Typical Pneumonia

Question 1

Pneumonia defn

Answer 1

Inflammatory condition affecting the alveoli

Question 2

What agents can cause pneumonia?

Answer 2

Viruses, bacteria (Strep pneumonia, H influenzae, and less typical ones), fungi (endemic), and [parasites]

Question 3

What can S pneumoniae cause?

Answer 3

Most common cause of pneumonia, also causes otitis media, sinusitis, bacteremia and meningitis

Question 4

Description of S pneumoniae bacteria?

Answer 4

Gram positive cocci in pairs or short chains. Capsule is huge! 95 types - immunity issue. IgA protease; Adhesins; Extracellular products (Pneumolysin, hyaluronidase, Dnases).

Question 5

Carriers of S pneumoniae

Answer 5

Many people have it naturally in nasopharynx.

Question 6

Common symptoms of S pneumoniae in lungs

Answer 6

High resp rate, lower O2 sats, fever, chest pain, rusty sputum

Question 7

What should you do with someone who presents with what looks like a chest infection?

Answer 7

O2, IV fluids, CBC, chest Xray, Sputum and blood cultures, and antibiotics

Question 8

How does S. pneumoniae cause crackles and X ray findings?

Answer 8

binds with adhesins; Capsule is antiphagocytic, prevents opsonization. Causes inflammatory response, fluid increases in lung: great place for growth and move around

Question 9

After S pneumoniae binding and fluid coming into lung, what happens?

Answer 9

Damage endothelium - RBC enter alveoli (cause rusty sputum); 4. WBC and fibrin accumulate, normally air filled areas become “consolidated”; can spread from lungs to lymph and eventually blood; if not filtered by spleen (key for capsules) it can cause other infections

Question 10

What other infections can S pneumonia cause if it reaches the blood and is not filtered by spleen?

Answer 10

infections in other areas like meninges, joints and heart valves

Question 11

Acute Bacterial Otitis Media

Answer 11

Often after viral infection, S pneumoniae or Hi B are common. Bulging, non mobile ear drum, Yellow/gray drum, Fever, ear pain

Question 12

Resistance issues with S pneumoniae?

Answer 12

Resistance with ß lactams, TMPSMX, macrolides, tetracyclines, quinolones. Can overcome penicillin resistance with higher dose

Question 13

S pneumonia vaccines

Answer 13

Pneumococcal polysaccharide vaccine (23 capsule types, short lived). Pneumococcal conjugate vaccine (13 capsule types, induce memory, produce IgG)