Untitled Quiz

Study Notes

Segmental or lobar distribution, often seen in bronchopneumonia, especially in infants, young children, elderly, and immobile patients with cardiac failure
Upper respiratory infection may occur several days before symptoms appear
High fever, chills, and a single episode of true rigor in about a third of patients
Cough (90%) and sputum (often bloody) are common symptoms
Pleuritic chest pain is a typical complaint
Physical examination may reveal findings due to consolidation
Laboratory tests show WBC (15,000-30,000 with left shift) and Gram-stained sputum with predominant Gram-positive, bullet-shaped diplococci
Blood cultures are positive in 15-25% of cases
Treatment involves penicillin, cephalosporins, macrolides, and new quinolones
Complications include pleural effusion (10-20%), empyema, meningitis, and endocarditis
Prevention involves conjugate (PCV13) and polysaccharide vaccines (PPSV23)

2-10 day incubation period
Pneumonia and involvement of other organ systems are typical features
Pontiac fever is a mild form of the disease with a 5-66 hour incubation period, fever, and no pneumonia or organ involvement
Common modes of spread include contaminated potable water and heat-exchange apparatus
Sporadic cases occur more frequently in late summer and early fall
No person-to-person transmission occurs
Elderly, COPD, renal failure, DM, smokers, and immunosuppressed patients are more susceptible
The disease does not respond to penicillin or cephalosporin
Symptoms include high fever with repeated rigors, diarrhea, and unexplained impairment of mental function
Diagnosis involves direct immunofluorescence, serology, and urine antigen test
Therapy involves macrolides with rifampin, quinolones, and tetracycline

Causes pharyngitis, tracheobronchitis, and pneumonia
Cold agglutinins are present in 50% of cases
Affects children and young adults (5-20 years)
Incubation period is 2-3 weeks
Clinical characteristics include insidious onset, mild fever, and severe, disabling, paroxysmal cough
Auscultation findings are not impressive, with patchy infiltration on radiography
Complications include pulmonary spread, pleural effusions, and extrapulmonary manifestations (2-10%) such as Stevens-Johnson syndrome, Raynaud's phenomenon, and hemolysis
Clinical course and diagnosis involve self-limited pneumonia (4-6 weeks), relapse in 5-10%, and laboratory tests showing Gram stain with mild inflammation, no bacterial organisms, and cold agglutinins (> 1:32 – 2. and 3. weeks of illness)
Therapy involves macrolides, quinolones, and tetracycline

Common causes include Gram-negative bacilli (P. aeruginosa, Acinetobacter spp., Enterobacter spp., and K. pneumoniae) and S. aureus
The increasing prevalence of MRSA is a growing concern

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