Gram Negative Pneumonia

Aka: Gram Negative Pneumonia, Coliform Pneumonia

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II. Etiologies:

  1. Klebsiella
  2. Escherichia coli
  3. Enterobacter
  4. Proteus
  5. Pseudomonas aeruginosa

III. Epidemiology

  1. Represents <15% of all Community Acquired Pneumonia

IV. Risk Factors

  1. Debilitated Patients
  2. Chronically ill patients
  3. Alcoholism

V. Diagnosis

  1. Pleuritic Chest Pain (Sudden onset)
  2. Hemoptysis
    1. Thick Bloody Sputum

VI. Complications

  1. Tissue Necrosis
  2. Lung cavitation
  3. Empyema
  4. Similar to Pneumococcal Pneumonia

VII. Course

  1. Virulent infection with frequent complications

VIII. Labs: Gram Stain

  1. Gram Negative Bacilli

IX. Radiology: Chest XRay

  1. Upper lobes most frequently involved

X. Management

  1. Third Generation Cephalosporin
  2. Cefoxitin
  3. Imipenem
  4. Ticarcillin-Clavulanate (Timentin)
  5. Piperacillin-Tazobactam (Zosyn)
  6. Amoxicillin-Clavulanate (Augmentin)

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