Pulmonary 3 Flashcards
MC in 6 mo to 6 year old. Caused by parainfluenza virus Seal-like barking cough inspiratory stridor and hoarseness. Subglottic narrowing. *
Laryngotracheitis (Croup)
*Steeple sign.
What is the treatment of Croup?
Supportive
If moderate: Dexamethasone and or nebulized Epi.
If severe: Above plus hospitalization.
MC caused by CAP.
Chills and rigors, fever productive cough, blood-tinged (rusty) sputum.
Gram-positive diplococci
Strep pneumoniae
Pneumonia organism seen in extremes of ages (<6 y, and elderly, immunocompromised, underlying pulmonary disease, COPD, bronchiectasis, CF.
Gram negative rod.
H. influenzae
MC cause of atypical walking pneumonia.
RF of young and healthy patients.
Reticulonodular pattern most common on CXR.
Mycoplasma pneumoniae
This is an aerobic pleomorphic intracellular gram -negative bacterium that causes outbreaks related to contaminated water sources such as cool towers and ventilation systems.
GI symptoms of prominent diarrhea, hyponatremia, and increased LFT’s. Neuro symptoms of Headache, confusion, alt mental status.
Legionella pneumophila
What is the TX for legionella pneumophila?
Macrolides or levofloxacin
Caused by anaerobes.
MC in right lower lobe, foul-smelling sputum “rotten egg” smell.
Aspiration pneumonia
What is the TX for aspiration pneumonia?
Ampicillin-Sulbactam or Amoxicillin-clavulanate
Inhalation of soil containing bird and bat droppings in the Mississippi and Ohio river valleys.
Seen in demolition, spelunkers, or excavators.
Histoplasmosis
What is the treatment for mild-moderate histoplasmosis?
Itraconazole
If severe, amphotericin B.
What is CD4 count risk factor for pneumocystis pneumonia?
CD4+ < 200
Diffuse bilateral interstitial infiltrates.
Increased LDH
Pneumocystis pneumonia
Tx for pneumocystis pneumonia?
Trimethoprim-sulfamethoxazole x 21 days
If HIV+ add prednisone if hypoxic.
