RRAPID Pneumonia Flashcards
Causative organisms of CAP? Most common? (4)
Step pneumonia: 40% H.influenza Staph.aureus Klebisella pneumoniae Morexella Catarrhalis
Atypical causative organisms? (3)
Mycoplasma Pneumonia
Legionella pneumophilia
Chylamdia pneumoniae
Which organism is particularly associated with high fever, rapid onset, pleuritic chest pain, rust coloured sputum and herpes labialis?
Streptococcus pneumonia
Which organism is particularly common in patients with COPD?
H.influenza
Which organism often occurs in patient following influenza infection?
Staph.aureus
Which organism is classically seen in alcoholics?
Klebsiella pneumoniae
Which organism often presents with a dry cough and atypical chest signs/x-ray finding
Mycoplasma pneumoniae
Presentation? (5)
Cough (productive/non-productive) SOB Fever Pleuritic chest pain Prodrome: coryzal symptoms Respiratory distress
Investigations? (5)
CXR ABG Bloods: FBC, U&E's, CRP, LFT's Blood/sputum cultures Urinanalysis (for legionella)
What is used to asses severity of pneumonia?
CURB-65
What does CURB-65 stand for?
Confusion <= 8 (GCS) Urea > 7mmol RR >= 30 BP =< 90 systolic or = <60 diastolic 65 (>=65 years old)
What does a CURB-65 score of > 3 mean?
Severe (inpatient)
What does a CURB-65 score of 2 mean?
inpatient or supervised outpatient
What does a CURB-65 score of 0-1 mean?
outpatient
Mx?
ABCDE O2 Fluids Analgesia Start empirical Antibiotics (review in 48 hrs) (5-7 days) (10 days in high risk patient)
Antibiotic Rx for low-moderate severity CAP?
Amoxicillin PO
Add doxycycline or clarithromycin (for patients admitted or atypical)
Antibiotic Rx for high severity CAP?
Co-amoxiclav IV + clarithromycin
OR
Cefotaxime/cefuroxime + clarithromycin
Plus Gentamicin if gram -ve bacilli
BNF guidlines:
Benzylpenicillin IV + clarithromycin
OR benzylpenicillin + doxycycline.
Antibiotic Rx for HAP < 5 days admission?
Co-amoxiclav or cefuroxime (5-10 day course)
Antibiotic Rx for HAP > 5 days admission?
Cefotaxime + metronidazole (5-10 day course)
