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Community Aquired PneumoniaCAP - Coggle Diagram

- - - - Strep pneumoniae
      - Haemophilus influenzae
      - Staph. Aureus
    - - Influenza
      - Respiratory syncytial virus
      - Parainfluenza
      - Adenovirus
      - Human metapneumovirus
      - Coronavirus ( SARS CoV-2)
    - - Endemic mycoses
      - Opportunistic mycoses
      - Pneumocystis jirovecii
    - - Rickettsia
        Coxiella burntii (Q fever)
      - Mycoplasma
        Mycoplasma pneumoniae
      - Legionella
        Legionella pneumophila
      - Chlamydia
        Chlamydophila psittaci
        C. pneumoniae
      - Mycobacteria
        M. tuberculosis
      - Parasites
        Toxoplasma gondii
        Ascariasis
        Strongyloidiasis
  - - - Sputum / bronchoalveolar lavage (BAL) examination
        
        Sputum microscopy (gram stain)
        
        Strep pneumoniae
        Gram pos diplococci
        
        Sputum culture
      - Pleural fluid aspirate
      - Blood cultures
      - PCR
        Throat swab for SARS Co-V2, influenza, other viruses
      - Urinary antigen
        Strep pneumo
        L. pneumophilia
      - Serology
      - Procalcitonin / C-reactive protein (CRP)
        markers of inflammation
  - - - Bronchial breath sounds
      - Focal coarse crackles
      - Dullness to percusion
    - - Fever :thermometer:
      - Sweats :sweat_drops:
      - Myalgia :muscle:
      - Headache :face_with_head_bandage:
  - - - PMhx (COPD)
      - Revent viral infx
      - Travel hx :airplane:
      - Animal / pet exposure :bird:
      - Occupational exposure :male-farmer:
      - VAccination hx :syringe:
    - - Labratory
      - Radiology
  - - - Mycoplasma pneumoniae
    - - Staph Aureus including CA-MRSA
    - - Staph Aureus
    - - Klebsiella pneumonia
    - - P. jirovecii
      - Mycoplasm tuberculosis
    - - CMV
      - P. jirovecii
      - Toxoplasma
      - Legionella
    - - Strep pneumoniae
      - H. influenza
    - - Anaerobes
    - - Psittacosis
    - - Legionellosis
      - Leptospirosis
      - Q fever
    - - Melioidosis
      - Anthrax
      - Endemicmycoses
      - Helminths
    - - • Pneumocystis jirovecii
      - • Cytomegalovirus (a herpes virus)
      - • Other respiratory viruses (e.g. RSV)
      - • Tuberculosis
      - • Fungi
    - - Pseudomonas aeruginosa
- - - - Capsular polysaccharide
      - Adults >65 yrs
      - Adults and children at increased risk > 2 yrs
    - - Polysaccharide antigens conjugated to a protein
        ENhanced immunogenicity
      - Childhood immunisation
  - - - Pathogens causing invasive infx after splenectomy
        
        Strep pneumoniae
        
        • Haemophilus influenzae
        
        • N. meningitides
        
        • Salmonella spp
        
        • Capnocytophaga canimorsus (dog bites)
        
        • Babesia microti (tick borne or transfusion)
        
        • Plasmodium malaria
      - Sepsis
        
        • Sickle cell disease
        
        • Coeliac disease
        
        • Graft-versus-host disease after stem cell transplant
        
        • Idiopathic Thrombocytopenic Purpura
        
        • Splenic irradiation
        
        • Surgical removal
- - - - Fever
      - Headache
      - Confusion
    - - Dry cough
      - Sore throat
      - Congestion
      - Pneumonia
    - - Nausea
      - Vomiting
      - Diarrhoe
    - - Myalgia
      - Fatigue
  - - - Risk of drug resistance
      - Indication
        
        HCWs
        
        Antiviral prophylaxi for high risk pts (cancer)
        
        Severe cases of influenza
      - MOA
        
        Neuroaminidase inhibitor
    - - MOA
        
        Neuraminidase inhibitor
      - Inhaled / IV
    - - MOA
        
        Endonuclease inhibitor
      - Indication
        
        Treatment of uncomplicaed influenza
        
        Post-exposure prophylasix in pts > 12yrs
      - Single dose
        
        Oral antiviral
        
        Influenza A and B
        
        Not approved in HSE
- - - - Bronchiolitis in babies
      - Pneumonia in immunocomprimesed
- - - - No cell wall -does not respons to beta lactam antibiotics
      - Macrolides or Tetracyclines
    - - Adolescence
      - Young adults
    - - Dry hacking cough
      - Low grade fever :thermometer:
      - Headache :face_with_head_bandage:
    - - High CFT
      - Rising titre of specific antibodies (serology)
      - Isolation by culture is difficult
  - - - Intracellular
      - Gram negative
    - - Inhalation of contamined dust
      - Zoonosis - infects:
        Goats
        Sheep
        Cattle
      - Drinking raw milk
    - - Flu-like illness
      - Pneumonia
      - Hepatitis
      - Infective endocarditis
    - - Doxycyline (tetracycline)
    - - Incubation: 3 weeks
      - Phase 1 chronic antibodies
      - Phase 2 antibodies - acute post infx
  - - - Obligae intracellular bacterium
    - - Birds are resevoir
        Parrots!
      - Inhalation of contaminated dust
    - - Sore throat
      - Hoarsness
      - URT symptoms
    - - Seological rather than culture
    - - Tetracyclines
  - - - Humidified air conditioning
      - SHowers
      - Cooling towers
    - - Gram Negative
      - Flagelleted rod :fishing_pole_and_fish:
      - Aerobic
      - Facultative intracellular parasite in amoebe and human monocytes/ macrophags
    - - Smoking :smoking:
      - Male :man::skin-tone-2:
      - Acloholism :beer_mugs:
      - Chronic lung disease
      - Immunosuppresion :arrow_double_down::shield:
      - Malignancy :crab:
    - - Levofloxanin (fluoroquinolone)
      - Azithromycin (macrolide)
    - - High fever
      - Chest pain
      - Haemoptysis
      - Diffuse patchy infiltrates
      - Cough
      - Myalgia
      - Mucopurulent cough