Loading....
Coupon Accepted Successfully!

Medicine

Open Flashcards

Respiratory

Question
9 out of 26
 

Atypical pneumonia can be caused by the following microbial agents except? (DNB Dec 2010)



A Mycoplasma pneumoniae.
B Legionella pneumophila.

C Human Corona virus.
D Klebsiella pneumoniae.

Ans. D

Klebsiella pneumoniae

1). Staphylococcal pneumonia

a. It may complicate influenza Q infection or occur in the children Q, elderly Q, intravenous drug users Q or patients with underlying disease (eg leukemia Q, lymphoma Q, cystic fibrosis Q, (CF).

b. It causes a bilateral CXR pneumatocele cavitation Q bronchopneumonia & pneumothorax.

c. Treatment: flucloxacillin Q. MRSA: vancomycin Q.

2). Pneumococcal pneumonia

a. It is the commonest Q cause of community acquired bacterial pneumonia.

b. It affects all ages, but is commoner in the elderly Q, alcoholicsQ, post-splenectomy Q, immuno­suppressed Q, and patients with chronic heart failure Q or pre-existing lung disease Q.

c. Clinical features: fever, pleurisy, herpes labialis Q. Rusty sputum

d. CXR shows lobar consolidation

e. Treatment: amoxicillinQ, benzylpenicillin Q, or cephalosporin Q.

3). Klebsiella pneumonia.

a. Occurs in elderly Q, diabetics and alcoholics Q

b. Causes a cavitation pneumonia Q, particularly of the upper lobes, chocolate colour sputum.

c. Treatment: cefuroxime Q. Aminoglycoside

4). Pseudomonas pneumonia

a. It is a common pathogen in bronchiectasis Q and Cystic Fibrosis Q.

b. It also causes hospital acquired infections Q.

c. Treatment: anti pseudomonal penicillin, ceftazidime, meropenem, or ciprofloxacin.

Extra Edge

Table 257-4 Empirical Antibiotic Treatment of Community-Acquired Pneumonia (Ref. Hari-18th ed., Pg- 2135)

1). Outpatients

a. Previously healthy and no antibiotics in past 3 months

i. A macrolide [clarithromycin or azithromycin

ii. Doxycycline

b. Comorbidities or antibiotics in past 3 months: select an alternative from a different class

i. Respiratory fluoroquinolone [moxifloxacin, gemifloxacin, levofloxacin

ii. β-lactam – ceftriaxone, cefpodoxime, cefuroxime plus a macrolide

2). Inpatients, Non-ICU

a. A respiratory fluoroquinolone [moxifloxacin, gemifloxacin, levofloxacin.

b. β-lactam [cefotaxime, ceftriaxone, ampicillin, ertapenem] plus a macrolide [oral clarithromycin or azithromycin.

3). Inpatients, ICU

a. β-lactam [cefotaxime, ceftriaxone, ampicillin-sulbactam] plus

b. Azithromycin or a fluoroquinolone

4). Special Concerns

a. If Pseudomonas is a consideration

i. [Piperacillin/tazobactam, cefepime, imipenem, meropenem] plus either ciprofloxacin or levofloxacin

ii. The above β-lactam plus an aminoglycoside [amikacin or tobramycin and azithromycin]

iii. The above β-lactam plus an aminoglycoside plus an antipneumococcal fluoroquinolone

b. If CA-MRSA is a consideration

Add linezolid or vancomycin.

Respiratory Flashcard List

26 flashcards
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
13)
14)
15)
16)
17)
18)
19)
20)
21)
22)
23)
24)
25)
26)