CMN 568 - Unit 2
CAP caused by Viruses vs Bacteria? Which is more common in adults? Which is more
common in kids?
Adults - Bacterial
Peds - Viral
HERF BBB
Most common viral cause of CAP
Influenza
HERF BBB
Common symptoms of CAP
+ Cough, with our without sputum production
+ Fever, chills, rigor, sweats
+ Dyspnea
+ Chest/ pleuritic pain
+ Nausea, anorexia, diarrhea
+ Headache, myalgias
+ Fatigue
+ Patients appear acutely ill
HERF BBB
Common signs of CAP
+ Fever: present in 80%. May be low or absent, especially in elderly
+ Tachycardia
+ Tachypnea (may be the most sensitive sign in elderly)
+ Rales, inspiratory crackles or bronchial breath sounds
+ Dullness to percussion over areas of consolidation
+ Oxygen desaturation
+ Mental status changes, esp. in elderly
NOTE: No clear constellation of signs or symptoms has been found to accurately predict the
diagnosis of pneumonia.
HERF BBB
, Common causes of bacterial CAP
+ Strep pneumo -- #1
+Haemophilus influenzae
+ Mycoplasma pneumoniae
+ Chlamydia pneumoniae
+ Staph aureus
+ Neisseria meningitidis
+ Klebsiella pneumoniae
+ Moraxella catarrhalis
+ Legionella spp.
HERF BBB
Common viral causes of CAP
+ INFLUENZA (#1)
+ RSV
+ Adenoviruses
HERF BBB
Gold standard of CAP dx?
CXR which indicates a pulmonary opacity. (CT scan will show it too.)
HERF BBB
After a positive CXR, what other tests should patients have to confirm dx of CAP?
+ NONE for most pts. Start tx with empiric abx
+ Atypical causes (Exposure to TB or flu, recent travel, immunosuppressed) should prob
undergo additional testing.
--Sputum gram stain
--UA antigen tests for s.pneumo or legionelle
--Rapid flu
HERF BBB
ABX tx of CAP in previously healthy patients with no recent antibiotic use?
MACROLIDES (-mycins) or Doxycycline
+ Azithromycin (z-pack) 500mg/d x1 day, then 250mg/d x 4d
OR
+ Clarithromycin 500mg BID x 5 days
OR
+ Doxycycline 100mg BID x 5 days
CAP caused by Viruses vs Bacteria? Which is more common in adults? Which is more
common in kids?
Adults - Bacterial
Peds - Viral
HERF BBB
Most common viral cause of CAP
Influenza
HERF BBB
Common symptoms of CAP
+ Cough, with our without sputum production
+ Fever, chills, rigor, sweats
+ Dyspnea
+ Chest/ pleuritic pain
+ Nausea, anorexia, diarrhea
+ Headache, myalgias
+ Fatigue
+ Patients appear acutely ill
HERF BBB
Common signs of CAP
+ Fever: present in 80%. May be low or absent, especially in elderly
+ Tachycardia
+ Tachypnea (may be the most sensitive sign in elderly)
+ Rales, inspiratory crackles or bronchial breath sounds
+ Dullness to percussion over areas of consolidation
+ Oxygen desaturation
+ Mental status changes, esp. in elderly
NOTE: No clear constellation of signs or symptoms has been found to accurately predict the
diagnosis of pneumonia.
HERF BBB
, Common causes of bacterial CAP
+ Strep pneumo -- #1
+Haemophilus influenzae
+ Mycoplasma pneumoniae
+ Chlamydia pneumoniae
+ Staph aureus
+ Neisseria meningitidis
+ Klebsiella pneumoniae
+ Moraxella catarrhalis
+ Legionella spp.
HERF BBB
Common viral causes of CAP
+ INFLUENZA (#1)
+ RSV
+ Adenoviruses
HERF BBB
Gold standard of CAP dx?
CXR which indicates a pulmonary opacity. (CT scan will show it too.)
HERF BBB
After a positive CXR, what other tests should patients have to confirm dx of CAP?
+ NONE for most pts. Start tx with empiric abx
+ Atypical causes (Exposure to TB or flu, recent travel, immunosuppressed) should prob
undergo additional testing.
--Sputum gram stain
--UA antigen tests for s.pneumo or legionelle
--Rapid flu
HERF BBB
ABX tx of CAP in previously healthy patients with no recent antibiotic use?
MACROLIDES (-mycins) or Doxycycline
+ Azithromycin (z-pack) 500mg/d x1 day, then 250mg/d x 4d
OR
+ Clarithromycin 500mg BID x 5 days
OR
+ Doxycycline 100mg BID x 5 days
