Recommended
More Related Content
Similar to Pneuminia in children.pptx
Similar to Pneuminia in children.pptx (20)
More from GururajaRamaiah1
More from GururajaRamaiah1 (20)
Recently uploaded
Recently uploaded (20)
Pneuminia in children.pptx
- 1. Pneumonia in children Dr Gururaja R MD,DNB (Paed)
- 2. Pneumonia
- 3. Pneumonia - classification • Lobar pneumonia • Bronchopneumonia • Interstitial pneumonia
- 5. Etiology • Viral – 40% • Bacterial -60% • Viral – RSV, Influenza, parainfluenza, adenovirus • Bacterial - < 2 months – klebsiella, E coli, pneumococci, staphylococci • 3 months to 3 yrs – pneumococci, H influenzae and staphylococci • After 3 yrs – pneumococci and staphylococci
- 6. Etiology • Chlamydia and mycoplasma – in > 5yrs and adolescents • Pneumocystis jiroveci and Histoplasma in immunocompromised children • Unknown in one third of cases
- 7. Risk factors • Low birth weight • Malnutrition • Vitamin A deficiency • Lack of breast feeding • Passive smoking • Family history • Air pollution
- 8. Clinical feaures • Insidious onset • Starts with URTI • FEVER • TACHYPNOEA • DYSPNOEA • RETRACTIONS OF CHEST
- 10. Pneumococcal pneumonia • Transmitted by droplets • Winter months • Bacteria multiply in alveoli • Inflammatory exudate • Lobar pneumonia • 1-3 days incubation period • Fever, chills, cough, rusty sputum • Tachypnoea, retractions of chest, • Difficulty in feeding, cyanosis • Percussion impaired • Decreased air entry, crepitations and bronchial breathing
- 11. Pneumococcal pneumonia • Chest x ray • CBC – leucocytosis • Sputum gram staining and culture • Blood culture • Treatment • Penicillin G • Augmentin – (amoxycillin and clavulanate) • Cefotaxime • Ceftriaxone • IV injection – 7 days
- 12. Staphylococcal pneumonia • Early infancy and childhood • Primary infection of alveoli or secondary to staphylococcal septicaemia • May be complications of measles, influenza • May follow pyoderma • Underlying conditions – cystic fibrosis, DM, malnutrition
- 13. Staphylococcal pneumonia • Initially diffuse lesions • Lesions suppurate -- brochoalveolar obstruction • Multiple microabscess – erode brochial wall and discharge their contents to bronchi • Pneumatocoeles – pathognomonic finding • Lung abscess • Erodes pleura and pericardium • Empyemia --- < 2yrs is always staphylococcal
- 15. Staphylococcal pneumonia • Complications • Disseminated disease • Bone, joints infection • Liver abscess • Brain abscess • Pyopneumothorax • pericarditis
- 16. Staphylococcal pneumonia • Treatment • Hospitalisation • Oxygen • IV fluids • Antibiotics • Augmentin • Cloxacillin • Vancomycin • Teicoplanin • Linezolid • Prolonged therapy 2-6 weeks
- 17. Staphylococcal pneumonia • Complications • ICD tube for empyema • May require VATS(video assisted thoracoscopic surgery) • Decortication
- 18. H influenzae pneumonia • < 3months to 3 yrs • Associated bacteremia • Begins in nasopharynx and spreads locally or through blood • Fever,dyspnoea,retraction s • Course is sub acute and prolonged • Treatment – augmentin/cefotaxime/ • ceftriaxone
- 19. Streptococcal pneumonia • Group A – may follow measles, varicella, influenza or pertusis • Group B – uncommon in India – important cause in west(new borns) • Interstitial pneumonia • haemorrhagic
- 20. Streptococcal pneumonia • Fever,chills,dyspnoea,retr actions • Cough, blood streaked sputum • Pleural effusion • Interstitial pneumonia • Leucocytosis • Sputum microscopy • Treatment – penicillin/third generation cephalosporins - for 7-10 days
- 21. Primary atypical pneumonia • Mycoplasma pneumoniae • Chlamydia • Legionella • Common in more than 4 yrs of age • Winter season • Droplet infetion • Subclinical mild infection
- 22. Primary atypical pneumonia • Incubation 12-14 days • Insidious or abrupt • Malaise, headache, fever, sore throat, myalgia and cough • Dyspnoea – unusual • Physical signs are minimal
- 24. Primary Atypical pneumonia • Difficult to differentiate from viral pneumonia and rickettesial pneumonia • Diagnosis is by detection of antibodies by ELISA/PCR • Treatment – macrolide antibiotics – erythromycin/azithromycin/clarithromycin • Or doxycycline • For 7 – 10 days
- 25. Viral pneumonia • Diffuse involvement rather than lobar • RSV common in infants • Parainfluenza/influenza/adenovirus • Interstitial pneumonia • Clinical signs of consolidation are absent • X ray – perihilar and peribronchial infiltrates • Supportive treatment • Ribavirin for RSV • Oseltamivir – for influenza
- 26. Viral pneumonia
- 28. COVID 19 • Novel corona virus – detected in wuhan, china in Dec 2019 • Soon spread all over world • 63 crore people affected so far all over world • 62 lakh people died officially all over world • Unofficial ? • Severe disease less common in healthy children • Airborne – droplets infection • Many variants – alpha, beta, gamma, delta, omicron • Mild cough and cold to Severe acute respiratory syndrome • RT-PCR/CT Chest/RAT • Treatment – supportive, oxygen, remdesivir, molnupiravir, monoclonal antibodies, corticosteroids, IvIg
- 29. SARS – CoV 2 (COVID 19)
- 30. •THANK YOU