types, classification, feature , treatment

1. PNEUMONIAS
By-kajal sansoya

2. Defination
• Pneumonia is define as inflammatory with
exudate solidification of the parenchyma,
generally acute.

3. CLASSIFICATION
1. By site
2. By etiology
3. By mode

4. BY SITE
Alveolar or air space pneumonia or lobar
pneumonia-
Most common type, the organism causes an
inflammatory exudate that involves many
contiguous alveoli.
Bronchopneumonia
Inflammation restricted to the conducting
airways, especially terminal & respiratory
bronchioles & the surrounding alveoli.

5. Intestinal pneumonia
Inflammation is confined to intralveolar septa.

6. BY ETIOLOGY
Primary pneumonias
Caused by some specific pathogenic organism.
There is no pre-existing abnormality of respiratory
system.
Aspiration/secondary pneumonias
Characterized by the absence of any specific
pathogenic organism in sputum & the presence of
some pre-existing abnormalities of respiratory
system.

7. Suppurative/ necrosting pneumonia
In some cases complete healing does lung
disease not occur, features are destruction of
lung disease/ tissue by inflammation, abscess
formation & fibrosis & bronchiectasis.

8. BY MODE
Community-acquired pneumonia
Indicates pneumonia occurring in a person in
a community. Define as an acute pulmonary
infection in a patient who is not hospitalised
or living in a long-term care facility 14 or
more, before presentation & does not meet
the criteria for health care associated
pneumonia.

9. NASOCOMIAL/HOSPITAL-ACQUIRED
PNEUMONIA
Indication the development of pneumonia after
more than 48 hur. Of hospitalization. Most of
occur outside ICU. Higher risk in patient on
mechanical- ventiliation.

10. Pneumonia in immunocompromised host.
Seen immunocompromised patient like
neutropenic, HIV, maligancies.
Health care associated pneumonia (HCAP)
Infection occurring within 90 days of a 2 day or
longer hospitalization, stay in nursing home or
within 30 days receiving IV antibiotic therapy
haemodyalysis.

11. Pathological stages in development of
pneumonia
Stage of congestion
Stage of red hepatisation
Stage of grey hepatisation
Stage of resolution

12. Clinical features
• Systemic- fever, rigors, shivering, malaise,
headache.
• Pulmonary- dry cough, later expectoration of
muccopurrelent sputum, rust colour sputum,
upper abdominal tenderness, pleuritic chest
pain.

13.  Examination-
• high RR
• tachycardia
• crepitation in involved area
• 1-3 bronchial breathing.
 Investigation-
• blood count
• urea & electrolyte
• ESR
• blood culture
• serology
• cold aggulutinis
• LFT.

14. Treatment chart of pneumonia
Types of pneumonia Antibiotic treatment
Uncomplicated pneumonia Erythromycin 500mg/ 6hur
clarithromycin
Moderately sick patients require
hospitalization
Ceftriaxone 2g once/day.I.V
Severe sick patients Ceftraiaxone 2g once/day I.V
Underlying disease piperacillin+ tazobactam /cefeime

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