4.08.2012

Atypical vs. Typical CAP - Clinical Signs/Sx



Definition of CAP: Community Acquired Pneumonia is acquired in the community or within the first 72hrs of hospitalization

Typical
Bugs: 
S. pneumo (most common)
H. Flu
Staph aureus
Klebsiella

Clinical Symptoms:
Quick onset with fever/chills
Pleuritic chest pain
Productive (thick) cough

Signs:
Tachycardia
late inspiration crackles

CXR:
Lobar consolidation

Tx:
Doxycycline, Azithromycin, Clarithromycin, Flouroquinolones


Atypical
Bugs: 
Mycoplasma pneumoniae (most common)
Chlamydia pneumoniae
Chlamydia psittaci 
Coxiella burnetii
Legionella
Viruses

Clinical Symptoms:
Slow onset
HA, sore throat, fatigue, myalgias
Dry cough
Fever

Signs:
normal pulse with high fever
wheezing/rhonci

CXR:
Diffuse infiltrates
No/minimum consolidation

Tx:
start empiric tx with:
 erythromycin (for Mycoplasma pneumoniae and Legionella)
tetracycline (for Chlamydia pneumoniae)

Pic: http://emedicalppt.blogspot.com/2011/02/community-acquired-pneumonia-cap.html
Source: Step Up to Medicine 2nd Ed Agabegi and Agabegi

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