This document discusses non-resolving pneumonia, beginning with an overview of different types of pneumonia and risk factors. It then covers potential causes of non-resolving pneumonia, separating them into infectious causes such as resistant or unusual organisms, complications, and host factors, as well as non-infectious causes like neoplasms, inflammatory disorders, and cardiac issues. The document concludes with recommending approaches to evaluating non-resolving pneumonia through re-evaluating tests and procedures like bronchoscopy, CT-guided biopsy, echocardiogram, and CT chest to identify underlying causes, many of which may require prolonged treatment.

1. NON RESOLVING
PNEUMONIA
Moderators:
Dr R Ramesh, MD, Professor
Dr K Thulasiram, MD, Associate Professor
Dr V Rushendra Kumari, MD, Assistant Professor
Presented by,
Dr Arun R M
1st year postgraduate

2. PNEUMONIA

3. PNEUMONIA
Community acquired pneumonia
Hospital acquired pneumonia
Hospital care acquired pneumonia

4. RISK FACTORS FOR PNEUMONIA

5. PATHOPHYSIOLOGY OF PNEUMONIA
Entry of
pathogen
Host
inflammatory
response
Inflammatory
mediators

6. PATHOLOGICAL STAGES

8. DIAGNOSIS
INVESTIGATIONS
CXR
Sputum
analysis
Blood culture
Urinary Ag
detection
PCR/Serology
Biomarkers

9. TREATMENT

10. VENTILATOR ASSOCIATED PNEUMONIA

11. RATE OF RESOLUTION

12. NON RESOLVING PNEUMONIA

13. CAUSES OF NON RESOLVING PNEUMONIA
INFECTIOUS
CAUSES
Host factors
Resistant organisms/Unusual organisms
Complications

14. HOST FACTORS

15. RESISTANT/UNUSUAL ORGANISMS

16. COMPLICATIONS

17. CAUSES OF NON RESOLVING PNEUMONIA
NON
INFECTIOUS
CAUSES
Neoplasia
Inflammatory disorders
Cardiac causes

18. NEOPLASMS

19. INFLAMMATORY DISORDERS

20. CARDIAC CAUSES

21. DRUGS CAUSING PNEUMONITIS

22. CAUSES OF NON RESOLVING PNEUMONIA
40%
28%
20%
12%
TB Bacterial Pneumonia Malignancy other

23. APPROACH TO NON RESOLVING PNEUMONIA
Persistent
pulmonary
opacity
Non Infectious
causes
Bronchoscopy
CT guided FNAC
ECHO
C ANCA
Infectious causes
Re evaluate
CT Chest

24. TREATMENT

25. TAKE HOME MESSAGE

26. THANK YOU