Pneumonia Flashcards
what is it
inflammation of one of both of lungs normally due to infection
what causes strep pneumoniae (community)
found worldwide - most common cause
what causes staph aureus (community)
recent flu, IV drug user
what causes mycoplasma pneumonia (community)
older kid, young adult
what causes legionella (community)
traveller - bad water
what causes gram negative enterobacteria (community)
alcoholic
what causes bordatella pertussis (community)
whooping cough / broncho pneumonia
what causes haemophilus influenzae (hospital)
atypical, nursery workers, COPD
what causes coxiella burnetti (hospital)
Q fever - sheep, goats, cattle, farm
what causes chlamydophilia pstaci (hospital)
pet birds
what causes klebsiella pneumoniae (hospital)
common in alcoholism, diabetes and chronic lung disease
what are other causes
viral (RSV, measles) aspiration fungal (aspergillus - chest infection become pneumonia) chlamydia pneumoniae (person to person) PCP (immunosuppressed patients)
what are the symptoms
cough dyspnoea tachypnoea fever rigors sweats pleuritic pain myalgia malaise arthralgia preceding UTI diarhhoea headache haemoptysis AF confusion sputum after 24 hours
what are the signs
fever rigors pleural rub cyanosis hypotension tachypnoea pleural effusion
what would be found upon examination
crepitations
dull percussion
consolidation
tactile vocal fremitus
what other tests are taken to diagnose it
serology
blood culture
CXR, ABC, FBC, U&Es, LFTs
sputum culture
what are severity markers
temp <35 or >40
cyanosis - PaCO2 <9
WBC - <4 or >30
multi lobar involvement
treatment is dependent on CURB65 score - what is this?
confusion - 1 point Urea >7 - 1 point BP<90 or <60 - 1 point RR <30 - 1 point Age >65
community acquired treatment with CURB65 score of 0-2 (mild)
amoxicillin 5 days
or doxycycline
or IV clarithromycin if NBM
community acquired treatment with CURB65 score of 3-5 (severe)
co-amoxicillin IV and doxycycline
allergic - IV levofloxacin
community acquired treatment if in ICU/HDU or NBM
co amoxiclav and clarithromycin
allergic - IV levofloxacin
hospital acquired treatment if severe
amoxicillin IV and metrondiazole and gentamicin
step down to co-trimoxazole and metrondiazole
allergic - IV co-trimoxazole and metrondiazole +/- gentamixin
hospital acquired treatment if non severe
PO amoxicillin and metrondiazole
what are complications
empyema
lung abscess
septicaemia
how do you prevent it
pneumonia and flu vaccine
smoking cessation
treat alcohol misuse
