Chest Infections

Please see the pneumonia section in respiratory for more on chest infections.

Chest infections typically present with a cough and sputum production, shortness of breath, fever, lethargy and crackles on the chest. Remember that viral bronchitis is very common, will also present with a productive cough and does not require antibiotics.


Common causes

  • Streptococcus pneumoniae (50%)
  • Haemophilus influenzae (20%)


Other Causes and Associations

  • Moraxella catarrhalis in immunocompromised patients or those with chronic pulmonary disease
  • Pseudomonas aeruginosa in patients with cystic fibrosis or bronchiectasis
  • Staphylococcus aureus in patients with cystic fibrosis


Atypical Bacteria

You can remember the 5 causes of atypical pneumonia with the mnemonic “legions of psittaci MCQs”:

  • Legions – Legionella pneumophila
  • Psittaci – Chlamydia psittaci
  • M – Mycoplasma pneumoniae
  • C – Chlamydydophila pneumoniae
  • Qs – Q fever (coxiella burnetii)


Antibiotic Choice 

An appropriate initial antibiotic in the community would be

  • Amoxicillin


  • Erythromycin / clarithromycin
  • Doxycycline

To treat atypical bacteria:

  • Macrolides such as clarithromycin
  • Quinolones such as levofloxacin
  • Tetracyclines such as doxycycline


Last updated March 2019
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