Pneumonia Flashcards
What is pneumonia?
respiratory infection characterized by inflammation of the alveolar space and/or the interstitial tissue of the lungs
What are some causative organisms in community acquired pneumonia?
Streptococcus pneumoniae Haemophilus influenzae Staphylococcus aureus atypical pneumonias (e.g. Due to Mycoplasma pneumoniae) viruses
What are some causative organisms in hospital acquired pneumonia?
(Gram-negative pathogens)Pseudomonas aeruginosa, Enterobacteriaceae
Staphylococci (Staphylococcus aureus)
Streptococcus pneumoniae
What are the risk factors of pneumonia?
Old age
(Chronic diseases) cardiopulmonary conditions (e.g., bronchial asthma, COPD, heart failure); abnormalities of the airways (e.g., bronchiectasis, space-occupying lesions, cystic fibrosis)
Immunosuppression
Smoking
What are the clinical features of pneumonia?
Severe malaise
High fever and chills
Productive cough with purulent sputum (yellow-greenish)
(Auscultation) Crackles and decreased bronchial breath sounds
(Palpation + Percussion) Tactile fremitus, Dullness on percussion
How is pneumonia assessed in primary care?
(CRB65 criteria) Confusion (abbreviated mental test score <= 8/10)
Respiration rate >= 30/min
Blood pressure: systolic <= 90 mmHg and/or diastolic <= 60 mmHg
65 Aged >= 65 years
How is pneumonia diagnosed in hospitals?
(CURB65)Confusion (abbreviated mental test score <= 8/10)
Urea >7 mmol/L
Respiration rate >= 30/min
Blood pressure: systolic <= 90 mmHg and/or diastolic <= 60 mmHg
65 Aged >= 65 years
(Chest X-ray)
(For medium to high risk patients) blood and sputum cultures, pneumococcal and legionella urinary antigen tests
(CRP monitoring) Determine treatment response
What is the treatment for pneumonia?
(low-severity CAP) 5 day course of: amoxicillin is first-line
if penicillin allergic then use a macrolide or tetracycline
(high-severity CAP) 7-10 day course of: dual antibiotic therapy is recommended with amoxicillin and a macrolide
