Pneumonia (peds): Difference between revisions

Revision as of 23:28, 7 June 2011

Background

fever and tachypnea have high degree of sens but not specific

Causes

Common Causes

viruses- rsv, influenza, parainflu, adeno, rhino, measles
mycoplasma
chlamydia- pneumoniae and trachomatis
bacteria- strep, tb, staph, hflu, nontypable hflu
measles and nontypable hflu common in undeveloped world
c. pneumonia frequently recovered from asymptomatic subjects

Uncommon Causes

viruses- varicella zoster, corona, entero, coxsackie, echo, cmv, ebv, mumps, hsv- newborns, hanta is animal exp,
chlamydia psittaci
coxiella
bacteria- strep pyogenes, anaerobic mouth, hflu, pertussis, klebsiella, ecoli, listeria, nesseria, legionella, pseudomonas, tularremia, brucella, leptospira,
Fungi- cocci, histo, blasto

Diagnosis

cxr cannot differentiate between viral and bact pna (but lobar infiltrate more often bacterial)

WHO Criteria

Tachypnea
1. RR >50 (<1 yr old)
2. RR >40 (>1 yr old)
Retractions

Treatment

tx with azithromycin or clarithromycin after 3 months

Disposition

ADMIT

<3months old
SaO2 <91%
severe dehydration
moderate dehydration and unable to hydrate themselves orally after intravenous (IV) hydration
moderate or severe respiratory distress
failed outpatient antibiotic treatment, or
unsafe to send home

Sources

Adapted from Donaldson, Pani

Authors:

@@ Line 1: / Line 1: @@
 ==Background==
+fever and tachypnea have high degree of sens but not specific
-- fever and tachypnea have high degree of sens but not specific
 ==Causes==
+===Common Causes===
+# viruses- rsv, influenza, parainflu, adeno, rhino, measles
+# mycoplasma
+# chlamydia- pneumoniae and trachomatis
+# bacteria- strep, tb, staph, hflu, nontypable hflu
+# measles and nontypable hflu common in undeveloped world
+# c. pneumonia frequently recovered from asymptomatic subjects
+===Uncommon Causes===
-Common Causes
+# viruses- varicella zoster, corona, entero, coxsackie, echo, cmv, ebv, mumps, hsv- newborns, hanta is animal exp,
+# chlamydia psittaci
-- viruses- rsv, influenza, parainflu, adeno, rhino, measles
+# coxiella
+# bacteria- strep pyogenes, anaerobic mouth, hflu, pertussis, klebsiella, ecoli, listeria, nesseria, legionella, pseudomonas, tularremia, brucella, leptospira,
-- mycoplasma
+# Fungi- cocci, histo, blasto
-- chlamydia- pneumoniae and trachomatis
-- bacteria- strep, tb, staph, hflu, nontypable hflu
-- measles and nontypable hflu common in undeveloped world
-- c. pneumonia frequently recovered from asymptomatic subjects
-Uncommon Causes
-- viruses- varicella zoster, corona, entero, coxsackie, echo, cmv, ebv, mumps, hsv- newborns, hanta is animal exp,
-- chlamydia psittaci
-- coxiella
-- bacteria- strep pyogenes, anaerobic mouth, hflu, pertussis, klebsiella, ecoli, listeria, nesseria, legionella, pseudomonas, tularremia, brucella, leptospira,
-- Fungi- cocci, histo, blasto
 ==Diagnosis==
+# cxr cannot differentiate between viral and bact pna (but lobar infiltrate more often bacterial)
+===WHO Criteria===
-- cxr cannot differentiate between viral and bact pna (but lobar infiltrate more often bacterial)
+# Tachypnea
+##RR >50 (<1 yr old)
+##RR >40 (>1 yr old)
+# Retractions
-WHO Criteria
-. Tachypnea
-RR >50 (<1 yr old)
-RR >40 (>1 yr old)
-. Retractions
-Pneumonia: admit if <2 months, tx with azithromycin or clarithromycin after 3 months
 ==Treatment==
+tx with azithromycin or clarithromycin after 3 months
 ==Disposition==
 ADMIT
+# <3months old
--< 3months
+#SaO2 <91%
+#severe dehydration
--SaO2 <91%
+#moderate dehydration and unable to hydrate themselves orally after intravenous (IV) hydration
+#moderate or severe respiratory distress
--severe dehydration
+#failed outpatient antibiotic treatment, or
+#unsafe to send home
--moderate dehydration and unable to hydrate themselves orally after intravenous (IV) hydration
--moderate or severe respiratory distress
--failed outpatient antibiotic treatment, or
--unsafe to send home
 ==Sources==
 Adapted from Donaldson, Pani
 [[Category:Peds]]
+[[Category:Pulm]]