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Micro - Typical Pneumonia
Terms in this set (16)
Define Typical Pneumonia:
- inflammation of alveoli resulting in illness char by symptoms such as cough, fever and dyspnea and by radiographic inflitrates
Clinically what differentiates Typical Pneumonia from bronchitis?
What is the peak season for Typical Pneumonia ?
What are the most common causes of Typical Pneumonia?
1. streptococcus pneumoniae
2. haemophilus influenza
3. moraxella catarrhalis
What are symptoms of Typical Pneumonia?
2. cough productive purulent (yellow or green) or rusty sputums
4. pleuritis pain
5. lobar pattern of consolidation by x-ray
What are the microbiological characteristics of streptococcus pneumoniae?
- Gram pos
- catalase neg
- inhibited by optochin (unlike strep viridans)
What are the Dx test for typical pneumonia?
- sputum for G stain and culture
- blood culture
- urinary antigen for strep pneumo and legionella
- serology (preferred for mycoplasma, chlamydophila)
- PCR : new - good for mycoplasma
What are the virulence factors of streptococcus pneumoniae?
1. capsular polysaccharide* (inhibited phagocytosis)
2. surface adhesin A - attaches to epithelial cells of nasopharynx
3. surface protein C - binds to complement factor H inhibiting C3 convertase & reducing phagocytosis
4. pneumolysin cytotoxin - acivates compliment
What is the pathogenesis of streptococcus pneumonia?
1. colonization (asymp) of nasopharynx
2. organism reaches trachea and bronchi by inhalation or aspiration - normally cleared by ciliary movement and cough, but clearance may be impaired by allergies, smoking or viral upper resp infections resulting in entry to the alveoli
3. inflammatory mechanisms include cell well peptidoglycan and lipoteichoic acid activating alternative pathway of complement - cell wall substances stimulate TLR-2 leading to production of inflammatory cytokines
What are the pathways toward death in a patient with typical pneumonia?
1. respiratory failure
What causes organisms to reach alveoli instead of being expelled by the upper airway?
- organisms reach tranchea and bronchi by inhalation or aspiration.
- clearance is usually impaired by allergies, smoking, or URI
What are the microbiological char of haemophilus influenza?
- gram neg rod
- non-encapsulated normal URT flora
On what agar is haemophilus influenza grown?
- grow on chocolate agar, blood agar around S.aureus (source of V factor);
What factors do haemophilus influenza need to grow?
- X protoporphyrin (hemin)
- V = NAD
What are the microbiological char of moraxella catarrhalis?
- gram neg diplococci
What are the vaccines that help prevent moraxella catarrhalis?
1. pneumococcal polysaccharide vaccine (pneumococcal conjugate vaccine)
2. influenza vaccine
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