Pneumonia Flashcards
Pneumococcal
Commonest bacterial pneumonia, affects all. Fever, pleurisy, herpes labialis. CXR shows lobar consolidation. Amoxicillin, Penicillin G or Cephalosporins.
Staphylococcal
May complicate H. Influenza infection, occurs in IVDU/patients with underlying disease. Causes bilateral cavitating bronchopneumonia. Flucloxicillin, if MRSA suspected add Vancomycin.
Klebsiella
Rare, occurs in elderly/alcoholics. Upper lobe cavitation, often drug resistant. Cefotaxime or Imipenem.
Pseudomonas
Common in bronchiectasis and CF, also causes HAP. Anti-pseudomonal penicillin, Cerftazidime, Meropenum or Ciprofloxacin + an aminoglycoside.
Mycoplasma Pneumoniae
Occurs in epidemics every 4 years. Flu-like symptoms followed by dry cough. Complications include skin rash, myelitis, Guillian-Barre syndrome. CXR shows reticular-nodular shadowing 1 lower lobe. Clarithromycin, Tetracycline or Fluroquinolone.
Legionella Pneumophilia
Colonises water tanks/AC. Flu-like symptoms precede dry cough and SOB. Anorexia, GI complications, hepatitis, renal failure, confusion, deranged LFT’s. Clarithromycin + Rifampicin or Fluroquinolone.
Chlamydophila Pneumoniae
Most common chlamydial infection. Pharyngitis, hoarseness, otitis. Tetracycline or Clarithromycin.
Chlamydophila Psittaci
Causes psittacosis, acquired from birds. Headache, fever, dry cough, lethargy, GI complications. Can cause infective endocarditis, hepatitis, rash, splenomegaly. CXR patchy consolidation. Tetracycline or Clarithromycin.
Viral Pneumonia
Commonly caused by H. Influenza but also measles, CMV and varicella zoster. Typical in COPD patients. Ciprofloxacin and Co-Amoxiclav, prophylactic Oseltamivir.
Pneumocystis Pneumonia (PCP)
Common in immunosuppressed individuals. Dry cough, SOB, fever, bilateral crepitations. CXR could be normal or show bilateral perihilar shadowing. High dose Co-Trimoxazole or Pentamidine. Steroids are beneficial in severe hypoxaemia.
