Podcast
Questions and Answers
A 45-year-old male presents with a three-day history of fever, productive cough, and shortness of breath. He has no significant comorbidities or recent antibiotic use. Chest X-ray shows right lower lobe consolidation. Which of the following is the most appropriate outpatient empiric treatment?
A 45-year-old male presents with a three-day history of fever, productive cough, and shortness of breath. He has no significant comorbidities or recent antibiotic use. Chest X-ray shows right lower lobe consolidation. Which of the following is the most appropriate outpatient empiric treatment?
- Ciprofloxacin
- Piperacillin/tazobactam
- Cefpodoxime plus doxycycline
- Azithromycin (correct)
A 68-year-old female with diabetes and chronic obstructive pulmonary disease (COPD) presents with fever, cough, and dyspnea. She was treated with amoxicillin for a urinary tract infection one month ago. Chest X-ray reveals a left lower lobe infiltrate. Which of the following outpatient treatments is most appropriate?
A 68-year-old female with diabetes and chronic obstructive pulmonary disease (COPD) presents with fever, cough, and dyspnea. She was treated with amoxicillin for a urinary tract infection one month ago. Chest X-ray reveals a left lower lobe infiltrate. Which of the following outpatient treatments is most appropriate?
- High-dose amoxicillin plus azithromycin
- Levofloxacin (correct)
- Ciprofloxacin
- Amoxicillin alone
A 6-year-old child presents with fever, cough, and mild respiratory distress. Chest X-ray shows bilateral infiltrates. Which of the following is the most appropriate treatment?
A 6-year-old child presents with fever, cough, and mild respiratory distress. Chest X-ray shows bilateral infiltrates. Which of the following is the most appropriate treatment?
- Doxycycline
- Levofloxacin
- Amoxicillin (correct)
- Clindamycin
A 56-year-old male with a history of alcoholism presents with fever, foul-smelling sputum, and night sweats. Imaging reveals a cavitary lesion with an air-fluid level in the right upper lobe. Which of the following is the most appropriate treatment?
A 56-year-old male with a history of alcoholism presents with fever, foul-smelling sputum, and night sweats. Imaging reveals a cavitary lesion with an air-fluid level in the right upper lobe. Which of the following is the most appropriate treatment?
A 34-year-old HIV-positive male with a CD4+ count of 180 cells/µL presents with fever, non-productive cough, and hypoxemia. Chest X-ray reveals diffuse bilateral interstitial infiltrates. Which of the following is the first-line treatment?
A 34-year-old HIV-positive male with a CD4+ count of 180 cells/µL presents with fever, non-productive cough, and hypoxemia. Chest X-ray reveals diffuse bilateral interstitial infiltrates. Which of the following is the first-line treatment?
A patient presents with fever, weight loss, hepatosplenomegaly, and cough. They recently traveled to the Ohio River Valley region. Which of the following is the most appropriate treatment?
A patient presents with fever, weight loss, hepatosplenomegaly, and cough. They recently traveled to the Ohio River Valley region. Which of the following is the most appropriate treatment?
A 30-year-old male presents with fever, cough, and chest pain after traveling to southern Arizona. Diagnosis confirms Coccidioidomycosis. Which of the following is the most appropriate treatment?
A 30-year-old male presents with fever, cough, and chest pain after traveling to southern Arizona. Diagnosis confirms Coccidioidomycosis. Which of the following is the most appropriate treatment?
A 25-year-old immunocompromised patient presents with cough, fever, and hemoptysis. Chest CT reveals a halo sign suggestive of aspergillosis. Which of the following is the first-line treatment?
A 25-year-old immunocompromised patient presents with cough, fever, and hemoptysis. Chest CT reveals a halo sign suggestive of aspergillosis. Which of the following is the first-line treatment?
A 72-year-old immunocompromised male presents with fever, cough, and shortness of breath. Imaging shows a cavitary lung lesion. Blood cultures grow Nocardia. Which of the following is the first-line treatment?
