Pulmonary Infections

Question 1

How is PCP diagnosed?

Answer 1

Cannot be cultured.
Grocott or immunofluorescence staining - BAL or sputum

Question 2

How is PCP treated?

Answer 2

Iv co-trimoxazole 120mg/kg/day 3 days
90mg/kg/day 18 days
Prednisolone 40mg

Question 3

What bacteria might colonise upper airways?

Answer 3

Pneumonia due to streptococcus pneumoniae, haemophilus influenzae, e.coli are due to microaspiration from the oropharynx - thus bacteria may colonise the upper airways

Bacterioides fragilis is an anaerobic bacterium found in upper airways and can result in infection in cases of macroaspiration.

Question 4

What is first line treatment of mycobacterium avium?

Answer 4

Rifampicin, ethambutol, clarithromycin (or azithromycin)

Amikacin or streptomycin in severe disease

Question 5

What is treatment of m.kanasii

Answer 5

Rifampicin, Ethambutol, isoniazid, clarithromycin

Question 6

What is treatment of m. abscessus

Answer 6

4 /12 IV amikacin/tigecyline / impipenem as well as oral