pul infections w. gram- bacteria

Question 0

klebsiella (OI) and enterobacter (10% OF NOSOCOMIAL ACQ INF….PNA, UTI, BILIARY AND SURGICAL WOUNDS)

Answer 0

-short, encapped, gram-rod, INHALATION –> pul parenchyma consolidated and alv fills with exudate of microphage, fibrin, edema fluid. alv walls–>necrosis. abscesses may coalesce –> CAVITATION
-RF: obst pul dz, endotracheal tubes, indwelling catheters, IC;;2ary pna caused may complicate influenza or other resp viral inf.
SX: THICK MUCOID SPUTUM, sudden PNA, fever, PLEURITIC PAIN, COUGH. if severe: SOB, CYANOSIS, DEATH w/i 2-3d,
TX: aggressive Ab

Question 1

5 gram-bacteria that causes pul infections? (all gram-rods)

Answer 1

1. klebsiella
2. enterobacter
3. leginella
4. pseudomonas aeruginosa
5. melioidosis

Question 2

legionella

Answer 2

-RFs: smokers, ROH, lung dz
-caused by INHALED legionella pneumophilia (X in phagosomes of macrophages) thats normally in moist areas (fresh H2O, H2O heaters, humidifiers)–> PNA (mild/threatening), pontiac fever (NOOOOOO pul consolidation)
-SX: fever, DRY COUGH, myalgia, CXR: diffuse unilateral patchy consolidation/widespread consolidation
TX: macrolide ab

Question 3

pseudomonas aeruginosa

Answer 3

-has proteoglycan, elastase, endotoxin, exotoxin. HIGHLY AB-RESISTANT OI
hospital: PNA, WOUND INF, URINARY TRACT DZ, SEPSIS
RF: burns, catheters, diabetes, neutropenia
SX: ECTHYMA GANGRENOSUM - skin nodular necrotic lesions (disseminated organism)

Question 4

melioides = rangoon beggers dz

Answer 4

-caused by burkholderio pseudomallei (rice paddies), marshes (skin), INHALE contaminated dust, aerosolized droplets
-incub period months-yrs
ACUTE MELIOIDOSIS: pul infection (mild tracheobronchitis to cavitary pna), fever, constitutional sx, cough (?blood), diarrhea (?cholera), septicemia, shock, coma despite ab sometimes
-septicemic melioidosis –> discrete abscesses in lungs, liver, spleen, LN
CHRONIC MELIOIDOSIS: persistent localized inf of lungs, skin, bones, others, (suppurative/granulomatous abscess (lungs–>mistake for TB)