A 72-year-old immunocompromised male presents with fever, cough, and shortness of breath. Imaging shows a cavitary lung lesion. Blood cultures grow Nocardia. Which of the following is the first-line treatment?
A 55-year-old male with a history of right-sided endocarditis presents with fever and pleuritic chest pain. Imaging shows multiple nodular lesions with cavitation. Which of the following is the most likely diagnosis?
A 55-year-old male with a history of right-sided endocarditis presents with fever and pleuritic chest pain. Imaging shows multiple nodular lesions with cavitation. Which of the following is the most likely diagnosis?
A 60-year-old diabetic male presents with fever, chills, and cough producing thick, blood-tinged sputum. Imaging reveals a necrotizing pneumonia. Which of the following pathogens is the most likely cause?
A 60-year-old diabetic male presents with fever, chills, and cough producing thick, blood-tinged sputum. Imaging reveals a necrotizing pneumonia. Which of the following pathogens is the most likely cause?
A 42-year-old male with a history of stroke and poor dentition presents with fever, foul-smelling sputum, and right-sided chest pain. Imaging reveals a lung abscess. Which of the following is the most appropriate antibiotic regimen?
A 42-year-old male with a history of stroke and poor dentition presents with fever, foul-smelling sputum, and right-sided chest pain. Imaging reveals a lung abscess. Which of the following is the most appropriate antibiotic regimen?
A 70-year-old male with chronic obstructive pulmonary disease (COPD) is admitted to the ICU for severe pneumonia. Which of the following is the recommended empiric treatment?
A 70-year-old male with chronic obstructive pulmonary disease (COPD) is admitted to the ICU for severe pneumonia. Which of the following is the recommended empiric treatment?
A patient presents during flu season with fever, cough, and myalgias. Testing confirms influenza with concurrent pneumonia. Which of the following treatments is appropriate?
A patient presents during flu season with fever, cough, and myalgias. Testing confirms influenza with concurrent pneumonia. Which of the following treatments is appropriate?
A 50-year-old male with suspected Pseudomonas pneumonia is admitted to the ICU. He reports a severe penicillin allergy. Which of the following antibiotics should be included in the empiric treatment?
A 50-year-old male with suspected Pseudomonas pneumonia is admitted to the ICU. He reports a severe penicillin allergy. Which of the following antibiotics should be included in the empiric treatment?
A 29-year-old female with HIV presents with cough, weight loss, and lymphadenopathy. She recently visited caves in the Ohio River Valley. Chest imaging shows diffuse infiltrates. Which diagnostic test is most appropriate?
A 29-year-old female with HIV presents with cough, weight loss, and lymphadenopathy. She recently visited caves in the Ohio River Valley. Chest imaging shows diffuse infiltrates. Which diagnostic test is most appropriate?
A 64-year-old male undergoing chemotherapy develops fever, cough, and hemoptysis. Chest CT reveals a halo sign. Which of the following is the first-line treatment?
A 64-year-old male undergoing chemotherapy develops fever, cough, and hemoptysis. Chest CT reveals a halo sign. Which of the following is the first-line treatment?
A patient presents with pneumonia-like symptoms after exposure to contaminated soil in the southeastern United States. Which of the following is the most likely diagnosis?
A patient presents with pneumonia-like symptoms after exposure to contaminated soil in the southeastern United States. Which of the following is the most likely diagnosis?
A 35-year-old male with a cavitary lung lesion caused by Staphylococcus aureus is found to have methicillin-resistant Staphylococcus aureus (MRSA). Which of the following antibiotics should be added to the regimen?
A 35-year-old male with a cavitary lung lesion caused by Staphylococcus aureus is found to have methicillin-resistant Staphylococcus aureus (MRSA). Which of the following antibiotics should be added to the regimen?
A 47-year-old immunocompromised patient presents with fever, dyspnea, and chest pain. Blood culture grows Blastomyces dermatitidis. Which of the following treatments is recommended for moderate to severe disease?
A 47-year-old immunocompromised patient presents with fever, dyspnea, and chest pain. Blood culture grows Blastomyces dermatitidis. Which of the following treatments is recommended for moderate to severe disease?
