Pneumonia Flashcards
What is pneumonia?
A lower respiratory tract infection
How is pneumonia classified?
Community acquired pneumonia
Hospital acquired pneumonia
Aspiration pneumonia
What organisms can cause CAP?
Streptococcus pneumoniae
Haemophilus influenzae
Mycoplasma pneumoniae
Staph A
Legionella
What is HAP?
Occurs >48 hours of hospital admission
What organisms can cause HAP?
Enterobacteria
Staph A
Pseudomonas
Klebsiella
What causes aspiration pneumonia?
Infection caused by aspiration of fluid or food into respiratory tract
What side is aspiration more common in?
RIght - bronchi is more horizontal
What are the symptoms of pneumonia?
Fever
Rigors
Dyspnoea
Cough
What are the signs of pneumonia?
Confusion
Tachypnoea
Tachycardia
Fever
Signs of consolidation
- reduced percussion
- increased vocal resonance
How do you investigate suspected pneumonia?
Sputum sample
Bloods - FBC - U+Es - CRP Blood cultures
CXR
What would be seen on CXR?
Consolidation
+/- parapneumonic effusion
How do you asses the severity?
CURB-65
Confusion
Urea >7.0
RR >30
BP <90s or <60s
> 65
What is a CURB65 score of 0-1?
Treat at home
What is a CURB65 score of 2?
Hospital treatment
WHat is a CURB65 score of 3+?
Severe pneumonia - consider ITU
How is pneumonia managed?
Antibiotics
Oxygen
IV fluids
Analgesia
How is pneumonia followed up?
6 weeks follow up CXR to check to resolving
What are causes of non-resolving pneumonia?
CHAOS
Complication - empyema, lung abscess Host - immunocompromised Antibiotic - inadequate dose, wrong one Organism - resistant or unexpected Second diagnosis - PE, cancer
What are complications of pneumonia?
Type 1 respiratory failure Hypotension Atrial fibrillation Empyema Pleural effusion
