Page 104 - Medicine and Surgery
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         BLUK007-03  BLUK007-Kendall  May 25, 2005  17:29  Char Count= 0












                                         allergic,  (if  or  or     or                        or          or


                                   Specific  treatment  Penicillin  erythromycin)  Erythromycin,  azithromycin,  clarithromycin  doxycycline  Cefuroxime  co-amoxiclav  Cefuroxime  co-amoxiclav  Flucloxacillin  Erythromycin,  azithromycin,  clarithromycin  doxycycline  Erythromycin,  azithromycin,  clarithromycin  doxycycline




                                         –         cold                       and
                                         urine  antigen  IgG  and                                 to
                                         and  blood  and  IgM  (acute  titres),  50%)  (in  consolidation  CXR  on  Chlamydia  –  (immuno-  tests  types)

                                   Additional  investigations  Sputum,  pneumococcal  for  Serology  antibodies  convalescent  agglutinins  Nodular  cavitation  for  Serology  antibodies  complement-fixing  antibodies  fluorescent  distinguish






                                               pericarditis,  multiforme,  anaemia,  arthralgia,  meningo-encephalitis,  formation,  empyema  common.  infective  abscesses  causing  organs  renal encephalitis,


                                     Complications  Myocarditis,  erythema  haemolytic  myalgia,  agglutinins  cold  Abscess  pneumothorax,  relatively  Septicaemia:  emboli  other  in  Hepatitis,  failure



                                pneumonia



                                in       green/rusty  of  cough  1/3  in  e.g.  upset  GI  respiratory  be  may  be  may  be  cough,  and  abdomen.  or  recovering  Pneumonia
                                features   cases  of  90%  pneumonia.  – pneumonia  absent  flu-like Preceding  usually,  myalgia,  of  features;  lobar  features;  lobar  may  dry  fever,  the  on  illness  flu-like  mild


                                differentiating  features  Clinical  productive  Cough  sputum.  lobar  Atypical  sputum  and  cases.  symptoms  headache,  onset  before  symptoms  specific  or broncho-  pneumonia  specific  or broncho-  pneumonia  pneumonia,  Severe  post-influenza  fatal  rapidly  high  Malaise,  hepatosplenomegaly  spots  rose  mild  bronchitis  acute  spontaneously.  usually  also




                                and                         No      No                                Often
                                organisms      cycle        the  in  COPD  and  of  the  in  COPD  influenza  drug  secondary  line  avian  those  in  birds.  of  acquired


                                causative  Epidemiology  Commonest  epidemic  seen  heavy  elderly,  smokers  patients  cause  bronchopneumonia  especially  and  elderly  patients  common  following  pneumonia,  intravenous  abusers,  central  from  seen  excreta  to  exposed  5–10%  community



                                of             year  4      Especially  Common  More    to  Acquired  Causes
                                Summary


                                Table 3.8  Organism  Streptococcus  pneumoniae  Mycoplasma  pneumoniae  Haemophilus  influenzae  Moraxella  catarrhalis  Staphylococcus  aureus  Chlamydia  psittaci  ‘Psittacosis’  Chlamydophila  pneumoniae













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