A 52-year-old homeless male presents with fever, cough, and foul-smelling sputum. His medical history is significant for alcohol use disorder and poor dentition. Chest imaging reveals a cavitary lesion with an air-fluid level in the right lower lobe. Which of the following is the most appropriate treatment?
A 52-year-old homeless male presents with fever, cough, and foul-smelling sputum. His medical history is significant for alcohol use disorder and poor dentition. Chest imaging reveals a cavitary lesion with an air-fluid level in the right lower lobe. Which of the following is the most appropriate treatment?
A 34-year-old male presents with fever, productive cough, and shortness of breath. He reports recent travel to the Ohio River Valley region, where he cleaned an old barn. Physical examination reveals hepatosplenomegaly and lymphadenopathy. Imaging shows diffuse pulmonary infiltrates. Which of the following is the most likely pathogen?
A 34-year-old male presents with fever, productive cough, and shortness of breath. He reports recent travel to the Ohio River Valley region, where he cleaned an old barn. Physical examination reveals hepatosplenomegaly and lymphadenopathy. Imaging shows diffuse pulmonary infiltrates. Which of the following is the most likely pathogen?
A 41-year-old male undergoing chemotherapy presents with fever, cough, and hemoptysis. Chest CT reveals a nodule with a surrounding ground-glass opacity (halo sign). Which of the following is the most appropriate initial treatment?
A 41-year-old male undergoing chemotherapy presents with fever, cough, and hemoptysis. Chest CT reveals a nodule with a surrounding ground-glass opacity (halo sign). Which of the following is the most appropriate initial treatment?
A 67-year-old patient with a history of chronic obstructive pulmonary disease (COPD) presents with fever, chills, and cough producing thick, blood-tinged sputum. Imaging shows right upper lobe necrotizing pneumonia. Which of the following is the most likely causative organism?
A 67-year-old patient with a history of chronic obstructive pulmonary disease (COPD) presents with fever, chills, and cough producing thick, blood-tinged sputum. Imaging shows right upper lobe necrotizing pneumonia. Which of the following is the most likely causative organism?
A 58-year-old immunocompromised male presents with fever, weight loss, and chronic cough. He recently traveled to southern Arizona. Imaging shows a cavitary lesion in the right lower lobe. Which of the following is the most likely pathogen?
A 58-year-old immunocompromised male presents with fever, weight loss, and chronic cough. He recently traveled to southern Arizona. Imaging shows a cavitary lesion in the right lower lobe. Which of the following is the most likely pathogen?
A 25-year-old male with untreated HIV and a CD4+ count of 180 cells/µL presents with progressive dyspnea, fever, and non-productive cough. Chest X-ray shows bilateral interstitial infiltrates. Serum LDH is elevated. Which of the following is the most appropriate treatment?
A 25-year-old male with untreated HIV and a CD4+ count of 180 cells/µL presents with progressive dyspnea, fever, and non-productive cough. Chest X-ray shows bilateral interstitial infiltrates. Serum LDH is elevated. Which of the following is the most appropriate treatment?
A 45-year-old construction worker presents with fever, cough, and chest pain. He recently worked on a demolition site in the midwestern United States. Imaging shows patchy lung infiltrates, and bronchoalveolar lavage reveals a dimorphic fungus. Which of the following is the most appropriate treatment?
A 45-year-old construction worker presents with fever, cough, and chest pain. He recently worked on a demolition site in the midwestern United States. Imaging shows patchy lung infiltrates, and bronchoalveolar lavage reveals a dimorphic fungus. Which of the following is the most appropriate treatment?
A 72-year-old male presents with fever, pleuritic chest pain, and hemoptysis. Imaging reveals multiple cavitary nodules. Blood cultures are positive for gram-positive branching filaments that are weakly acid-fast. Which of the following is the most appropriate treatment?
A 72-year-old male presents with fever, pleuritic chest pain, and hemoptysis. Imaging reveals multiple cavitary nodules. Blood cultures are positive for gram-positive branching filaments that are weakly acid-fast. Which of the following is the most appropriate treatment?
