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24 Cards in this Set
- Front
- Back
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How does the course of atypical pneumonia differ frm typical?
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gradual onset
slow progression patchy distributin on x-ray (not lobar) NON-productive cough |
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What are 3 common causes of atypical pneumonia?
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Mycoplasma
Chlamydophila pneumoniae Legionella - most deadly |
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Mycoplasma pneumoniae
How does it grow in culture? |
slowly, aerobic or anaerobic
mulberry colonies |
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Mycoplasma pneumoniae
how does it act? |
attaches via terminal organelle to respiratory epithelium
base produces hydrogen peroxide to destroy cilia --> bact. can colonize |
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What is the incubation period for mycoplasma?
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2-3 wks
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What are 5 general symptoms of mycoplasma infection?
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non-productive cough, fever, malaise, coryza (inflamm. of mucus membrane of nose), headache
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what does the cxr look like on a person with atypical pneumonia?
Appearance on physical? |
patchy infiltrate
Don't appear sick, have pharyngeal erythema |
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What are 4 extrapulmonary manifestations of mycoplasma infection?
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1. hemolytic anemia - cold agglutination of IgM antibodies to I antigen on RBCs --> Raynaud's, necrosis
2. Arterial thrombosis 3. Stevens-Johnson syndrome - separation of dermis from epidermis 4. neurological complications |
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What are 5 methods for diagnosing mycoplasma pneumoniae?
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1. culture - slow
2. PCR on throat swab 3. direct antigen test 4. cold agglutinin titer 1:32 5. serology- antimycoplasma IgM, IgG |
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Chlamydophila
where do they live? |
obligate intracellular
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Chlamydophila
What are 2 forms |
elementary bodies - infectious form, inert
reticulate bodies - form inside host, metabolically active, persist |
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What are some symptoms of Chlamydophila infection?
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commonly asymptomatic OR mild cough, hoarseness, sore throat
SLOW progression |
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how do you diagnose Chlamydophila pneumniae?
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microimmuno-fluoresence antibodies
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Chlamydophila psittaci
a. comes from where? b. incubation time? c. symptoms d. diagnosis |
a. birds
b. 5-15 days c. fever, pharygeal erythema, rales, hepatomegaly, late cough d. serology |
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Treatments for mycoplasma?
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1. doxycycline
2. macrolide |
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Treatments for Chlamydophila?
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1. azithromycin (macrolide)
2. doxycycline 3. quinolone |
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Legionella
a. morpholgy b. stain c. how does it grow in culture |
a. gram neg rod
b. silver stain c. fastidious growth requirements |
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Legionella
a. spread b. risk factors |
a. aerosols - steam towers
b. old age, smoking, drinking, immunocompromised |
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Legionairres Disease
a. symptoms b. Physical c. cxr d. prognosis |
a. pneumonia - fever, cough, headache, myalgia, DIARRHEA
b. signs of consolidation c. infiltrates, sometimes nodular, often bilateral d. fatality 10% |
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Pontiac Fever
a. symptoms b. prognosis |
a. flu-like: fever, myalgia, dry cough
b. recovery after 2-5 days |
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What is the pathogenesis of Legioinella?
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Inhaled droplets to alveoli and bronchioles --> eaten by macrophages --> phagosome surrounded by ER --> Legionella multiply inside ER-derived sac --> destruction of cell
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How does the host defend against Legionella?
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cell mediated immunity
neutrophils interferon-gamma-activated macrophages |
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How do you detect Legionella?
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culture on media
serology FA/PCR of sputum urine antigen test (for type I) |
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How do you treat Legionella?
What can't you use? |
Use antimicrobial that concentrates in phagolysosomes
macrolides, fluroquinolones, rifampin beta lactams |
