Streptococcus pneumoniae

Question 1

Strep pneumoniae is most common cause of?

Answer 1

MOPS- meningitis (adults), otitis media (kids), pneumonia, sinusitis. MOPS are also Most OPtochin Sensitive

Question 2

List the virulence factors

Answer 2

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Polysaccharide, Pneumolysin, Hyaluronidase, Neuraminidase, Pili, Peptidoglycan/Teichoic acid, Choline binding protein, Competence protein, Autolysin, Lipoproteins

Question 3

Micro?

Answer 3

Lancet shaped diplococcus

Question 4

Epidemiology?

Answer 4

Children & elderly; transmitted by close contact

Question 5

MOA of disease?

Answer 5

1. Bypasses respiratory pathway defenses
2. Colonize and replicate in alveoli –> leaky alveolar capillaries –> inflammation & iron comes in as food source for bug
3. PNMs/complement cant kill bug cuz it is capsulated –> increased inflammation –> consolidation –> suffocation

Question 6

Symptoms?

Answer 6

cough, fever, shaking, chills, sweat, SOB, pleuritic chest pain. Also, crackles, increased TF, rust colored sputum.
CXR shows diffuse infiltrates in one lobe

Question 7

Diagnosis?

Answer 7

Sputum sample- should have decreased squamous epithelium

Gram stain- gram +, lancet shaped diplococci with increased PNMs

Question 8

Tx?

Answer 8

Outpatient: AQMD= Amoxicillin, quinolone, macrolide, doxycycline
Inpatient: CAP= ceftrixone, ampicillin, penicillin
If resistant, give B-LACTAM AND MACROLIDE

Question 9

Risk factors for getting strep pneumo?

Answer 9

Asplenia, immunocompromised, defects of complement or antibodies, diabetes, lung dz, CHF, alcohol, smoking, prior URI

Question 10

Major concern for complication?

Answer 10

Sepsis!!

Question 11

2 major tests for strep pneumo?

Answer 11

Quelling rxn & optochin sensitivity

Question 12

4 lab tests to ID strep pneumo?

Answer 12

1. alpha hemolysis on BAP
2. Catalase -
3. Optochin sensitive
4. Bile salts sensitive

Question 13

Prevention of pneumonia via what 2 vaccines?

Answer 13

Pneumovax, Prevnar 13