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Medicine

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Respiratory

Question
12 out of 26
 

True about legionella pneumonia is? (DNB June 2010)



A Interstitial pneumonia
B Dry cough

C Diarrhea
D All of the above

Ans. D

All of the above

Legionella pneumophila

1). Colonizes water tanksQ kept at <60°C (eg air cooling system Q) causing outbreaks of Legionnaire's disease.

2). It is type of interstitial pneumonia.

3). 'Flu-like symptoms (fever, malaise, myalgia) precede a dry cough Q and dyspnoea

4). Extra-pulmonary features include anorexia, Diarrhea & Vomiting, hepatitis Q, renal failure Q, confusion and coma Q.

5). IP: 2 – 10 day

6). CXR shows bi-basal opacity.

7). Blood tests may show lymphopenia Q hyponatremia, and deranged LFTs Q.

8). Urinalysis may show hematuria.

9). Diagnosis: Legionella serology/urine antigen.

10). Treatment: clarithromycin rifampicin Q, fluoroquinolone Q.

(Extra Edge: In legionella infection, commonest organ system involved is GIT & NOT respiratory!!!) (FAQ)

Extra Edge: Cold agglutinins may cause an Coombs positive autoimmune haemolytic anaemia Q

Extra Edge:

Chlamydia pneumoniae

1). Person to person spread occurs causing a biphasic illness Q: pharyngitis, hoarseness, otitis followed by pneumonia.

2). Diagnosis: Chlamydia serology (non-specific).

3). Treatment: doxycycline

a. Alternative agent

b. Erythromycin

c. Clarithromycin

d. Azithromycin

e. Fluoroquinolone

Chlamydia psittaci

1). It causes psittacosis, an ornithosis acquired from infected birds Q (typically parrots).

2). Symptoms include headache, fever, dry cough, lethargy, arthralgia, anorexia, and D&V.

3). Extra-pulmonary features are rare

4). Meningoencephalitis Q, infective endocarditis Q, hepatitis Q, nephritisQ, rash Q, splenomegaly Q

5). CXR shows patchy consolidation.

6). Diagnosis: Chlamydia serology.

7). Treatment tetracycline.

8). Viral pneumonia The commonest cause is influenza Q. Other viruses that can affect the lung are: measles, CMV, and varicella zoster.

Respiratory Flashcard List

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