Staphylococcus aureus pneumonia

Introduction

Introduction to Staphylococcus aureus pneumonia Staphylococcus aureus pneumonia, referred to as gold pneumonia, is a pneumonia caused by Staphylococcus aureus (generally coagulase-positive). Staphylococcus aureus pneumonia accounted for 2 to 3% of adult pneumonia. The incidence of infants, the elderly and the elderly was higher, and the overall mortality rate was 30% to 40%. Part of the cause of death is that most patients have severe comorbidities. However, some adults were originally healthy, but they got this pneumonia after the flu. The disease is developing rapidly. Eventually leading to death, antibiotics are slow. The recovery period is long. Clinically divided into two categories of primary and secondary. It is generally advocated to use penicillin which is resistant to penicillinase. basic knowledge The proportion of the disease: the probability of the population is 0.09% Susceptible population: the incidence of infants, the elderly, and the latter is higher. Mode of infection: respiratory transmission Complications: adult respiratory distress syndrome septic shock empyema endocarditis

Cause

Staphylococcus aureus pneumonia

Pathogenic bacteria infection (59%):

Staphylococcus is Gram-positive cocci, which can be divided into coagulase-positive Staphylococcus aureus (mainly Staphylococcus aureus, referred to as Staphylococcus aureus) and coagulase-negative Staphylococcus (such as Staphylococcus epidermidis). The pathogenic substances of Staphylococcus are mainly toxins and enzymes, which have the functions of hemolysis, necrosis and leukocyte killing. Staphylococcus aureus pneumonia is a serious condition and is one of the main causes of purulent infection in the lungs. In addition, Staphylococcus in skin infections (sputum, sputum, cellulitis, wound infection) can reach the lungs through the blood circulation, causing multiple lung infections, which can form single or multiple lung abscesses (blood-borne infections).

Prevention

Staphylococcus aureus pneumonia prevention

To prevent the production of Staphylococcus aureus enterotoxin, store food under low temperature and well ventilated conditions to prevent the formation of enterotoxin; in the spring and summer when the temperature is high, the food should be stored in a cool or ventilated place should not exceed 6 hours, and Thoroughly heat before eating.

Patients with Staphylococcus aureus infection, optional: erythromycin, new penicillin, gentamicin, vancomycin or cephalosporin VI treatment.

Complication

Staphylococcus aureus pneumonia complications Complications, adult respiratory distress syndrome, septic shock, empyema, endocarditis

Complications that are severe and can lead to death are progressive pneumonia, sometimes accompanied by adult respiratory distress syndrome and/or septic shock. Chest X-ray examination found that about 25% of patients had pleural effusion, and only about 1% of patients had empyema. Some patients develop infections in the vicinity of the lesion (such as empyema or suppurative pericarditis). Bacteremia can cause infections other than the lungs, including septic arthritis, endocarditis, meningitis, and (ascites). Some patients have repeated infections in the lungs, which manifests themselves in the course of treatment, with temporary improvement followed by fever and new lung infiltration leading to worsening of the condition.

Symptom

Symptoms of Staphylococcus aureus pneumonia Common symptoms Bronchial purulent secretion increased hyperthermia chills purulent dyspnea dyspnea emphysema pleural effusion abscess leukocytosis

1, primary: common in the flu, measles and antibiotics selection process, with fever, cough, cough, blood stasis, chest pain as the main symptoms, single or multiple abscess can be seen in the lungs.

2, secondary: also known as blood-borne, slow onset, clinically characterized by high fever, chills, dyspnea and other septic symptoms, severe right conscious disorder, respiratory failure and shock; multiple small abscesses in the lungs Primary suppurative lesions can be seen on the skin and other areas.

Although staphylococcal pneumonia is fierce, some conditions are not serious, and some cases are slow, sometimes forming chronic pneumonia or chronic lung abscess. The clinical symptoms are similar to the clinical symptoms of pneumococcal pneumonia. The characteristics of staphylococcal pneumonia are easy to cause. Repeated chills, tissue necrosis with abscess formation and pulmonary cysts (mostly found in infants and young children); acute and obvious failure, empyema is more common, Staphylococcus aureus mainly exists in the empyema after thoracic incision or chest wall traumatic hemothorax Use drainage in the empyema.

Examine

Examination of Staphylococcus aureus pneumonia

1, the patient cough out sputum found in Staphylococcus aureus can suspect the disease, the diagnosis should be confirmed from blood culture, pus or pus or chest extraction of Staphylococcus aureus. Staphylococcus aureus is different from pneumococci and is easier to culture, so false negatives are rare. The most common X-ray abnormalities are bronchial pneumonia with or without abscess formation or pleural effusion; large leaf consolidation is rare. Lung air sacs strongly suggest a staphylococcal infection. Embolization of staphylococcal pneumonia is characterized by multiple infiltrates in non-adjacent areas, and infiltrates are prone to cavities. These phenomena indicate that the cause is derived from intravascular (such as right endocarditis or septic thrombophlebitis).

2, X-ray examination: the primary visible blurred or dense shadow in the lungs, there is a translucent area, secondary manifestations of the two lungs scattered in nodular shadows and multiple holes.

3, laboratory examination: white blood cell count is significantly increased, up to 20 ~ 50 × 10 / L, and poisoning particles, sputum culture can be found Staphylococcus aureus.

Diagnosis

Diagnosis and identification of Staphylococcus aureus pneumonia

According to systemic toxic symptoms, cough, pus and blood stasis, white blood cell count increased, neutrophil ratio increased, nuclear left shift and poisoned granules and X-ray findings, can make a preliminary diagnosis, bacteriological examination is the basis for diagnosis, feasible, Pleural effusion, blood and lung puncture culture.

Staphylococcus aureus pneumonia must be differentiated from the following diseases: Streptococcus pneumoniae, Haemophilus influenzae or pneumoniae pneumonia, primary tuberculosis with cavity formation or caseous pneumonia, tracheal foreign body secondary to lung abscess and diaphragm, X-ray The characteristics of performance, such as lung abscess, bullous emphysema and empyema or pus pneumothorax can be used as the basis for the diagnosis of gold-glucose pneumonia; however, it must be differentiated from empyema and pus gas chest caused by other bacterial pneumonia. Therefore, the diagnosis of pathogens is very important.

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