Respiratory Tract Infections Flashcards
What are the various forms of respiratory tract infections?
Upper Respiratory Tract Infections (URTI), Lower Respiratory Tract Infections (LRTI), lung abscess.
What is pneumonia?
An acute inflammation (usually infectious) of the lung parenchyma associated with symptoms of infection and infiltrate on chest radiograph.
What are the types of pneumonia based on pathogenesis?
Hematogenous, Aspiration, Inhalation.
What are the classifications of pneumonia?
Community-Acquired Pneumonia (CAP) and Hospital-Acquired Pneumonia (HAP), which includes Ventilator-Associated Pneumonia (VAP).
What are the characteristics of Community-Acquired Pneumonia (CAP)?
3-4 million cases/year, 10 million patient visits/year, 80% mild to moderate severity, 500,000 hospitalizations, and 45,000 deaths/year.
What are the risk factors for Community-Acquired Pneumonia (CAP)?
Smoking, alcohol use, obstructive lung disease, institutionalization, immunosuppression, age >65, dementia, malnutrition, neurological disease, IV drug use.
What are common bacterial causes of pneumonia?
Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Pseudomonas aeruginosa, Legionella pneumophila.
What are common viral causes of pneumonia?
Influenza A/B, RSV, adenovirus, parainfluenza, coronavirus.
What are common fungal causes of pneumonia?
Blastomycosis, Histoplasmosis, Coccidioidomycosis.
What are the symptoms of pneumonia?
Cough, fever, chills, rigors, pleuritic chest pain, dyspnea, sputum production, malaise, fatigue, hemoptysis.
What are the physical exam findings for pneumonia?
Fever, increased respiratory rate, cyanosis, tachycardia, bronchial breath sounds, crackles.
What are the CXR patterns for pneumonia?
Lobar pneumonia (bacterial), interstitial pneumonia (viral/mycoplasma), bronchopneumonia (Staphylococcus aureus, Pseudomonas sp.).
What laboratory tests are recommended for admitted pneumonia patients?
CBC, renal and liver function tests, blood and sputum cultures, urinary antigen for Legionella.
What is the treatment approach for Community-Acquired Pneumonia (CAP)?
Supportive care, antibiotic selection based on likely organisms and patient risk factors, improvement expected in 2-4 days.
What should be considered if treatment for pneumonia fails?
Polymicrobial infection, resistant organisms, necrotizing pneumonia, empyema, incorrect diagnosis.
What are the incidence and mortality rates for Hospital-Acquired Pneumonia (HAP) and Ventilator-Associated Pneumonia (VAP)?
Incidence: ~5-10 per 1,000 hospital admissions. Mortality: HAP 18.8%, VAP 29.3%.
What are the risk factors for HAP/VAP?
Chronic disease, prior antibiotic therapy, prolonged ventilation, head trauma, immunosuppression.
What is the empiric therapy for early-onset HAP/VAP?
Ceftriaxone, moxifloxacin, ciprofloxacin, ampicillin/sulbactam.
What is the empiric therapy for late-onset HAP/VAP?
Antipseudomonal cephalosporin (cefepime, ceftazidime), antipseudomonal carbapenem (imipenem, meropenem), + fluoroquinolone or aminoglycoside, + Linezolid or vancomycin for MRSA coverage.
What are the prevention strategies for pneumonia?
Smoking cessation and vaccination (Influenza, Pneumovax, Prevnar 20).
What is the summary of pneumonia?
CAP is a major cause of morbidity and mortality; HAP/VAP has higher mortality. Diagnosis is based on symptoms, physical exam, CXR, and labs. Treatment includes supportive care and empiric antibiotics tailored to risk factors.
