneumo

A

microimmunofluroescent test (MIF) (EBs)
comp. fixation (CF), DFA/IFA, EIA (for c. LPS), PCR
CXR when appropriate, not vis. on Gs, Cx only spec. labs

145
Q

c. pneumo tx

A

macrolides: azithromycin$$, erythromycin

tetracyclines, doxycyclines

146
Q

viral pneumo

A

Influenza virus, RSV, adenovirus (Ad), PIV, hMPV, rhinoviruses, coronaviruses, measles, HSV-1, VZV, CMV

147
Q

viruses signif. in

A

cause 90%!

RSV causes 50%

148
Q

this virus is causes > 50% CAP (viral)

A

influenza virus A and B (esp. during influenza outbreak)

149
Q

70% of viral nosocomial viruses

A

Ad, influenza, PIV, RSV

150
Q

viral pneumo deets

A
  • multiply in up. airway epi–>inf. lung via secretions or blood
  • patchy/diffuse inflitrates, consolid., pleural eff (occasion.), hemorrhage, alveolar damage
  • cytopathic or inflammatory
  • cytokine production: Type 1: CMI, Type 2: allergic response
151
Q

viral pneumo deets

A

fever, chills, nonprod. cough, rhinitis/rhinorrhae–>sinus cong, ha, myalgias, body aches, fatigue, throat discomfort/pharyngitis, SOB
*most resolve w.in 2 weeks

152
Q

dx viral pneumo on clinical evidence?

A

NO, nearly impossible

153
Q

roentgenographic findings w. viral pneumo in kiddos

A 
hyperexpansion
parahilar peribronchial infiltrates
atelectasis
hilar adenopathy
*rarely seen: consolidated alveolar/diffuse interstitial infiltrates and large pleural effusions
154
Q

influenza virus tx

A

zanamirvir, oseltamivir

155
Q

RSV, PIV, Ad, hMPV tx

156
Q

HSV tx

157
Q

VZV tx

A

acyclovir and VZIG

158
Q

CMV tx

A

ganciclovir or foscarnet and IVIG

159
Q

measles tx

A

ribavirin and IVIG

160
Q

ppx viruses

A

vaccines for influenza, VZV, measles

Ig/MoAb for RSV

Micro (61 decks)

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