A 29-year-old male presents with fever, cough, and weight loss after spending time in a cave. Imaging shows diffuse pulmonary infiltrates. Which of the following diagnostic tests is most appropriate?
A 29-year-old male presents with fever, cough, and weight loss after spending time in a cave. Imaging shows diffuse pulmonary infiltrates. Which of the following diagnostic tests is most appropriate?
A 54-year-old male undergoing chemotherapy presents with fever, cough, and dyspnea. Imaging shows a cavitary lesion with an air-fluid level. Blood cultures are positive for gram-negative bacilli. Which of the following pathogens is most likely?
A 54-year-old male undergoing chemotherapy presents with fever, cough, and dyspnea. Imaging shows a cavitary lesion with an air-fluid level. Blood cultures are positive for gram-negative bacilli. Which of the following pathogens is most likely?
A 38-year-old farmer presents with fever, cough, and dyspnea after exposure to moldy hay. Imaging shows diffuse interstitial infiltrates. Which of the following is the most likely diagnosis?
A 38-year-old farmer presents with fever, cough, and dyspnea after exposure to moldy hay. Imaging shows diffuse interstitial infiltrates. Which of the following is the most likely diagnosis?
A 26-year-old agricultural worker presents with fever, cough, and chest pain. He recently cleaned a silo and inhaled fermenting plant material. Which of the following is the most likely diagnosis?
A 26-year-old agricultural worker presents with fever, cough, and chest pain. He recently cleaned a silo and inhaled fermenting plant material. Which of the following is the most likely diagnosis?
A 63-year-old immunocompromised patient presents with fever, weight loss, and cough producing thick sputum. Imaging reveals a cavitary lung lesion. Sputum culture shows gram-positive cocci in clusters. Which of the following is the most appropriate treatment?
A 63-year-old immunocompromised patient presents with fever, weight loss, and cough producing thick sputum. Imaging reveals a cavitary lung lesion. Sputum culture shows gram-positive cocci in clusters. Which of the following is the most appropriate treatment?
A 50-year-old male presents with a flu-like illness, including fever, cough, and myalgias during influenza season. Chest imaging shows patchy infiltrates. Which of the following is the best initial treatment?
A 50-year-old male presents with a flu-like illness, including fever, cough, and myalgias during influenza season. Chest imaging shows patchy infiltrates. Which of the following is the best initial treatment?
A 48-year-old patient with a history of aspiration due to stroke presents with fever, productive cough, and right-sided chest pain. Imaging reveals a cavitary lesion with an air-fluid level. Which of the following bacteria is most likely responsible?
A 48-year-old patient with a history of aspiration due to stroke presents with fever, productive cough, and right-sided chest pain. Imaging reveals a cavitary lesion with an air-fluid level. Which of the following bacteria is most likely responsible?
A 55-year-old male presents with fever, productive cough, and shortness of breath. His history is significant for diabetes mellitus. He reports that his sputum is thick and dark red in color. Chest X-ray reveals a right upper lobe consolidation with cavitation. Which of the following is the most likely pathogen?
A 55-year-old male presents with fever, productive cough, and shortness of breath. His history is significant for diabetes mellitus. He reports that his sputum is thick and dark red in color. Chest X-ray reveals a right upper lobe consolidation with cavitation. Which of the following is the most likely pathogen?
A 38-year-old female presents with fever, cough, and chest pain. She recently returned from a cruise where she experienced diarrhea and confusion. Chest imaging shows patchy infiltrates. Which of the following is the most likely pathogen?
A 38-year-old female presents with fever, cough, and chest pain. She recently returned from a cruise where she experienced diarrhea and confusion. Chest imaging shows patchy infiltrates. Which of the following is the most likely pathogen?
A 70-year-old male with a history of COPD presents with fever, green sputum, and shortness of breath. Chest X-ray shows a right lower lobe infiltrate. Which of the following pathogens is most likely responsible?
A 70-year-old male with a history of COPD presents with fever, green sputum, and shortness of breath. Chest X-ray shows a right lower lobe infiltrate. Which of the following pathogens is most likely responsible?
