pneumonia Flashcards
what is the incidence of pneumonia?
11/1000
what is the rate of mortality in pneumonia?
10%
what are the different types of causes of pneumonia?
- HAP
- CAP
- aspiration of orophargeal anaerobes eg/ oesophagitis, loss of conciousness
- immunocomprimised patients- pnuemocystis jirovecii/ AIDS
which organisms are causative of CAP?
- strep pnuemoniae
- haemophilis influenza
- mycoplasma pnuemoniae
less commonly: morexella catarrhalis
legionella, staph A
what organisms are most causative of HAP?
- s aureus most commonly
- klebsiella
- psuedomonas
- clostridia
- bateriodes
what is the pathophysiology of pneumonia?
the organisms infiltrate the liver parenchyma
this causes acute inflammatory response causing the release of neutrophils and macrophages round the alveoli and terminal bronchioles
they release cytokines and cause oedema and exudates which cause the consolidation
the exudate then turns into fibrinous debris which is then digested by enzymes
this is then coughed up as sputum
what is bronchopnuemonia?
diffuse pneumonia that affects the lobules of the lungs and the bronichioles
what are the most common symptoms of pneumonia?
- cough (with sputum later)
- dyspnoea
- fever
what other symptoms can be experienced
- malaise
- pleuritic chest pain
- rigors
what colour is the sputum?
- green/ rusty/ with blood, foul smelling
which features indicate severe pneumonia?
- confusion
- cyanosis
- resp distress
what signs are seen in pneumonia?
- reduced breath sounds/ resonance where consolidation/ percussion
- bronchial breathing
- pleural rub
- crackles
- also hypotensive/ tachycardic/ cyanosis/ raised temp
what investigations can be done?
CXR
- bloods- raised CRP/ESR/WBC
- could also do sputum sample
what is the CURB65 score and what do they mean?
Confusion Urea raised R esp rate higher than 30 Blood pressure low 90/60 65 over 65
1 - home treatment
2- hospital,
3- severe
what is the treatment for mild CAP?
- amoxicillin
- clarithromycin
