Pneumonia Flashcards
Define pneumonia.
Inflammation and fluid collection in the lungs due to infection.
What is the pathophysiology of pneumonia?
A microbe colonises the alveoli or bronchioles.
Give 3 common causative organisms of pneumonia.
gram +ve cocci: Strep pneumoniae (CAP, 90%), Staph aureus
gram -ve cocci/bacilli: H. Influenza. M. catarrhalis
Mycobacteria
Legionella - spain
Jirovecci -HIV
Influenza A virus
Give 3 risk factors for pneumonia.
Infants and elderly Chronic lung conditions eg COPD Immunocompromised (HIV/AIDS) Nursing home residents Impaired swallowing Diabetics/CV disease Heart failure Alcohol/drug abuse [pts]
Give 5 symptoms of pneumonia
Cough with sputum (purulent, green or rusty), rigors, pleuritic chest pain, dyspnoea, headache, malaise [pts]
Give 5 signs of pneumonia
Fever, tachycardia, bronchial breathing and crackles on auscultation, dullness to percussion, reduced air entry, pleural rub, tachypnoea, hypotension, confusion [pts]
How is pneumonia diagnosed?
Auscultation - bronchial breath sounds and crackles CXR shows consolidation (gold) Determine cause: Sputum and blood cultures Urinary antigen test for legionella Thoracentesis (pleural aspirate)
Describe the treatment of pneumonia
- Oxygen to maintain PaO2 >8kpa
- Treat hypotension and shock
- Antibiotics
- IV fluids if needed
- Paracetamol/NSAID for pain
- Ventilation if needed
CURB65 to indicate need for hospitalisation
Thromboprophylaxis - risk of venous thromboembolism
What are the indications for urgent hospitalisation for a patient with pneumonia?
Confusion Urea > 7 mmol/l RR >30 BP < 90 mmHg systolic or diastolic < 60 mmHg Age 65+ 2+= hospital 3+=urgent/ICU
What antibiotics would you give for pneumonia?
CAP amoxicillin, oral if mild, IV + clarithromycin if severe
Severe HAP may require tazosin
Legionella: fluoroquinolone + clarithromycin