A 32-year-old patient presents with a persistent cough lasting more than two weeks, accompanied by post-tussive vomiting. Which of the following is the most likely pathogen?
A 32-year-old patient presents with a persistent cough lasting more than two weeks, accompanied by post-tussive vomiting. Which of the following is the most likely pathogen?
A 44-year-old male presents with fever, cough, and hemoptysis after visiting a construction site in the Ohio River Valley. Imaging shows diffuse pulmonary infiltrates. Which of the following is the most likely pathogen?
A 44-year-old male presents with fever, cough, and hemoptysis after visiting a construction site in the Ohio River Valley. Imaging shows diffuse pulmonary infiltrates. Which of the following is the most likely pathogen?
A 50-year-old immunocompromised patient presents with fever, cough, and weight loss. Chest CT reveals a cavitary lung lesion. Sputum culture shows gram-positive branching filaments that are weakly acid-fast. Which of the following is the most appropriate treatment?
A 50-year-old immunocompromised patient presents with fever, cough, and weight loss. Chest CT reveals a cavitary lung lesion. Sputum culture shows gram-positive branching filaments that are weakly acid-fast. Which of the following is the most appropriate treatment?
A 27-year-old patient presents with fever, cough, and a rash. He recently cleaned a birdcage. Imaging shows bilateral interstitial infiltrates. Which of the following pathogens is most likely responsible?
A 27-year-old patient presents with fever, cough, and a rash. He recently cleaned a birdcage. Imaging shows bilateral interstitial infiltrates. Which of the following pathogens is most likely responsible?
A 58-year-old male presents with fever, hemoptysis, and weight loss. Imaging reveals miliary nodules throughout both lungs. Which of the following is the most likely diagnosis?
A 58-year-old male presents with fever, hemoptysis, and weight loss. Imaging reveals miliary nodules throughout both lungs. Which of the following is the most likely diagnosis?
A 43-year-old patient presents with fever, cough, and chest pain after visiting southern Arizona. Imaging shows a cavitary lung lesion. Which of the following treatments is most appropriate?
A 43-year-old patient presents with fever, cough, and chest pain after visiting southern Arizona. Imaging shows a cavitary lung lesion. Which of the following treatments is most appropriate?
A 49-year-old male undergoing chemotherapy presents with fever, hemoptysis, and pleuritic chest pain. Imaging reveals a nodule with a surrounding ground-glass opacity (halo sign). Which of the following is the most appropriate treatment?
A 49-year-old male undergoing chemotherapy presents with fever, hemoptysis, and pleuritic chest pain. Imaging reveals a nodule with a surrounding ground-glass opacity (halo sign). Which of the following is the most appropriate treatment?
A 30-year-old agricultural worker presents with fever, cough, and chest pain after exposure to fermenting plant material in a silo. Imaging shows diffuse pulmonary infiltrates. Which of the following is the most likely diagnosis?
A 30-year-old agricultural worker presents with fever, cough, and chest pain after exposure to fermenting plant material in a silo. Imaging shows diffuse pulmonary infiltrates. Which of the following is the most likely diagnosis?
A 68-year-old patient with right-sided endocarditis presents with fever, pleuritic chest pain, and hemoptysis. Imaging shows multiple nodular lesions with cavitation. Which of the following is the most likely diagnosis?
A 68-year-old patient with right-sided endocarditis presents with fever, pleuritic chest pain, and hemoptysis. Imaging shows multiple nodular lesions with cavitation. Which of the following is the most likely diagnosis?
Flashcards
CAP Definition
CAP Definition
Community-Acquired Pneumonia: Pneumonia contracted outside of a hospital or long-term care facility.
Empiric Treatment
Empiric Treatment
Treatment approach that selects antibiotics based on likely pathogens before specific identification.
Azithromycin
Azithromycin
Macrolide antibiotic often used for CAP.
