Summary MICROBIO in relation to pneumonia

CR-Micro RTI IC1


Pneumonia..

Acute lower respiratory tract infection with new radiological signs.

Classification:


Pneumonia

Community Acquired
Hospital Acquired

Typical Atypical
# E-coli
# Klebsiella
# Enterobacter
# Mycoplasma pneumonia # Pseudomonas
# Streptococcus pneumonia
# Legionella pneumophila # Serratia marcescens
# Haemophillus influenza
# Clamydia pneumoniae # Staphylococcus aureus /
# Staphylococcus aureus MRSA
# Clamydia psittaci
# Coxiella burnetti # Legionella spp



Risk Factors Age Chronic lung disease Season
Smoker Alcoholism Co-morbidity

Clinical Features Productive of purulent sputum Fever
Dyspnoea Haemoptysis Pleuritic chest pain
Tachypnoea Rigors Malaise
Myalgia and anorexia are proeminent in atypical pneumonia

Physical Exam Dullness on percussion
Crepitation, bronchial breathing
Pleural rub
These signs are absent or minor in atypical pneumonia

Diagnosis Sputum for Gram stain and culture
Blood for culture ,WCC, ESR, CRP
CXR
Urinary legionella antigen
Serology
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Treatment Antibiotics: usually co-amoxiclav and clarithromycin, cefuroxime
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RMSH-2012

, CR-Micro RTI IC1


Community Acquired Typical Pneumonia..

 Streptococcus pneumonia
Gram positive diplococci
Commonest cause of pneumonia
Antibiotic resistant strains emerging
High morbidity
10-20% mortality
Antibiotic
Benzylpenicillin IV
Cefotaxime IV
Rifampicin should be added as a second agent
Prevention
Pneumococcal vaccine

 Haemophillus influenza
COPD
Cefuroxime / co-amoxiclav

 Staphylococcus aureus
IV Drug Users
Head injuries
Influenza
Abscess formation
Treatment: Flucloxacillin




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RMSH-2012