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characteristics of etiologic agents of pneumonia
Etiology:
1) Streptococcus pneumonia
a) sudden onset of rigors, fever, pleuritic chest pain
b) cough productive of rusty sputum
c) evidence of consolidation on exam
d) Gram stain: lancet-shaped diplococci
e) chest X-ray: lobar process
f) 25-50% of community-acquired pneumonia
2) Haemophilus influenzae
a) increased frequency in:
1] alcoholics
2] patients with COPD
b) Gram stain: gram-negative coccobacilli
c) chest X-ray: frequently associated pleural effusion (generally sterile)
d) 4-15% of community-acquired pneumonia
3) Mycoplasma pneumonia 'Atypical pneumonia'
a) mostly in children & young adults
b) insidious onset of fever, malaise, headache, non-productive cough
c) bullous myringitis
d) Gram stain: WBC's but no organisms
e) usually bronchopneumonia
4) Legionella pneumophila 'Legionnaire's disease'
a) non-bloody diarrhea
b) nausea/vomiting
c) fever
d) bradycardia
e) hyponatremia (more frequently than other pneumonias)
f) obtain fluorescent antibody studies on sputum
g) Gram stain: WBC's but no organisms
5) Influenzae
a) seasonal (winter months)
b) fever, chills, myalgias, malaise, anorexia 'flu symptoms'
c) non productive cough
d) dyspnea
e) hypoxia
f) complications:
1] ARDS
2] secondary bacterial pneumonia
6) aspiration pneumonia
a) history is critical: look for risk factors
b) may be in any lobe or in multiple lobes
- recumbent patients tend to aspirate into the posterior segments of the upper lobes or superior segments of the lower lobes
c) community-acquired: oral-pharyngeal flora (anaerobes)
d) hospital-acquired
1] gram-negative bacilli (including Pseudomonas)
2] Staphylococcus
e) complications
- lung abscess
Related
pneumonia (PNA)