Pneumonia Flashcards
Causes of CAP and most common
Strep pneumonia - most common
Mycoplasma, haemophilus
S. aureus
Causes of atypical CAP
Legionella, chlamydia, pneumocystois
Cause of pneumonia in COPD/immunocompromised (and what is most common cause)
Haemophilus - most common
Moraxella catarrhalis (infective exacerbation not pneumonia)
Strep pneumonia, mycoplasma, staph aureus
Causes of pneumonia in CF
Early - S. aureus
Chronic - Pseudomonas, Burkholderia
Points on CURB65
Confusion - AMT less than/= to 8
Urea >7
RR >30/min
BP -
Mx based on CURB65
0-1 - home
2 - hospital
Over/=3 - consider ITU
Causes of HAP
Gram -ve enterobaceria
S. aureus
Mx in mild, moderate and severe
Mild - Amoxicillin/clarithro (PenA: clarith)
Mod - Amox + clarith
Severe - Co-amox/cef + clarith
COPD + infective exacerbation Mx
Amoxicillin
Mx mild and severe HAP
Mild - Co-amox
Severe - Tazocin +/- vanc +/- gent
Mx aspiration pneumonia
Co-amox 625mg PO TDS
Pneumococcal pneumonia risk factors
Elderly, alcoholic, post-splenectomy
Pneumococcal pneumonia CXR, extra pulmonary, sputum
CXR - lobar consolidation
Extra pulmonary - herpes labialis, urinary antigen
Sputum - Rusty/blood sputum
Staph pneumonia risk factor, CXR, treat
Risk factor - Post influenza, IVDU
CXR - bilateral cavitating bronchopneumonia
Treat - fluclox/vanc
Treat pneumococcal pneumonia
Amox/benpen/ceph
Klebsiella risk factor, CXR, features, treat
Risk factor - alcoholics
CXR - cavitating upper lobes
Features - abscess, aspiration pneumonia
Treat - Cefotaxime
Mycoplasma pneumonia pulmonary features
Reticulo-nodular shadowy/pathcy consolidation
Dry cough
Mycoplasma pneumonia extrapulmonary features
Flue like prodrome (headache) Cold agglutins --> AIHA Bullous myringits Cryoglobulin Erythema multiforme SJS, GBS, hepatitis
Mycoplasma diagnose and treat
Serology/urinary antigens
Clari/doxy/fluroquinolone
Legionella pulmonary features
Dry cough, dyspnoea, bi-basal consolidation
Legionella extra pulmonary
Flu like prodome
Anorexia, D&V
Hepatitis, renal failure
SIADH –> low Na –> confusion
Legionella diagnose and treat
Lymphopenia, low Na, deranged LFTs
Urinary antigen or serology
Treat - clari +/- rifampicin
Chlamydia pneumonia features, diagnose, treat
Pharyngitis, sinus pain,
Dx - serology
Treat - clari
Chlamydia psittaci risk factor, pulmonary features, diagnose and treat
Parrots
Dry cough, patchy consolidation
Diagnose - serology
Treat - Clari
Chlamydia psittaci extra-pulmonary features
Rose spots, spenomegaly, epistaxis, hepatitis, nephritis, meningo-encephalitis
PCP features and CXR
Dry cough, exertional dyspnoea, bilateral crep
CXR - normal/bilateral peri-hilar interstitial shadowing
PCP diagnose and treat
Dx - visualise from BAL, sputum, biopsy
Treat - Co-trimazole or pentamidine
