Bacterial Pneumonia

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General Diagnosis

General:

CBC, Sputum(culture), Radiography(chest), CT scan

Classification

Interstitial

Interstitial Lung Disease

Lobular

Related to inflammation of alveoli

Patchy white, diffuse x-rays; associated with Mycoplasma induced pneumonia

Intra-alveolar space infection; most community acquired pneumonia & bacterial pneumonia

Culture

Sputnum

X-ray Imaging

Bronchopneumonia

patchy white diffuse spots on lung x-ray

Lobar

Opacities in the lungs; may depend on severity of disease; progression of pathology

Physical Examinations

General Signs and Symptoms:

Fever,Rigors, Cough, Runny nose, Dyspnea, Chest pain

Atypical organisms

Atypical in response to antibiotics; Generally stains poorly due to lack of peptidoglycan or irregular cellular wall or absence of one

Chlamydia

Chlamydophila pneumoniae

Virulence Factors 11

Diagnosis 11

Immunofluorescent staining for the presence of the intercellular presence of C. pneumoniae

General Characteristics 11

Non-motile, grown within vesicles, no cell wall, obligate intracellular bacteria

Treatment 11

Azithromycin or Erythromycin for 14 days

Chlamydia psittaci

Treatment 10

Tetracycline or Azithromycin of a week

General Characteristics 10

Non-motile, grown within vesicles, no cell wall, obligate intracellular bacteria

Found in Birds, transmitted via aerosolization of avian feces

Diagnosis 10

serological testing for C. psittaci

Virulence Factors 10

Elementary Bodies, Reticulate Bodies, Inclusion bodies

Mycoplasma pneumoniae

Treatment 9

doxycycline, azithromycin, or levlofoxacin

Diagnosis 9

Incubation 3 weeks

Nonspecific flulike symptoms

dry or scantily productive cough

chest x-ray reveals patchy diffuse spots

General Characteristics 9

aerobic,lack cytochromes, enzymes of the citric acid cycle, and cell walls, pleomorphic;

transmitted by respiratory droplets; found in lower respiratory tract

Virulence Factors 9

P1 cytoadhesin,adenosinediphosphate–ribosylase exotoxin

Coxiella burnetti

Treatment 8

Long term antimicrobial treatment (doxycycline); vaccine

Diagnosis 8

Q fever is diagnosed by serological testing

General Characteristics 8

aerobic, obligate intracellular bacteria

transmitted to humans via aerosolized dried feces and urine

Causes Q fever

Virulence Factors 8

C. burnetii infective bodies

Legionella pneumophila

Treatment 7

Macrolides: Erythromycin, azithromycin or clarithromycin

Quinolones: Levofloxacin or gatifloxacin Doxycycline

Diagnosis 7

Abrupt onset of fever, chills, headache and non-productive cough; abnormalities in the GI tract, CNS, liver and kidneys

General Characteristics 7

aerobic, coccobacilli in tissue, filamentous in culture, saprophyte

causes Legionnaire's disease

Virulence Factors 7

proteolytic enzymes, phosphatase, lipase and nuclease, C3b porin binding

Gram-negative organisms

Pseudomonas aeruginosa

Treatment 6

combination of aminoglycosides and B-lactam antibiotics

Diagnosis 6

blue-green pigment pyocyanin on agar

General Characteristics 6

Multi-drug resistance; Hospital acquired illness

Gram (-), Aerobic

Virulence Factors 6

adhesins, bacterial neuraminidase, capsule, endotoxin, exotoxin A, exoenzyme S, exoenzyme T, Elastases, Phospholipase C, Antibiotic resistance, Pyocyanin

Haemophilus influenzae

Treatment 5

doxycycline; second generation cephalosporins

Diagnosis 5

Sputum grey or creamy; grows well in C02 enriched incubator on chocolate agar

General Characteristics 5

Gram(-), coccobacillary, facultatively anaerobic capnophilic, obligate parasites; normal residents of oral cavity, spread via direct contact, coughing, sneezing

Virulence Factors 5

phagocyte -resistant capsules (PRP), adhesion proteins, lipooligosaccharide, pilus, IgA protease, Outer MB protein

Escherichia coli

Treatment 4

Diagnosis 4

Serological Testing to determine strain

General Characteristics 4

Gram (-), Aerobic or facultative anaerobe, fermentative, catalase (+) rods

Urinary Tract; spread via consumption, commensal organisms, opportunistic infections, soil water, vegetation, -excretion from GI tract, animal reserve

Virulence Factors 4

O antigen, K antigen, H antigen, LPS, Capsule, Antigenic Phase Variation, Exotoxin , fimbriae, intracellular survival and multiplication, siderophores, hemolysins, resistance to serum killing, antimicrobial resistance, verotoxin,

Klebsiella pneumoniae

Treatment 3

Third-generation cephalosporins or fluoroquinolones

Diagnosis 3

Extended Spectrum B-Lactamase Testing

General Characteristics 3

Gram (-), Aerobic or facultative anaerobe, fermentative, catalase (+) rods, capsule;

Nosocomial infections, urinary tract,oropharynx and the GI tract, spread via opportunistic infections,

Virulence Factors 3

Capsule, endotoxins

Main topic

Gram-positive organisms

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Staphylococcus aureus

Treatment 2

floxacillin; Zyvox

Diagnosis 2

Culture Testing; clinical symptoms; golden colonies

General Characteristics 2

Gram (+), catalase (+), coagulase (+), facultative anaerobe, non-motile, cluster of spheres golden colonies

Virulence Factors 2

Capsule, peptidoglycan, lysozyme, protein A, teichoic acids, clumping factor, cytolytic toxins, exfoliative toxin, TSST-1, enterotoxin, coagulate, catalase, haluronidase, fibinolysin, lipase, nuclease, lactamase

Streptococcus pneumoniae

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Treatment 1

penicillin; however MDR strains need amoxicillin or erythromycin in extreme cases or allergies

Diagnosis 1

Clinical symptoms; culture confirmation

General Characteristics 1

Gram (+), catalase (-), facultative anaerobe, encapsulated, oval or lancet-shaped, paired or short chains, α-hemolysis

Virulence Factors 1

Capsule, adhesin, secretory IgA protease, pneumolysin, autolysin, hydrogen peroxide

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Bacterial Pneumonia