lower respiratory tract

what do strep pneumonia look like in patient samples (sputum)

diplococci

what do strep pneumonia look like in culture

streptococci

this has a cough with production of mucopurulent bloodstained sputum, fatigue, elevated pulse, grayish appearance, high fever, chest pain

pneumonia

where is pneumonia transmission common

day care, military, prison, shelter

what are adherence factors with strep pneumonia

teichoic acid, protein A, choline-binding proteins

how does strep pneumonia evade the immune system

bacterial capsule

what protein secreted by strep pneumonia inhibits beating of cell cilia resulting in mucosal cell death and the activity of PMNs

pneumolysin

this virulence factor associated with strep pneumoniae degrades a component of the tissue extracellular matrix

hyaluronidase

where do strep pneumonia grow in the lungs

alveolar spaces

what three things define pneumonia with strep

bacteria, exudative fluid, WBC

what are radiographic findings with pneumonia w strep

fluid accumulation, single lobe

what is the capsule based vaccine for strep pneumoniae

PPSV 23

what is the protein conjugate vaccine for strep pneumoniae

PCV13

what does PCV13 vaccine induce with strep pneumonia

T cell dependent memory

what two drugs are usually used in strep pneumoniae

penicillin, vancomycin

what organism causes atypical lobular pneumonia

legionella pneumophilia

what gram and shape is l. pneumophilia

gram negative bacillus

where is legionella pneumphilia found

ponds

how is legionella pneumophilia transmittted

inhalation following exposure to infected water system

is there person to person transmission w legionella

NO

this rare form of pneumonia has typical cough, SOB, chest pain, has rare sputum production, diarrhea, liver involvement, confusion, lethargy, delirium

legionellosis

where do L. pneumophilia survive and multiply

alveolar macrophages and monocytes

when nutrients are exhausted, what for do the legionella bacteria transform back to

transmissive form to infect other macrophages

what treatment is used for legionella pneumonia

macrolides/ketolides and quinolones

what organism causes atypical bronchopneumonia

mycoplasma pneumoniae

how do mycoplasma pneumonia appear

fried egg

what does chest radiograph look like with mycoplasma pneumoniae

patchy distribution, bronchial involvement

what symptoms appear with atypical bronchopneumonia

mild pneumonia, sore throat, fever, cough

what is used to treat atypical bronchopneumonia

erythromycin, quinolones

this is an inflammatory condition of the lung caused by infectious agents not present at time of admission

nosocomial pneumonia

what is early onset nosocomial pneumonia usually associated with

pneumococci, h. influenza

what is late onset nosocomial pneumonia usually associated with

klebsiella pneuminia or staph aureus

what major thing is nosocomial pneumonia associated with

ventillators

this pathogenesis of nosocomial pneumonia involves aspriration of secretions of upper airways that become colonized with bacteria into the lower rest tract

microaspiration

this pathogenesis of nosocomial pneumonia is less common and involves infection with esophagus or gastric material, bacteria condensate in ventilator tubing and drains

macroaspiration

what are some signs of nosocomial pneumonia

fever, leukocytosis, purulent sputum, lobar infiiltrate`

how to treat nosocomial pneumonia from gram positive organisms

beta-lactam, vanco

how to treat nosocomial pneumonia from gram negatives

pipericillin, tobramycin