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29 Cards in this Set
- Front
- Back
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A 50 yo has a 3 day fever and dry cough and has developed headaches, muscle aches and confusion. He is a smoker. PE shows tachypnea, inspiratory rales, scanty clear sputum. blood work shows hyponatremia. What might he have?
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L pneumophila
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What does the X ray look like in someone with L pneumophila?
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patchy interstitial infiltrates
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Who is the gayest person in the world?
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actually 2 people: Aaron Brown and Justin Klien
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What is seen on x ray in someone with L pneumophilia?
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patchy interstitial infiltrates
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In L pneumophilia does the congestion occur in the alveoli or interstitium?
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interstial
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What type of symptoms is L pneumophilia associated with compared to mycoplasma and chlamydophilia?
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L pneumophilia is seen with high fever, diarrhea, confusion, headache, where as the others are more indolent
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C. pstittaci, Coxiella and L pneumophilia are associated with what?
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specific exposures such as birds, pigs, and environmental
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Purulent sputum is seen with which type of pneumonia?
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S pneumoniae
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How can serogroup 1 L pneumophilia be detected?
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direct antigen in urine
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What are the characteristics of L pneumophilia?
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motile, flagellated, pleomorphic rods, gram -
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What stains can be used on L pneumophilia?
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weakly stain with Gram
dieterle silver |
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Is L pneumophilia gram + or gram -?
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gram - but doesn't stain well with gram stain
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what is the definitive test for L pneumophilia?
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culture
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Are L pneumophilia aerobic or anaerobic?
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nutritionally fstidious aerobe that grows slowly on selective media with cysteine and iron
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What L pneumophilia serogroup causes most virulence?
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1 they are LPS specific
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Where are 23% of L pneumophilia cases acquired?
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nosicomial origin
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Where does L pneumophilia survive to later cause infection?
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tap water and cooling towers
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What are common sources that carry L pneumophilia?
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showers, air-conditioning units, humidifiers, nebulizers, nasogastric tubes
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How is L pneumophilia spread?
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airborne not person to person
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Flagellated L pneumophilia can penetrate respiratory epithelium. Where in respiratory tract does this commonly occur? How do they adhere?
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1) lower part
2) use pili |
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What is unique about the L pneumophilia outer membrane?
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it binds C3 favoring opsonization
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Where do L pneumophilia grow?
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they are strict intracellular bacteria
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L pneumophilia containing the dot gene prevent what?
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phago-lysosome fusion
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What is the primary host defense mechanism against L pneumophilia?
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cell mediated
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Does L pneumophilia directly cause lung damage?
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no damage is from PMNs and t cells, complement that lead to patchy diffuse infiltrates
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How is L pneumophilia treated?
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macrolide (clarithyromycin) or levofloxacin or gatifloxacin or doxycycline
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What is the most severe form of L pneumophilia? When does it begin? How does it present?
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1) Legionnaires disease
2) 2-10 days after exposure 3) severe fibrinopurulent pneumonia with alveolitis and bronchitis |
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What other systems are impacted by Legionnaires disease? What blood values are altered?
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1) lymph nodes, brain, kidney, liver, spleen, bone marrow, and myocardium.
2) hyponatremia and hypophosphatemia |
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Someone with acute onset of flu-like symptoms, non-pneumonic illness without pneumonic infiltrates that was exposed to L pneumophilia in the past 48 hours may have what?
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pontiac fever
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