Clozapine
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Which of the following is the most common organism ~
A) Klebsiella pneumoniae
B) Mycoplasma pneumoniae
C) Strepto pneumoniae
D) Chlamydia pneumoniae
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| Ancylostoma
Forum Guru
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I'm not completely sure about this, but almost. This is one of those tricky questions.
C reasoning: Strep pnuemo is the most common pnuemonia causing organism. In alcoholics you should also consider Klebsiella but I would think strep is more likely.
We will see if i'm right
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| Clozapine
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| Clozapine
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Klebsiella pneumoniae causes CAP usually in older males, specially diabetics, alcoholics and patients with chronic lung diseases.
But the most common pathogen causing pneumonia in alcoholics is Strepto pneumoniae
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| bacteriophage
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So, what is the final answer? A or C?
I knew it was A in alcoholics, but generally of course C. Since question is about alcoholics I would say correct answer is A
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| Ancylostoma
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Thats why I wrote its one of the tricky questions, the answer is still C
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| new_n_lost
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yup Strep still wud be the overall MC
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| bacteriophage
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I wonder what Bactitech would comment about this.
Sorry, I am new here and do not know much about this forum. Where is this question from?
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| residency_2008
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i dont find it tricky. MCC is C. its a straight question
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| bactitech
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Strep pneumoniae is the most common cause of bacterial pneumonia. That being said, I think this is one of those "classic" questions.
http://www.medscape.com/viewarticle/501977_3
Check out this page. You may have to register for Medscape to read it, however. Exerpt:
"Alcohol has been observed to be a common comorbidity in MICU patients with pneumonia.[60] Interestingly, there is a 60% increase in the use of the MICU when an alcoholic has pneumonia compared with a nonalcoholic patient. Moreover, the length of stay is increased compared with a nonalcoholic patient.[61] The mortality rate of pneumonia with alcohol-related diagnoses was reported to be 10%; however, in the case of Klebsiella pneumoniae, there was a higher incidence of bacteremia, with mortality up to 66%.[62] In addition, the incidence of tuberculosis, pleurisy, bronchitis, and empyema are significantly higher among alcoholics compared with nonalcoholics.[63]
The pathophysiology of pneumonia in alcoholics is primarily due to depression of normal defense mechanisms. Alcohol is known to depress normal mucociliary function.[64] Furthermore, the ability of neutrophils and macrophages to fight against infection is hampered.[65,66] Other inhibited lower respiratory tract defenses include nonspecific antibacterial activity of surfactant, opsonization by immunoglobulin or complement, and intracellular killing by alveolar macrophages.[67] Aspiration of material from the mixed oropharyngeal flora may be due to a diminished cough or epiglottic reflex seen during alcoholic withdrawal seizures or a decrease in level of consciousness associated with heavy drinking.[67] Other contributors to an increased risk of development of pneumonia include poor nutrition, immunosuppression from alcohol-related liver disease, and smoking abuse.
The symptoms of pneumonia in alcoholics are similar to those with community-acquired pneumonia but may be more severe. The organisms most commonly isolated are Streptococcus pneumoniae , Haemophilus influenza, and K pneumoniae. [68] In addition, because of the frequent occurrence of poor oral dentition, seizures, and subsequent aspiration, alcoholics are susceptible to a variety of anaerobic pleuropulmonary diseases, including anaerobic pneumonitis, necrotizing pneumonia, primary lung abscess, and empyema..."
So, again, a vague Kaplan question.....
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| darkhorse
Forum Elite
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its s. pnemonie
alcoholics with aspiration and abscess...K. pnemonie
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| Clozapine
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Don`t blame kaplan bactitech ... I cooked it up  ... it`s from the overzealous days when I was too much enthusiastic putting up questions in the forums  ... I know we can only dream about getting such trivial questions in the real exam .... didn mean to stir things up !! Sorry !!
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| Clozapine
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 guess what !! check the links @ the bottom ... they r talking about pneumonia in alcoholics in IM forum too !! wasn`t too bad a question I guess !!
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| bactitech
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OK Clozapine - I'll blame you for the murky question :-). You guys are the ones taking the exams, not I 
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| lq2006
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C
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| unique1
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According to score95.com Klebsiella pneumoniae is the most common cause of pneumonia in alcoholics . I am not sure about the credibility of this source though. Can someone please give a reliable resource ? or I should trust score 95 ?
Edited by unique1 on 05/27/07 - 09:56 AM
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| usmlefever
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i think unique score95 ans are not reliable don't waste ur time on it.
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| SmokyWaters
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S. pneumonia is the most common cause buddy...
kleb is characteristic...
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| Ig F
Forum Elite
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klebsiella frequently causes pnemonia in alcoholics,diabetics,chronic lung disease patients but the most common organism causing pnemonia in alcoholics is still Streptococcus pnemoniae......
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i m not perfect but i wanna get close to it......
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