Persistant pneumonia

1. Persistent pneumoniaPersistent pneumonia
Soumya Ranjan ParidaSoumya Ranjan Parida
Basic B.Sc. Nursing 4Basic B.Sc. Nursing 4thth
yearyear
Sum Nursing CollegeSum Nursing College

9. This slide shows the sputum Gram stain from thatThis slide shows the sputum Gram stain from that
patient with an abundance of white blood cells aspatient with an abundance of white blood cells as
well as gram-positive lancet-shaped diplococci.well as gram-positive lancet-shaped diplococci.
This sputum Gram stain is classic forThis sputum Gram stain is classic for
Streptococcus pneumoniaeStreptococcus pneumoniae

11. Chest x-ray of patient with atypical pneumoniaChest x-ray of patient with atypical pneumonia

20. Persistent pneumoniaPersistent pneumonia

21. DefinitionDefinition
It is defined as persistance ofIt is defined as persistance of
symptoms and radiographicsymptoms and radiographic
abnormailties for more than 1 month.abnormailties for more than 1 month.

22. Signs and SymptomsSigns and Symptoms
1. Fever1. Fever
2. Cough2. Cough
3. Tachypnea3. Tachypnea
4. Chest pain4. Chest pain
5. Cynosis5. Cynosis

23. CausesCauses
AA.. Congenital MalformationsCongenital Malformations::
1.1. AirwaysAirways
Cleft palateCleft palate
Pierre Robin syndromePierre Robin syndrome
Tracheoesophageal fistulaeTracheoesophageal fistulae
TracheomalaciaTracheomalacia
2.2. LungsLungs
Pulmonary hypoplasiaPulmonary hypoplasia
Pulmonary sequestrationPulmonary sequestration
Congenital adenomatoid malformation of the lungCongenital adenomatoid malformation of the lung
Bronchogenic cystBronchogenic cyst
3.3. CardiovascularCardiovascular
Congenital heart disease (L to R shunt)Congenital heart disease (L to R shunt)
Vascular ringVascular ring

24. CONT’DCONT’D
B. AspirationsB. Aspirations::
Gastroesophageal refluxGastroesophageal reflux
Swallowing abnormalitiesSwallowing abnormalities
Foreign bodyForeign body
Anomalies of the upper airwaysAnomalies of the upper airways
C. Defects in the clearance of airways secretionsC. Defects in the clearance of airways secretions::
Cystic fibrosisCystic fibrosis
Abnormalities of the ciliary structure of functionAbnormalities of the ciliary structure of function
Abnormal clearance secondary to infections,repair ofAbnormal clearance secondary to infections,repair of
congenital defects.congenital defects.

25. CONT’DCONT’D
D. Disorders of local / systemic immunity:D. Disorders of local / systemic immunity:
Primary immunodeficienciesPrimary immunodeficiencies
Acquired immunodeficienciesAcquired immunodeficiencies
HIV infectionHIV infection
Immunosuppresive therapyImmunosuppresive therapy
MalnutririonMalnutririon

26. Etiological OrganismsEtiological Organisms
1. Tuberculosis1. Tuberculosis
2. Cytomegalovirus virus2. Cytomegalovirus virus
3. Chlamydia3. Chlamydia
4.4. Pneumocystis cariniiPneumocystis carinii
5. Fungi5. Fungi
6. Legionella6. Legionella
7. Common organisms responsible for7. Common organisms responsible for
acute LRTIacute LRTI

27. InvestigationsInvestigations
1. Hematological:Hb,TDLC,ESR1. Hematological:Hb,TDLC,ESR
2. Chest X-Ray2. Chest X-Ray
3. Montoux test3. Montoux test
4. Sputum test4. Sputum test
5. Pulse oxymetry5. Pulse oxymetry
6. Serum immunoglobulins6. Serum immunoglobulins
7. HRCT of the chest7. HRCT of the chest
8. MRI Chest8. MRI Chest
9. Pulmonary function tests9. Pulmonary function tests
10. Bronchoscopy( if abnormality of bronchial10. Bronchoscopy( if abnormality of bronchial
anatomy or foreign body is suspected)anatomy or foreign body is suspected)
11. Barium swallow for identifying disorders of11. Barium swallow for identifying disorders of
swallowingswallowing
12. Sweat chloride estimation for cystic fibrosis12. Sweat chloride estimation for cystic fibrosis

29. Staphylococcal pneumoniaStaphylococcal pneumonia

34. Approach to a child with persistantApproach to a child with persistant
pneumoniapneumonia
1. Age of onset1. Age of onset
2. Details of the episodes2. Details of the episodes
3. Past history/Associated complaints3. Past history/Associated complaints
4. Perinatal history4. Perinatal history
5. Family history5. Family history
6. Environmental history6. Environmental history

35. TreatmentTreatment
1. Therapy for current infection1. Therapy for current infection
2. Therapy for underlying disease2. Therapy for underlying disease

36. THANKS