Pneumonias Flashcards
Viral Pneumonias bugs
Usually influenza virus
Also other viruses
Viral pneumonia presentation
Bilateral pneumonia Hemorrhage Edema Necrosis Serum antibodies
Influenza pneumonia meds
Influenza A-Amantadine Hydrochloride
Vaccination Strategies
Annual influenza
Pneumococcal every 6 yrs for elderly and immunicompromised
Community acquired pneumonias (CAP) bugs
Strep pneumo (most common) H-flu Staph Group A strep others
When to suspect H-flu in CAP
Elderly and underlying pulmonary dz
When to suspect Mycoplasma in CAP
School-aged children
college students
military recruits
CAP from alcohol abuse =?
Klebsiella
Also likes the upper lobes
Bloody, rust colored sputum =?
pneumococcal
Bloody, Currant jelly sputum =?
klebsiella
Green sputum =?
Pseudomonas
Also think shivering rigor and chills
Foul smelling sputum =?
Anaerobic bugs
Cavitary lesions and pleural effusions =?
H flu
Staph A
Anaerobic, TB
Where does TB like to colonize in the lungs?
The apices
obtain apical lordotic view
Hospital Acquired Pneumonia (HAP)
Leading cause of death due to nosocomial infxn
Occurs more than 48 hrs after admission
Common HAP bugs
Pseudomonas Staph A Enterobacter Klebsiella E-coli
Aspiration Pneumonia
Secondary to entrance of foreign materials or gastric contents
gram- rods
Fungal pneumonia
Uncommon
May occur in immunocompromised individuals
Typically the spores are inhaled
Where is coccidiomycosis common?
Southwest US
Parasitic Pneumonia
Enter body through skin or swallowed
Generally travel to lungs through blood
Most common parasites causing pneumonia
Toxoplasma gondii
Strongyloides
Ascariasis
Primary atypical pneumonia
Mycoplasmal Pneumonia
Walking pneumonia
Common in children and young adults
Where is histoplasmosis common?
mississippi river valey
Lobar pattern infiltrate =
S pneumo, Kleb, H Flu
Patchy infiltrate =
Atypicals, viral, legionella
Interstitial infiltrate =
VIral, legionella
Cavitary infiltrate =
anaerobes, kleb, TB, Staph. A
Large effusion
Staph, anaerobes, kleb
Abx of choice for outpatient pneumonia if healthy pt
Macrolide (Azithro, clarithro)
or
Doxycycline
Abx of choice for outpatient pneumonia in patient with comorbidities
Respiratory quinolone
or
Advanced macrolide
In-patient pneumonia mgmt
Respiratory flouroquinolone or
Advanced macrolide + beta lactam