Pneumonia Flashcards
Typical COmmunity acquired pneumonia
- Purulent sputum
- GN
- Lobar infiltrate
- S. Pneumo
- H. influ
- M. catarrhalis
- S. aureus (CA-MRSA)
*note that atypical pneumo is usually patchy/diffuse, with promin. cough
Atypical pneumonia
- Cough prominent +/- sputum
- GN - PMN, few org
- Patchy or diffuse infiltrate (not lobar)
- M. pneumo
- C. pneumo
- L. Pneumophila
Influenza, RSV, adenovirus
*note that typical pneumo usually has purulent sputum, and lobar infiltrate
Top 2 causes of pneumonia in neonates
- GBS
2. E. coli
Top 4 causes of pneumonia in children (4 wk-18yr)
- RSV
- Mycoplasma
- C. trachomatic
- C. pneumoniae
Top 4 causes of pneumonia in Adults (18-40)
- Mycoplasma
- C. pneumonia
- S. pneumo
*in children:
1. RSV
2. Mycoplasma
3. C. trachomatic
4. C. pneumoniae
In 40-65:
1. S. pneumo
2. H. influ
3. Anaerobes
4. Viruses
In elderly”
1. S pneumo
2. Anaerobes
3. H influ
4. GNR
Top 4 causes of pneumonia in adults (40-65)
- S. pneumo
- H. influ
- Anaerobes
- Viruses
- In 18-40yrs:
1. Mycoplasma
2. C. pneumonia
3. S. pneumo
Top 4 causes of pneumonia in elderly
- S pneumo
- Anaerobes
- H influ
- GNR
Pneumonia is the leading cause of what?
Death from infectious disease
- majority of deaths are in children
*pneumoniae kills more children than any other illness
Pneumoniae affects which part of the resp. tract?
Lower resp tract (below head/neck)
RSV
- what is it?
- Why is it imp?
- is it seasonal?
- Tx?
Respiratory syncytial virus (a paramyxovirus)
SS linearRNA virus
Most common cause of pneumonia in children (4 wk-18yr)
Seasonal (Dec-Apr)
Tx: oseltamavir
Why do smokers cough more in the morning?
Smoking inhibits cilia action.
Cilia wake up at night and try to clear it out.
How does S. pneumo bind in the lungs?
Binds to surface epithelium
Cho-P binds to PAF-R (platelet activ. factor)
Has pneumolysin that causes epithelial cell injury
CURB-65
Confusion
Uremia (BUN >7)
RR >30/min (12-16)
BP 65
If your score is >40, you get admitted to ICU for severe community acquired pneumonia (CAP)
Community acquire pneumo (CAP) 4 risk groups
and their tx
1. previous healthy
2. Outpts w/ co-morbidities or aspiration (prior ab)
3. Inpts not in ICU
4. ICU Pts
- previous healthy
- tx: macrolide, doxy - Outpts w/ co-morbidities or aspiration
- Resp FQ (Moxy, levo),
Macrolide + Amox/clav - Inpts not in ICU
- tx: Rsp FQ,
Macrolide + b-lactam (3rd gen Ceph) - ICU Pts
- tx: Resp FQ + 3rd gen ceph
or
Macrolide
Pneumo vaccine in adults
- When is it effective and not effective?
23-valent pneumococcal vaccine
- effective for bacteremia (get systemic ab in blood)
- NOT EFFECTIVE for pneumonia (no mucosal ab)
