pneumonia Flashcards
aetiology
community acquired hospital acquired atypical immunocompromised aspiration recurrent
what types of organisms cause pneumonia
strep pneumoniae - 36%
H influenzae - 10.2%
legionella ssp
mycoplasma pneumoniae
staph aureus
viral viruses - 13.1%
pathology
acute lower resp tract infection affecting he lung parenchyma
what happens in bronchopneumonia
diffuse throughout lung
bugs in bronchioles = inflammation = patches of pus
patchy opacification on CXR
what happens in segmental/lobar pneumonia
pneumonia in specific lobe of the lung
localised opacification on CXR
symptoms
malaise fever pleuritic chest pain cough purulent sputum duspnoea
signs
tachypnoea tachycardia central cyanosis dullness on percussion of affected lobes bronchial breath sounds inspiratory crackles increased vocal resonance decreased chest expansion
tests
U&E - CRP - LFT - FBC - ABG CXR (Shadowing/Consolidation) Blood Cultures Throat Swab Urinary Legionella Antigen Sputum microscopy/culture
CURB 65
what are the different aspects of CURB 65
C - confusion U - Blood Urea>7mmol/L R - Resp. Rate > 30 B - BP Diastolic < 60 or Systolic < 90 65 - Age > 65
what is the scoring for CURB 65
0 = Low risk, treated in community 1-2 = Hospital Treatment 3-5 = High death risk/ITU
what is the management of pneumonia
Antibiotics - based on CURB65 score
Add Flucloxacillin if Staph Aureus & Vancomycin if MRSA
IV Fluids
O2
Continuous Positive Airway Pressure (CPAP)
Intubation/Ventilation
Analgesia if pleurisy causing pain (e.g. paracetamol)
what are the specific antibiotics for the different CURB65 scores
0-1 = Amoxicillin or Clarithromycin/Doxycycline
2 = Amoxicillin and Clarithromycin/Levofloxacin
3-5 = Co-Amoxiclav and Clarithromycin/Levofloxacin
(Levofloxacin if penicillin allergic)
Add Flucloxacillin if Staph Aureus & Vancomycin if MRSA
what are the Dx for pneumonia
TB lung cancer PE cardiac failure pulmonary vasculitis
what are the possible outcomes of pneumonia
Resolves
Pleurisy/effusion/empyema
Organisation & scarring (cryptogenic organising pneumonia)
Lung Abscess (painful collection of pus under pressure in the lung)
Bronchiectasis (infection & scarring leads to abnormal dilated airways)
what are the complications of pneumonia
septicaemia acute kidney injury empyema lung abscess haemolytic anaemia ARDS
