etiologies of pneumonia

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etiologies of pneumonia
2011-09-20 17:14:18

Overview of Etioligoeis of pneumonia taken from step up to USMLE step IIh
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  1. non productive cough

    most common pneumonia in children and common in adults
    • Viral pneumonia
    • (influenza, parainfluenza, adenovirus, cytomegalovirus, RSV)

    treatment - self limited, osaltamavir, tamvir
  2. high fevers, pleuritic chest pain, productive cough

    most common pneumonia in adults, higher risk in sickle cell patients
    Streptoccus pneumoniae

    treatment - beta lactams, macrolides
  3. slower onsent of symptoms

    patients with CPD, higher risk of infection in patients with sicle cell disease
    Haemophilus influenzae

    treat with beta-lactams, TMP-SMX
  4. absscess formatin, history of recent flu symptoms

    nosocomial pneumonia, immunocompromised patients
    Staphylococcus aureus

    treatment - beta lactams, remember to cover MRSA
  5. Currant-jelly sputum

    Alcoholics, patients with high risk of aspiration, patients staying in the hospital ofr extended amounts of time, sickle cell patients
    Klensieall pnumoniae

    Treatment - cephalosporins and aminoglycosides (gentamicin, tobramycin)
  6. Less severe symptoms (walking pneumonia), possible rash, positive cold-agglutinin test

    Young adults
    Mycoplasma pneumniae (atypical)

    treat with macrolides (azithromycin, clarithromycin, erythromycin)
  7. Rapid onset

    Chronically ill and immunocompromised patients, patients with cystic fibrosis, noscomial pneumonia
    Pseudomonas aeruginosa

    treatment - fluoroquinolones (ciprofloxacin), aminglycosides, 3rd generation cephalosporins
  8. Slow onsenct of classic symptoms, nausea, diarrhea, confusion or ataxia

    Assoicated with aerosolized water
    Legionell pneumophilia (atypical)

    treat with macrolides, fluorquinolones
  9. Slow onsent of classic symptoms; frequent sinusitis

    Common in the very young and elderly
    Chlamydia pneumoniae (atypical)

    treat with doxycycline, macrolides
  10. Respiratory distress leathargy in neonates and infants
    Group B streptococcus

    • Treat with beta lactams
    • Ampicillin and Gentamicin
  11. Classical symptoms

    Nosocomial pneumonia, elderly patients
    Ennterobacter sp.

    Treat with TMP-SMX
  12. Less severe symptoms, subacute disease for initail history

    Travelers to Southwest US
    Central America
    • Southwest US - coccidioidomycosis
    • Caves - histoplasmosis
    • Central America - blastomycosis

    Treatment - amphotericin B for severe infections, ketoconazole
  13. Slow onset of classic symptoms, GI symptoms

    Immunocompromised patient (HIV, CD4 count < 200)
    Pneumocystis jiroveci (old name Pneumocystis carinii or PCP)

    treatment TMP-SMX