MODULE 1: INFECTIOUS DISEASES

Study Guide #2 PNEUMONIA

TYPE OF ORGANISM CLINICAL FEATURE TREATMENT COMPLICATION

1. Streptococcal Abrupt onset, toxic Penicillin G, Amoxicillin Shock, pleural effusion,
pneumonia appearance, pleuritic superinfection,
(Streptococcus chest pain. pericarditis
pneumoniae)
2. Hemophilus irritability, fever, ceftriaxone, cefotaxime, Persistent fever.
Influenzae lethargy, poor feeding, cefuroxime Recurrence of fever
and vomiting after an afebrile
interval (termed
secondary fevers)
Increased ICP.
Prolonged obtundation
or coma. Development
of focal neurologic
signs. Development or
recurrence of seizures.
3. Legionnaire’s Acute onset of lower macrolides Respiratory failure,
Disease (Legionella respiratory illness with (azithromycin), and the shock and acute kidney
pneumophila) fever and/or cough. quinolones and multi-organ
Myalgia, shortness of (ciprofloxacin, failure.
breath, headache, levofloxacin,
malaise, chest moxifloxacin,
discomfort, confusion, gemifloxacin,
nausea, diarrhea, or trovofloxacin).
abdominal pain
4. Myoplasma Cough that may Tetracycline and Serious pneumonia.
pneumoniae produce mucus. Fever erythromycin Asthma attacks or new
and chills. Shortness of asthma symptoms.
breath. Chest pain. Encephalitis (swelling
Feeling tired. of the brain) Hemolytic
anemia (too few red
blood cells, which
means fewer cells to
deliver oxygen in the
body) Renal
dysfunction (kidney
problems)
5. Chlamydial Runny or stuffy nose. Macrolides Encephalitis (swelling
pneumonia Fatigue (feeling tired) (azithromycin), in the brain)
 Low-grade fever. Tetracyclines Myocarditis (swelling
Hoarseness or loss of (tetracycline and of the heart)
voice. Sore throat. doxycycline)
Slowly worsening
cough that can last for
weeks or months.
Headache.
6. Psedumonas chronic productive antipseudomonal beta- congestive heart
pneumonia cough, anorexia, lactam (eg, penicillin or failure, conduction
weight loss, wheezing, cephalosporin) and an heart block, cerebritis,
and tachypnea. aminoglycoside. mycotic aneurysms, or
Symptoms of Carbapenems (eg, brain abscess. Septic
pneumonia include imipenem, emboli to the lung and
fever, chills, severe meropenem) with spleen also have been
dyspnea, cyanosis, antipseudomonal reported.
productive cough, quinolones may be used
confusion, and other in conjunction with an
signs of a systemic aminoglycoside.
inflammatory
response.
7. Staphylococcal Gastrointestinal signs: Chloramphenicol and empyema and abscess
pneumonia nausea, vomiting, erythromycin formation. Infection
diarrhoea, painful can spread
abdominal distention. hematogenously to the
– Respiratory signs: dry central nervous
cough, tachypnoea, system, bones, joints,
signs of distress (nasal skin, and kidneys.
flaring, chest
indrawing). Pulmonary
auscultation is often
normal; sometimes
dullness indicating
pleural effusion.
8. Klebsiella acute onset of high ampicillin/sulbactam, cavitation, empyema,
pneumonia fever and chills; flulike piperacillin/tazobactam bronchopulmonary
symptoms; and , ticarcillin/clavulanate, fistula, and pleural
productive cough with ceftazidime, cefepime, adhesions.
an abundant, thick, levofloxacin,
tenacious, and blood- norfloxacin,
tinged sputum moxifloxacin,
meropenem, and
ertapenem.
9. Pneumocystis Fever (It's usually low if trimethoprim and Pleural effusion
pneumonia you have HIV and sulfamethoxazole (extremely rare)
higher if you don't.) Pneumothorax
Dry cough or (collapsed lung)
wheezing. Shortness of Respiratory failure
 breath. Fatigue. (may require breathing
support)
10. Fungal pneumonia fever, chills, and fluconazole (Diflucan), disease dissemination
fatigue. Neutrophils itraconazole to other sites (ie, brain,
and fluid leaked from (Sporanox), flucytosine meninges, skin, liver,
surrounding blood (Ancobon), and spleen, kidneys,
vessels fill the alveoli ketoconazole (Nizoral). adrenals, heart, eyes)
and sepsis syndrome
and blood vessel
invasion, which can
lead to hemoptysis,
pulmonary infarction,
myocardial infarction,
cerebral septic emboli,
cerebral
11. Mycobacterium Coughing that lasts Isoniazid. Rifampin Spinal pain. Back pain
tuberculosis three or more weeks. (Rifadin, Rimactane) and stiffness are
Coughing up blood. Ethambutol common complications
Chest pain, or pain (Myambutol) of tuberculosis. Joint
with breathing or Pyrazinamide. damage. Tuberculous
coughing. arthritis usually affects
Unintentional weight the hips and knees.
loss. Fatigue. Fever. Swelling of the
Night sweats. Chills. membranes that cover
your brain (meningitis).
Liver or kidney
problems. Heart
disorders.
12. Pneumonia from Cough with purulent ampicillin-sulbactam, or acute respiratory
Aspiration sputum. Fever or chills. a combination of failure, acute
Malaise, myalgias. metronidazole and respiratory distress
Rigors may be present amoxicillin can be used. syndrome (ARDS), and
or absent. Shortness of In patients with bacterial pneumonia.
breath, dyspnea on penicillin allergy, Complications of
exertion. Pleuritic clindamycin is bacterial pneumonia
chest pain. Putrid preferred. include parapneumonic
expectoration (a clue effusion, empyema,
to anaerobic bacterial lung abscess, and
pneumonia) suprainfection.