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22 Cards in this Set
- Front
- Back
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A 70 yo man has a cough, fever, night sweats and chest pain. He has lost 10 lbs in 3 weeks and is an alcoholic. His sputum is blood tinged. What does he have?
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infection with klebsiella
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What is the sputum of someone with klebsiella called?
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currant jelly
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What is seen on PE in someone with klebsiella infection?
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fever, tachycardic, tachypnea, rales, ronchi unilaterally
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What does blood work show in someone with a klebsiella infection?
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leukocytosis and elevated neutrophils. Decreased pO2
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What do cavitary lesions in the lung often imply?
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polymicrobial infection, could be TB though
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what is one of the more common causes of peumonia among the poor?
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klebsiella
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What types of pneumonia are typically community acquired?
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pneumoccocal and staphylococcal pneumonia
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What family is K. pneumonaie a member of?
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enterobacteriaceae
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What are the characterisitics of K. pneumonaie?
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1) short, plump, nonmotile gram - bacilli
2) lactose fermentor 3) urease + 4) indole negative |
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What is the K antigen?
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virulence factor of K. pneumonaie. it is antiphagocytic
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What color are colonies that can ferment lactose?
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pink, ie E coli and Klebsiella
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If colonies of any bacteria in general appear highly mucoid what can be said about them?
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they have capsule
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Are K. pneumonaie part of the normal flora?
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yes intestinal flora
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What 2 groups of people are at risk for developing K. pneumonaie pneumonia?
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alcoholics and people with seizure disorders
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How does K. pneumonaie adhere to cells?
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fimbriae
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What is the main virulence factor of K. pneumonaie? How does it work?
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1) capsular polysaccharide with k antigen
2) prevents phagocytosis by neutraphils 3) inhibits activation of complement 4) binds C3b to capsule which prevents MAC from perforating |
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What is used to treat K. pneumonaie?
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extended spectrum penicillins like piperacillin and ticarcillin, aminoglycosides, quinolones
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What is found on plasmids that giving K. pneumonaie resistance? Where are resistant strains typically found?
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1) extended spectrum beta lactamases, also have resistance to 3rd gen cephs
2) hospitals |
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What is the mortality rate in K. pneumonaie infection?
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high even with therapy
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After giving someone with a mixed pneumonia infection antibiotics they become hypotensive. Why?
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release of large amounts of LPS
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What are the complications of endotoxin mediated sepsis?
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DIC, hypotension, fever, shock
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What is organism is frequently in someone recieving a tracheostomy or mechanical ventilation?
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K. pneumonaie
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