Community Acqired Pneumonia (CAP) CAP is usually caused by S. pneumonia, H. influenza, S. aureus, legionella (usually more severe), mycoplasma and Chlamydophila (less severe), and pseudomonas and Enterobacteriaceae sometimes isolated You don’t usually do cultures in CAP. Chest infiltrate and cough/sputum are diagnostic. Don’t go by procalcitonin to diagnose or to discontinue therapy. For CAP, there are a […]
Updated 2020
COPD and Bronchitis
Chronic obstructive pulmonary disease (COPD) causes a significant amount of morbidity and mortality. It’s the fourth leading cause of death in the world. COPD produces anatomical changes in the lungs that lead to narrowing of small airways, destruction of lung tissue, overproduction of mucous, reduced ciliary function, and airflow limitation. Smoking is the most common […]
Asthma
Asthma is pretty common. Over 25 million people in the US have it, and over 3500 people died from it in 2017. Hispanics and blacks suffer disproportionately. It’s a disease of chronic airway inflammation causing expiratory limitations including wheezing, chest tightness, shortness of breath, and cough. It can be spontaneous or triggered by exercise, allergens […]
Clostridium/Clostridiodes Difficile
Clostridiodes difficile is a pretty big problem, causing quite a bit of morbidity and mortality every year, and it’s becoming more and more common. It can be pretty tricky to treat. C. diff is an anaerobic, spore-forming rod and it makes a toxin that contributes to the severity of the disease. It causes diarrhea and […]
Sinusitis
Sinusitis is usually viral. Only use antibiotics if signs and symptoms are greater than 10 days or purulent discharge with a fever greater than 102 degrees. Viral is quick, usually lasting less than a week. Bacterial often has double sickening and purulent discharge. Do not do imaging unless immunocompromised or orbital cranial involvement. Only symptomatic relief for […]