Pneumonia microorganisms and management protocol

Pneumonia

🛌🏼🛌🏼* Severity and prognostic value - CURB-65 score

C- confusion (<=8 in AMTS)

U- urea( >7mmol/L

R- RESPIRATORY RATE{>=30/min)

B- BP, SBP<=90, DBP<=60 mmHg

65- years age

🎯Key point to reach underlying causative oraginsm::

1️⃣S. Pneumoniae- --pneumonia+ sore around mouth, herpes labialis

2️⃣S. Aureus----- previous flu infection+ pneumonia

3️⃣Klebsiella--- alcoholic+ pneumonia

4️⃣Legionella pneumophilia--- SIADH+ pneumonia+ extra thorasic complain

5️⃣Mycoplasma pneumoniae ----systemic upset+ hemolytic anemia+ cold agglutination+ erythema multiforme+/- hyponatremia

6️⃣Chlamydia psittaci--- bird exposure+pneumonia

7️⃣Coxiella burnetti--- cattle exposure+ pneumonia

8️⃣Pneumocystis jirovecii pneumonia---- AIDS+ saturation fall on exercise+ lung clear+ x-ray diffuse bilateral infiltration

💉💉Treatment::::

💊CURB. 0 or 1---

Amoxicillin.

😓Penicillin allergic or atypical organism suspect, then doxycycline/ clarithromycin/erythromycin

💊CURB. 2--- amoxicillin with (if atypical organism suspect) doxycycline/ clarithromycin/

erythromycin

💉CURB 3-5----

Coamoxiclav with clarithromycin/ erythromycin

If penicillin allergic then levofloxacin

Treatment source: NICE guidance

By:: Dr. Manilal Biswas

SSMC (2012-13)

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