Staphylococcal Pneumonia

Aka: Staphylococcal Pneumonia, Pneumonia due to Staphylococcus aureus

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II. Epidemiology

  1. Represents <10% of all Community Acquired Pneumonia
  2. Debilitated or chronically ill patients

III. Risk factors

  1. Preceding viral respiratory infection
    1. Influenza
    2. Measles
  2. Cystic Fibrosis
  3. Nosocomial acquisition in Intensive Care unit
  4. Aspiration
  5. Nursing Home residents
  6. Obstructing Bronchogenic Carcinoma

IV. Symptoms and Signs

  1. Similar to Pneumococcal Pneumonia

V. Complications

  1. Tissue necrosis
  2. Lung Cavitation
  3. Empyema (common)
  4. Pleural Effusion (common)
  5. Pneumatocele (common)
  6. Pneumothorax (25%)

VI. Labs

  1. Gram Stain
    1. Gram Positive Cocci within the Leukocytes
  2. Blood Culture
    1. Frequently negative

VII. Radiology: Chest XRay

  1. Right lung involved in 65% of cases
  2. Bilateral involvement in <20% of cases

VIII. Management

  1. Avoid antibiotics with higher resistance
    1. Penicillin
    2. Ampicillin or Amoxicillin
  2. Methicillin Sensitive Staphylococcus aureus
    1. Oxacillin
    2. Nafcillin
    3. Clindamycin (risk of inducible resistance)
  3. Methicillin Resistant Staphylococcus Aureus
    1. Vancomycin
    2. Linezolid

IX. References

  1. Gilbert (2001) Sanford Antimicrobial, p. 28

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