Pneumonia Flashcards
What is the definition of pneumonia
Inflammation of the lung parenchyma due to infection
What does the term pneumonitis mean
Inflammation caused by physical, chemical or allergic processes
Where are upper respiratory tract infections
Above the larynx
Where are lower respiratory tract infections
They affect the bronchial tree or the parenchyma
What pathogens usually cause URTIs
Viruses. They are often self-limiting and do not require treatment
What are the common pathogens that cause community acquired pneumonia
Streptococcus pneumonia - most common Mycoplasma pneumoniae Chlamydophila pneumonia Viruses (eg. influenza) Haemophilus influenzae Staph aureus Legionella pneumophila
What are the atypical organisms that cause pneumonia
MLC
Mycoplasma pneumoniae
Legionella pneumophila
Chlamydia pneumoniae
What is the definition of hospital acquired pneumonia
Pneumonia developing 48-72hrs after admission to hospital
What are the common pathogens that cause hospital acquired pneumonia
Gram -ve bacteria - most common
Staph aureus
Strep pneumoniae
Anaerobes - particularly in aspiration pneumonia
Who should receive pneumococcal vaccines
Patients >65 Immunocompromised patients - splenectomy, HIV, steroids COPD Heart disease Chronic kidney disease Chronic liver disease DM
How do you assess the severity of pneumonia
CURB-65 score
Confusion (AMTS less than or equal to 8) Urea >7mmol/L Resp rate >30 BP less than 90/60 65 years old
1 point for each feature present
How do you interpret the CURB-65 score
0-1 - likely suitable for home treatment
2 - Consider hospital treatment
3 or above - Manage in hospital as severe pneumonia - assess for ITU admission
How would a patient with pneumonia present
Cough with purulent sputum Fever Pleuritic pain SOB *Confusion - may be the only symptom in the elderly
Typical organisms - mostly cause chest symptoms
Atypical organisms - mostly cause constitutional symptoms
What might you expect to find on examination of a patient with pneumonia
Fever Raised resp rate Reduced chest expansion - on affected side Dull percussion Bronchial breathing Coarse crackles Increased vocal resonance
What organisms cause cavitation on CXR
TB
Staph
Klebsiella
