Pneumonia Flashcards
What is pneumonia?
An acute lower RTI associated with fever, chest signs, and CXR abnormalities.
What is pneumonia presentation?
Fever, cough with purulent sputum, pleuritic chest pain.
Pyrexia, confusion, tachypnoea, tachycardia.
What are the typical causes of pneumonia?
Strep pneumoniae: most common
Haemophilus influenzae: more in older people with underlying lung disease.
Moraxella catharralis: more in people with underlying lung disease.
What are the atypical causes of pneumonia?
Legionella pneumoniae: found in water.
Mycoplasma pneumoniae
What is the presentation of typical pneumonia?
Chest symptoms mostly.
Examination shows dull percussion, coarse crepitations, and increased vocal resonance due to consolidation.
What is the presentation of atypical pneumonia?
More non-specific symptoms e.g. headache, fever, fatigue.
What is a complication of atypical pneumonia? e.g. mycoplasma
Cold AIHA, GB syndrome, reactive arthritis, erythema multiforme.
How is mycoplasma pneumonia diagnosed?
PCR or serology.
How is mycoplasma pneumonia treated?
Macrolides
Doxycyline
Quinolones
What are risk factors for pneumonia?
Underlying lung disease
immunosuppression
What investigations in suspected pneumonia?
FBC: see if WCC is raised
U+Es
O2 sats
Culture blood and sputum
For suspected legionella, test for urine antigen by PCR
CXR
What is treatment of non-severe CAP?
Amoxicillin (oral)
What is treatment of severe CAP?
Clarithromycin plus amoxicillin or co-amoxiclav (IV)
What other infections can legionella cause?
Pontiac fever: acute, self limiting illness with non-specific symptoms
Extrapulmonary: a complication of pneumonia seen in immunocompromised. Causes abscesses, septic arthritis, meningitis, pericarditis etc.