Doxycycline Use
Doxycycline Use
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Cefpodoxime
Cefpodoxime
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Fluoroquinolones
Fluoroquinolones
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Levofloxacin
Levofloxacin
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Amoxicillin
Amoxicillin
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CAP with Comorbidities
CAP with Comorbidities
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CAP First-Line Antibiotic
CAP First-Line Antibiotic
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Pulmonary Infiltrate
Pulmonary Infiltrate
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Recent Antibiotic Use
Recent Antibiotic Use
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Lobar Pneumonia
Lobar Pneumonia
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Consolidation Meaning
Consolidation Meaning
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Productive Cough
Productive Cough
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Pathogen Identification
Pathogen Identification
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Age-Based Antibiotics
Age-Based Antibiotics
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Patient History
Patient History
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Chest X-Ray
Chest X-Ray
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Common in kids CAP
Common in kids CAP
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Study Notes
- Study notes on various lung infections, their presentations, likely pathogens, and appropriate treatments are provided in the form of questions and answers.
Common Community-Acquired Pneumonia (CAP) Treatment
- For CAP without comorbidities, recommended outpatient empiric treatments include macrolides or amoxicillin or doxycycline.
- Azithromycin is appropriate for a 45-year-old male presenting with fever, productive cough, and shortness of breath, showing right lower lobe consolidation on chest X-ray, and that has no comorbidities or recent antibiotic use.
- For CAP with comorbidities or recent antibiotic use, respiratory fluoroquinolones are recommended
- Levofloxacin is appropriate for treating CAP in a 68-year-old female with diabetes and COPD, recent amoxicillin use, and left lower lobe infiltrate on chest X-ray.
- A high dose of amoxicillin is the recommended treatment for CAP in children under the age of 5
Lung Abscess Treatment
- Lung abscesses typically require anaerobic coverage
- Clindamycin is appropriate for a 56-year-old male with alcoholism, fever, foul-smelling sputum, night sweats, and a cavitary lesion on imaging
- Clindamycin is appropriate for a 42-year-old male with a history of stroke and poor dentition presents with fever, foul-smelling sputum, and right-sided chest pain.
- For 52-year-old homeless male with alcoholism, poor dentition, fever, cough, and foul-smelling sputum with lung abcess use clindamycin
- Mixed anaerobic bacteria are the most likely pathogen in the cavitory lession with an air-fluid level for a 62-year-old chronic alcoholic presents with fever, chills, and cough producing foul-smelling sputum.
Pneumocystis jirovecii Pneumonia (PCP) Treatment
- For Pneumocystis jirovecii Pneumonia (PCP), TMP-SMX should be administered.
- TMP-SMX is the correct first-line treatment for Pneumocystis jirovecii pneumonia (PCP) in a 34-year-old HIV-positive male with a CD4+ count of 180 cells/µL presenting with fever, non-productive cough, and hypoxemia and having diffuse bilateral interstitial infiltrates in the lung.
Histoplasmosis
- For Histoplasmosis in Ohio and Mississippi River valleys, itraconazole should be administered.
- Itraconazole is used for a patient who presents with fever, weight loss, hepatosplenomegaly, and cough after recently traveling to the Ohio River Valley region.
- Bronchoalveolar lavage for Histoplasma capsulatum is the best diagnostic test, as well as amphotericin B as therapy.
- Is a likely pathogen in bird/bat droppings that presents with hepatosplenomegaly, and fungal pneumonia
- Histoplasma capsulatum is the most likely pathogen for a 44-year-old male presents with fever, cough, and hemoptysis after visiting a construction site in the Ohio River Valley
- Amphotericin B should be administered in Histoplasmosis cases that occurs at construction site in the Ohio River Valley on a 42 year old presenting with fever, weight loss, and cough
Aspergillosis
- Aspergillosis, treat with Voriconazole
- Voriconazole is the first-line treatment for Aspergillosis found in immunocompromised patients, and with a halo sign.
- Voriconazole is first-line for Aspergillosis in a 64-year-old male undergoing chemotherapy who develops fever, cough, and hemoptysis, and has Chest CT which reveals a halo sing
- Voriconazole is for a 41-year-old male undergoing chemotherapy with fever, cough, and hemoptysis, with Chest CT that reveals a nodule with a surrounding ground-glass opacity (halo sign).
