Respiratory - Pneumonia Flashcards
What is pneumonia?
Infection of lung tissue, causing inflammation in the alveolar space
How does pneumonia present?
- Cough (wet and productive)
- Higher fever
- Tachypnoea
- Tachycardia
- Increased work of breathing
- Lethargy
- Delirium
What are the signs of pneumonia?
Tachypnoea
Tachycardia
Hypoxia
Hypotension
Fever
Confusion
Bronchial breath sounds
Focal coarse crackles - air passing through sputum
Dullness to percussion- due to lung tissue collapse or consolidation
What causes bronchial breath sounds?
Consolidation of lung tissue around airway
What are the bacterial causes of pneumonia?
Steptococcus pneumoniae
Group A strep (streptococcus pyogenes)
Group B strep (pre-vaccinated infants, contracted during birth)
Staphylococcus aureus
Haemophilus influenzae (pre-vaccinated or unvaccianted children)
Mycoplasma pneumoniae
What are the typical CXR signs of staphylococcus aureus pneumonia?
Pneumatoceles (round air filled cavities)
Consolidation in multiple lobes
What are the viral causes of pneumonia?
Respiratory syncytial virus
Parainfluenza virus
Influenza virus
What investigations are used for pneumonia?
CXR- for diagnosis
Sputum cultures
Throat swabs for bacterial cultures and viral PCR
Capillary blood gas to assess for respiratory or metabolic acidosis
Serum lactate levels
How is pneumonia managed?
Amoxicillin
Add, erythromycin, clarithromycin or azithromycin (for atypical pneumonias)
Macrolides can be used as a monotherapy in penicillin allergy
IV antibiotics in sepsis or problem with absorption
Oxygen used to maintain sats over 92%
What tests should be done if a child has recurrent LRTIs?
FBC
CXR
Serum immunoglobulins
Test IgG to previous vaccines, some patients unable to convert IgM to IgG
Sweat test for CF
HIV test if mum’s status is unknown
What is immunoglobulin class-switch recombination deficiency?
Patient unable to convert IgM to IgG
Unable to form long-term immunity
