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23 Cards in this Set
- Front
- Back
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Fever, cough, headache
Insidious onset |
Atypical pneumonia
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Atypical pneumonia - features
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Wispy findings on x-ray - no consolidation
Clear sputum Few constitutional symptoms No response to penicillin Bronchopneumonia |
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Atypical pneumonia - organisms
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Mycoplasma pneumoniae
Chlamydophila pneumoniae Chlamydophila psittaci Legionella pneumophila Pneumocystis carinii if infected with HIV Influenza Endema fungi |
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Cough, fever, headache
Rales Few neutrophils on gram stain Normal WBCs No consolidation on x-ray Resolves spontaneously |
Mycoplasma pneumoniae
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Mycoplasma pneumoniae - characteristics
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Smallest bacteria
No cell wall Cell membrane with sterols |
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Mycoplasma pneumoniae - growth
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Colonies with fried egg appearance
Growth on cell-free medium with sterols |
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Mycoplasma pneumoniae - epidemiology
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Mostly in school age children and young adults
Epidemics in fall Most cases are sporadic Transmitted by respiratory route Reservoir is humans |
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Mycoplasma pneumoniae - pathophysiology
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P1 attachment factor attaches to ciliated respiratory epithelium
Stimulates lymphocyte and plasma cell inflammatory response - H2O2 mediated irritation and cough |
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Mycoplasma pneumoniae - treatment
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Macrolides
Tetracycline Fluoroquinolones |
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Mycoplasma pneumoniae - complications
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Otitis media
Hemolytic anemia - cross-reaction of I antigen with RBCs Red skin rash Meningoencephalitis Myopericarditis Arthritis |
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Mycoplasma pneumoniae - diagnosis
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Mycoplasma specific IgA or IgM
PCR of respiratory secretions |
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Mild cough, fever, headache
Rales No consolidations on CXR Few neutrophils Can have pharyngitis |
Chlamydia
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Chlamydiae - characteristics
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Obligate intracellular
Can't grow on cell free media Can't synthesize ATP |
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Chlamydiae - life cycle
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Elementary body released from infected cell
Internalized into vacuole Forms reticulate body and replicates Breaks off into elementary bodies and lyses infected cell |
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Chlamydiae - epidemiology
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School-age children
Reinfections can occur Humans are only known reservoir |
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Chlamydiae - diagnosis
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Serology
PCR and culture |
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Chlamydiae - treatment
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Macrolides
Tetracycline Fluoroquinolones |
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High fever, malaise, non-productive cough
Normal WBCs Airspace disease and multifocal consolidation on CXR Can have diarrhea, abdominal pain, hepatic or renal impairment |
Legionella
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Legionella - characteristics
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More like pneumococcal pneumonia
Aerobic gram negative Require cysteine and ferric ion supplementation for growth |
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Legionella - epidemiology
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Widespread in aquatic environment - often contaminates large building water supplies
Grows within free living amoeba Transmission via airborne route or aspiration |
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Legionella - risk factors
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Male sex
Older age Cigarette smoking Immunosuppression |
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Legionella - diagnosis
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Culture of sputum, pleural fluid, and blood
Antigen detection |
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Legionella - treatment
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Macrolides
Fluoroquinolones Rifampin in severe cases |
