• Bacterial
  • Strep pneumonia
  • Haemophilus influenza
  • Mycoplasma pneumonia
    • Young people
    • Headache, malaise and cough
    • WCC can be normal
    • Cold agglutinins in 50%
      • Other complications: pericarditis, myocarditis, erythema multiforme, D&V, meningoencephalitis
    • Treatment
      • Erythromycin
        • Doxy is second line.
        • Has no cell wall, so pen and cef useless
  • Legionella
    • Middle-aged smokers (M>F 2:1)
    • Presentaiton
      • Mild WCC, hyponatraemia
      • Proteinuria and haematuria
    • Investigations
      • Urinary antigen is pretty easy
      • IgG and IgM titres in urine, blood or sputum
    • Treatment
      • Erythromycin
        • Rif if allergic
  • Staph aureus
  • Moraxella
  • Chlamydia pneumoniae
  • Chlamydia psittacosis

• Viral
  • Influenza
•  Fungal
  • Aspergilloma
  • Invasive aspergillosis
    • Diffuse shadowing on CXR
  • ABPA
    • High IgE and abs to aspergillus (skin prick positive)
    • CXR: perihilar infiltrates
    • Sputum: hyphae
    • Biopsy: stains with H&E (unusual for a  fungi)
    • Treatment – Antifungals. Itraconazole in ABPA
• Aspiration
• Eosinophilic pneumonia
  • Flitting peripheral X-Ray shadows
  • Large numbers of eosinophils on BAL

·        Treat with steroids

• Tropical pulmonary eosinophilia
  • Immune reaction wuceria bancroftii
  • Patchy infiltrates on CXR and all the other systemic pneumonia things including lymphadenopathy
  • Treatment: diethylcarbamizine

• Organising pneumonia (often cryptogenic)
  • Pneumonia, which then recurs on a different place.
  • Non-specific malaise and dry cough as well
  • CT: patchy avlveolar opacities (granulation tissue)
  • Treatment
    • Steroids

• Persistent hypoxia
• Acidosis
• Hypercapnia
• Hypotension
• Reduced GCS