1
Q
What are the patient populations affected by immunocompromised Pneumonia?
A
- HIV Positive
- Chemotherapy
- Organ transplants
- Connective Tissue Disease
- Other Immunosuppressive diseases such as Hodgkin Disease
2
Q
What are the symptoms of PNA?
A
- Fever
- Tachypnea
- Tachy or Bradycardia
- Crackles and/or Rhonchi
- Decreased B/S, Dullness to Percussion
- Less likely to have purulent sputum if neutropenic
3
Q
What are acute symptoms in PNA more likely caused by?
A
Bacterial
4
Q
What are subacute symptoms of PNA more likely caused by?
A
Fungal, Mycobacterial, PCP
5
Q
What are the 3 types of CXR you would see in PNA?
A
- Localized airspace consolidation - Bacterial
- Diffuse interstitial pattern - PCP (P. jirovecii), CMV
- Diffuse nodular lesions - Mycobacterium, fungus or tumor
6
Q
What causes PCP (Pneumocystis Pneumonia)?
A
P. Jirovecci….previously known as P. carinii
7
Q
What kind of infection is PCP?
A
Opportunistic
8
Q
PCP is common with a CD4 of what value?
A
<200
9
Q
With PCP, who has a greater mortality?
A
Non-HIV patients
10
Q
What is the treatment plan PNA?
A
- Collect sputum sample (BAL)
- Abx or other agents
- Respiratory Therapy
11
Q
What’s included in the respiratory therapy Tx PNA?
A
- O2
- CPT
- Mechanical Ventilation
- TMP-SMX (trimethoprim-sulfamethoxazole), and/or Pentamidine for prevention with hx of PCP or CD4 <200
