Specific Pneumonias and their characteristics

Question 1

which patients is pneumococcal pneumonia more common in ?

Answer 1

the elderly, alcoholics, post-splenectory, immunosuppressed and patients with chronic heart failure or pre-existing ung disease

Question 2

what are the clinical features of pneumococcal pneumonia?

Answer 2

Clinical

features: fever, pleurisy, herpes labialis. CXR shows lobar consolidation

Question 3

which patients is staphylococcal pneumonia more common in ?

Answer 3

can be in those who have had an influenza infection

in the young , elderly, IV drug users, patients with underlying disease e.g. leukemia, lymphoma, CF

Question 4

what are the clinical features of staphylococcal pneumonia

Answer 4

It causes a bilateral cavitating bronchopneumonia.

Question 5

who gets klebsiella pneumonia?

Answer 5

it is rare

occurs in the elderly, diabetics and alcoholics

Question 6

what are the clinical features of klebsiella pneumonia

Answer 6

Causes a cavitating pneumonia, particularly of the upper lobes, often drug resistant

Question 7

who may get pseudomonas ?

Answer 7

common pathogen in bronchiectasis and CF.

Also causes HAP, particularly on ITU or after surgery.

Question 8

what are the characteristic appearances of mycoplasma

Answer 8

occurs in epidemics about every 4yrs. It presents insidiously
with fl u-like symptoms (headache, myalgia, arthralgia) followed by a dry cough.
CXR: reticular-nodular shadowing or patchy consolidation often of 1 lower lobe, and
worse than signs suggest.

Question 9

how is the diagnosis for mycoplasma made?

Answer 9

by PCR ssputum or serology

Question 10

what are the complications of mycoplasma ?

Answer 10

Complications: skin rash , Stevens–Johnson syndrome, meningo encephalitis or myelitis;
Guillain–Barré syndrome.

Question 11

what are the symptoms of legionella ?

Answer 11

Flu-like

symptoms (fever, malaise, myalgia) precede a dry cough and dyspnoea

Question 12

what are the extra-pulmonary symptoms of legionella

Answer 12

anorexia, D&V, hepatitis, renal failure, confusion, and coma.

Question 13

what would a CXR for legionella show?

Answer 13

bi-basal consolidation

Question 14

what may blood tests show for legionella?

Answer 14

lymphopenia, hyponatraemia,

and deranged LFTS. Urinalysis may show haematuria

Question 15

how is the diagnosis for legionella made?

Answer 15

legionella urine antigen/culture

Question 16

what are common symptoms of chlamydophila pneumoniae?

Answer 16

pharyngitis, hoarseness, otitis, followed by pneumonia

Question 17

how is chlamydophila diagnosed?

Answer 17

chlamydophila complement fixation test, PCR invasive samples

Question 18

how do you get chlamydophila psittaci?

Answer 18

birds (typically parrots)

Question 19

what are symptoms of chlamydophila psittaci?

Answer 19

headache, fever dry cough, lethargy, arthalgia, anorexia, and D and V.

Question 20

what are the extra-pulmonary symptoms of chlamydophila pstittaci

Answer 20

they are legion but rare

• meningo-encephalitis
• infective endocarditis
• hepatitis
• nephritis
• rash
• splenomegaly

Question 21

what would a CXR for chlamydophila psittaci show?

Answer 21

patchy consolidation

Question 22

how is psittaci diagnosed?

Answer 22

chlamydophila serology

Question 23

which viruses can affect the lungs

Answer 23

commonest is influenza

• measles, CMV, varicella zoster

and many others

Question 24

what are the symptoms of PCP?

Answer 24

dry cough, exertional dyspnoea, decreased PaO2, fever and bilateral crepitations

Question 25

what would PCP show on a CXR?

Answer 25

normal or bilateral perihilar interstitial shadowing

Question 26

how is the diagnosis of PCP made?

Answer 26

visualization of the organism in induced sputum,

bronchoalveolar lavage, or in a lung biopsy specimen

Question 27

which people are more commonly affected by mycoplasma pneumonia

Answer 27

• children and young adults have the highest incidences

- also generally affects people with asthma

Question 28

what is chlamydia trachomatis?

Answer 28

an STI which can cause inflantile pneumonia

Question 29

what does chlamydia trachomatis present as?

Answer 29

conjunctivitis in the first weeks of life

Question 30

how is chlamydia trachomatis diagnosed?

Answer 30

by PCR on urine of mother or perinatal/ throat swabs of child

Question 31

what is coxiella burnetti?

Answer 31

uncommon, sporadic zoonosis that causes pneumonia and pyrexia of unknown origin (q-fever)

Question 32

what is a complication of coxiella burnetti?

Answer 32

culture negative endocarditis