Coccidioidomycosis
- Coccidioidomycosis (Valley Fever), commonly treated with Fluconazole or Itraconazole
- Fluconazole is the most appropriate treatment for confirmed Coccidioidomycosis after traveling to southern Arizona.
- Fluconazole is the first-line treatment for Coccidioidomycosis presents with fever, cough, and weight loss
Nocardia Treatment
- For Nocardia, an immunocompromised, cavitary lesion use, TMP-SMX.
- TMP-SMX should be administered to 72-year-old immunocompromised male presenting with fever, cough, and shortness of breath, showing a cavitary lung lesion and blood cultures growing Nocardia.
Klebsiella pneumoniae
- Is the most likely pathogens in thick, blood-tinged sputum found in necrotizing pneumonia
- Klebsiella pneumoniae is the most likely cause of a 60-year-old diabetic male presents with fever, chills, and cough producing thick, blood-tinged sputum and necrotizing pneumonia
- Klebsiella pneumoniae is the most likely causative organism with COPD that presents with fever, chills, and cough producing thick, blood-tinged sputum which shows right upper lobe necrotizing pneumonia
Influenza Pneumonia
- Oseltamivir is the recommended antiviral treatment for influenza pneumonia, can also treat mild cases.
- Oseltamivir is appropriate for a patient presenting during flu season with fever, cough, and myalgias and confirms influenza with concurrent pneumonia.
- Oseltamivir is the best initial treatment for a 50-year-old male presents with a flu-like illness, including fever, cough, and myalgias during influenza season that presents with patchy infiltrates
Pseudomonas Pneumonia
- In the case of a Penicillin allergy, Aztreonam can be used
Ohio River Valley
- In the Ohio River Valley Histoplasma capsulatum pneumonia should be suspected.
- Ohio River Valley, bird/bat droppings, hepatosplenomegaly, think fungal pneumonia
- Histoplasma capsulatum pneumonia confirmed with bronchoalveolar lavage.
Blastomycosis
- Blastomycosis is likely in the southeastern United States presenting with pneumonia-like symptoms after exposure to contaminated soil.
- In Blastomycosis moderate to severe cases, Amphotericin B is the recommended treatment
- In midwestern US, and with soil exposure that is a dimorphic fungus Itraconazole should be administered
Cavitary Lung Lesions
- MRSA pneumonia, cavitary lesion, vancomycin or linezolid should be administered.
- For Lung Abscess, aspiration, anaerobic coverage clindamycin is the most likely prescribed drug.
Farmer’s Lung
- In Farmer’s lung, the most likely characteristics are moldy Hay, hypersensitivity pneumonitis, Farmer's lung.
- In this case, avoiding the source of the mold is key
- Farmer’s lung can be caused by inhaling fermenting plant material, toxic gas Silo filler's disease.
Miliary Nodules
- For Miliary nodules, think tuberculosis
- 58-year-old male with fever, hemoptysis, and weight loss presenting Miliary nodules throughout both lungs, the most likely diagnosis is Tuberculosis.
Bird Exposure
- Think of psittacossis
- For Bird exposure can use a rash, showing bilateral infiltrates. A likely pathogen is Chlamydia psittaci
Alcoholics
- In Alcoholic the most likely causative agent are Anaerobes
Right side endocarditis
- in cases of cavitary nodules with septic pulmonary emboli on a 68 year olds
Septic pulmonary emboli
- In cases of right sided endocarditis multiple nodular lesions with cavitation
Tularemia
- Can be suspected if patient cleans their rabbit hutch
- Can be confirmed using a patchy infilitrate
Persistant cough
- If with post tussive vomiting, its key pathogen is bordetella pertussis
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Description
Study notes covering various lung infections, including community-acquired pneumonia (CAP) and lung abscesses. Guidance is provided on appropriate treatments based on patient presentation, comorbidities, and likely pathogens. Empiric treatments and specific antibiotics like azithromycin and levofloxacin are discussed.
