Pneumonia (Community Acquired)

Question 1

What is SMART COP?

More sensitive than CURB-65
score of >/= 4 correlated with a 1/3 chance of requiring intensive respiratory or vasoactive support

Answer 1

S – systolic BP < 90mmHg
M – multilobe infiltrate
A – albumin < 35g/L
R – RR (age adjusted < 50yrs >25/min, > 50yrs >30/min)
T – tachycardia > 125/min
C – confusion (acute onset)
O – oxygenation (age adjusted: SpO2 < 93%, PaO2 < 70mmHg, PF < 333mmHg)
P – pH < 7.35

• Respiratory rate >30/min,
• Systolic blood pressure <90 mmHg,
• SaO2 <92%
• Acute confusion
• Multi-lobar involvement on chest X-ray
• pH <7.35

Question 2

1. What is the most common causes of CAP in adults?

2. Other important causes

Answer 2

1. S.pneumonia.
2. Mycoplasma pneumonia
   Chlamydophila (Chlamydia) pneumoniae
   Legionellaspecies.
   H.influenzae (causes less than 5% of CAP)

(Ref etg)

Question 3

causative agents in immunocomprimised patients?

Answer 3

M. Cattarahlis
Klebsiella
Strep pneumoniae –> septic shock
(Ref etg)

Question 4

When should patients be reviewed

Answer 4

24 to 48 hrs

Infectious Diseases check 2014

Question 5

Complications?

Answer 5

Empyema
Parapneumonic effusion
Abscess
Metastatic infection
Nosocomial superinfection
Cavitation
(Infectious Diseases check 2014)