Respiratory Pathogens (Golgan) Flashcards
Rhinovirus
MCC of common cold
Transmitted by hand to eye-nose contact
Other causes of cold: coronaviruses, adenoviruses, influenza C, coxsackievirus
Coxsackievirus
Acute chest syndrome: fever and pleuritis
Parainfluenza
MCC of croup (laryngotracheobronchitis) in infants
Can cause bronchiolitis in infants
Rx: cold water humidifiers and aersolized racemic epinepherine
CMV
Common pneumonia in immunocompromised hosts.
Enlarged alveolar macrophages/pneumocytes, contain eosinophilic intranuclear inclusions surrounded by a halo
Rx: Cidofovir, foscarnet, ganciclovir
Common test scenario for:
Prophylaxis - Treat before exposure or sx
Pre-emptive - Treat if exposed (i.e. CMV virus identified) but now symptoms
Empiric - Treat the sx/disease before organism identified
Definitive - Treat the identified organism directly based on sensitivity.
Influenza virus
Type A virus are most often involved
Hemagglutinins bind virus to cell receptors in the nasal passages.
Neuraminidase dissolves mucus and facilitates the release of viral particles.
Inflenza A: worldwide epidemics; pneumonia may be complicated by a superimposed bacterial pneumonia (usually Staph. Aureus)
Influenza B: causes major outbreaks
Antigen Drift: Minor mutation; doesn’t require a new vaccine
Antigen Shift: Major mutation in hemagglutinin or neuraminidase; new vaccine required
Clinical Presentation: Fever, headache, cough, myalgias, chest pain
Vaccination: (all people!) Manadatory for >65 and w/ chronic illnesses
Rx: Oseltamivir (neuraminidase inhibitor)
Associations: Reye syndrome w/ salicylate injestion; Gullain-Barre
Rubeola
Fever, cough, conjunctivitis, and excessive nasal mucus production.
Koplik spots in the mouth precede the onset of the rash.
Warthin Finkedly multinucleated giant cells are a characteristic sign
Respiratory Synctial Virus (RSV)
MCC of pneumonia and bronciolitis (wheezing) in infants
Causes otitis media in older children
Hand washing and use of gloves prevents nosocomial outbreaks in nurseries.
Winter primarily
Rapid detection by nasopharyngeal wash.
Passive immunizations for high risk children.
SARS
First trasmitted to humans through contact w/ masked palm civets (China) and then human-to human contact through respiratory secretions (hospitals, families)
Develop severe respiratory infection
Rx: w/ viral detection by PCR assay or detection of antibodies
Children: no therapy or Vitamin A
Hantavirus pulmonary syndrome
Trasnmission: inhalation of urine/feces from deer mice (Peromyscus leukopus!) in SW US.
Pulmonary syndrome: ARDS, hemorrhage, renal failure
Dx: detect viral RNA in lung tissue
No Rx –> high mortality rate
Chlymydia pneumoniae
Second MCC of atypical pneumonia (esp. young adults)
Seroepidemiologic association w/ CAD
Rx: Doxy
Chlamydia trachomatis
Newborn pneumonia (passage through birth canal)
Afebrile, STACCATO cough, conjunctivitis, wheezing
Rx: erythromycin
Mycoplama pneumoinae
MCC of atypical pneumonia
Common in adolescents and military recruits (closed spaces)
Risk factor for Guillain-Barre
Insidious onset w/ low grade fever
Cold agglutinins in blood –> IgM
Complications: bullous myringitis, cold AHA
Rx: Macrolides
Coxiella burnetti
Usually transmitted without a vector
Contracted by dairy farmers, vets
Associated w/ birthing process of infected sheep, cattle, and goats, and handling of milk or excrement
Atypical pneumonia, myocarditis, granulomatous hepatitis
Rx: Doxy
Streptococcus pneumoniae
Gram positive lancet shaped diplococcus
MCC of typical community acquired pneumonia
Rapid onset, productive cough, signs of consolidations
Urine antigen test is an excellent screen
Rx: penicillin G; vancomycin +/- rifampin (if penicillin resistant)
Staph aureus
Gram positive cocci in clumps
Yellow sputum
Commonly superimposed on influenza or measles
Major lung pathogen in CF and IV drug users
Hemorrhagic pulmonary edema, abscess formation, and pneumatoceles (thin walled air-filled cysts that develop in the lung parenchyma, usually after a pneumonia)
Rx: Naf/Dic ; Vanco for MRSA
