Pneumonia Flashcards
Chlamydia psittaci: Two states
Extracellular: infectious, elementary body
Intracellular: replicative
Chlamydia psittaci: Risk/exposure
Pets, poultry, pigeons Native birds o Lawn mowing
Chlamydia psittaci: Physical exam “clue”
> temperature/pulse dissociation > Headache
Drug-induced pneumonitis/pneumonia
Antibiotics: o INH o PAS o Sulfasalazine o Daptomycin CV: o Amiodarone o Flecainide Chemotherapy: o Bleomycin
Nitrofurantoin pneumonitis presentation . . .
May present like atypical pneumonia or interstitial fibrosis • Acute • Subacute (after 1 month) • Chronic
Legionella diagnostics
> Culture > Urinary Ag
Löffler’s syndrome
“PNA” + migratory pulmonary infiltrates + Peripheral eosinophilia
• Migration of parasites
Acute eosinophilic pneumonia Drugs association . . .
o Daptomycin
o Nitrofurantoin
o Minocycline
o Ampicillin
o Sulfonamides
NSAIDs
Phenytoin
Mycoplasma pneumoniae
Extra-pulmonary manifestations
Stevens-Johnson syndrome (SJS), E. multiforme
Hemolytic anemia
Hepatitis
CNS: encephalitis, meningitis
Possible Microbial Causes of Community-Acquired Pneumonia
Lung cavity infiltrates
Community-associated MRSA
Oral anaerobes,
Endemic fungal pathogens,
Mycobacterium tuberculosis,
Atypical mycobacteria
Possible Microbial Causes of Community-Acquired Pneumonia
Exposure to bat or bird droppings
Histoplasma capsulatum
Possible Microbial Causes of Community-Acquired Pneumonia
Exposure to birds
Chlamydophila psittaci (if poultry: avian influenza)
Possible Microbial Causes of Community-Acquired Pneumonia
Exposure to rabbits
Francisella tularensis
Possible Microbial Causes of Community-Acquired Pneumonia
Exposure to farm animals or parturient cats
Coxiella burnetii
Possible Microbial Causes of Community-Acquired Pneumonia
Hotel or cruise ship stay in previous 2 weeks
Legionella species
Possible Microbial Causes of Community-Acquired Pneumonia
Travel or residence in southwestern United States
Coccidioides species,
Hantavirus
Possible Microbial Causes of Community-Acquired Pneumonia
Bronchiectasis or cystic fibrosis
Burkholderia cepacia,
P. aeruginosa,
S. aureus
Possible Microbial Causes of Community-Acquired Pneumonia
Bioterrorism
Bacillus anthracis,
Yersinia pestis,
Francisella tularensis
Suppurative lymphadenitis + septic shock due to a Gram-negative bacillus . . .
Treatment . . .
Tularemia or plague.
TOC for tularemia or plague: streptomycin or gentamicin (or FQs)
Melioidosis, facts . . .
- Burkholderia pseudomallei, a facultative intracellular gram negative
- Southeast Asia and Northern Australia; soil/dust or water.
- described after near drowning, or after tsunamis.
- may be misidentified as B. cepacia, P. stutzeri, or other Pseudomonas species.
- Common Clx manif : skin lesions, pneumonia, and abscesses.
- acute, sub-acute or chronic course.
- Tx: Ceftazidime or imipenem.
