Respiratory Tract Infection Flashcards
Most common cause of CA bacterial pneumonia?
Strep. pneumoniae
Most common cause of CA viral pneumonia?
influenza virus
Most common cause of hospital acquired pneumonia?
gram negative microbes (Klebsiella pneumoniae, E. coli, Enterobacter, Proteus, etc.)
How is CA pneumonia treated in an inpatient vs. outpatient setting?
- Inpatient: macrolide + beta-lactam
- Outpatient: macrolides or doxycycline + respiratory FQ if co-morbid illness or recent antibiotic therapy
What are the syndromes under the diagnosis of Upper Respiratory Tract Infection (URI)?
- Rhinitis
- Sinusitis
- Otitis
- Pharyngitis
- Laryngotracheitis
- Epiglottitis
- Bronchitis
The vast majority of URIs are [viral/bacterial].
viral and self-limited
synonymous with the “common cold”
infectious rhinitis
Most common cause of infectious rhinitis (common cold)?
Rhinovirus (however, no etiologic agent is identified in more than half of cases because the cause is not investigated, as knowing the cause will not change management)
What is the benefit to treating strep throat?
It prevents the severe potential complications (rheumatic fever and post-strep glomerulonephritis), but it does not change the course/duration of the pharyngitis itself.
Why is epiglottitis being seen less commonly?
because it is commonly due to H. flu, and infants are being immunized against H. flu
Recommended treatment for bronchitis?
Etiologic agents are most commonly viral, so antibiotics are NOT recommended. Treatment consists of supportive care (rest, fluids). Anti-tussives and cough syrups generally do not have much of an effect.
What are the 5 ways that pathogens can enter the lungs and cause pneumonia?
- direct inhalation
- aspiration of upper airway contents
- spread along mucous membranes
- hematogenous spread
- direct penetration (rare)
What are the clinical predisposing factors for pneumonia?
- old age
- underlying pulmonary disease
- smoking
- recent viral illness
- diabetes mellitus
- chronic kidney disease
- immunodeficiency
How do patients with CA bacterial pneumonia present?
fever, shaking chills, rusty colored sputum, dyspnea, and pleuritic chest pain
What is a commonly used score to predict mortality for community acquired pneumonia patients?
CURB-65 C=Confusion U=Uremia (BUN >19) R=RR >30 B=BP <90/60 65=65+ y/o
