Pneumonia is inflammation of the lung parenchyma that can be caused by infectious or non-infectious etiologies. Streptococcus pneumoniae is the most common cause of bacterial pneumonia in children aged 3 weeks to 4 years. Pneumonia is the leading infectious cause of death in children under 5 years globally. Clinical manifestations include cough, increased respiratory rate, grunting, and fever. Chest x-ray and laboratory tests are used for diagnosis. Management involves oxygen therapy, fluid therapy, antibiotics, and admission is indicated for young infants or those with respiratory distress. Prevention includes vaccines for pathogens like Streptococcus pneumoniae, influenza, and RSV.
Bronchopneumonia is a type of pneumonia that causes inflammation in the bronchi and bronchioles. It can be classified based on origin (community acquired vs hospital acquired) or infecting organism (bacterial vs viral). Common causes include Streptococcus pneumoniae and Haemophilus influenzae. Clinical manifestations include fever, cough, and breathlessness. Chest x-ray often shows patchy areas of consolidation, particularly in the lung bases. Treatment involves antibiotics and supportive care, with hospitalization sometimes required depending on severity. Preventive measures include vaccination and smoking cessation.
Pneumonia is a common and potentially serious lung infection that can be caused by bacteria, viruses, or fungi. It is classified as community-acquired, hospital-acquired, or ventilator-associated based on where the infection was contracted. Common symptoms include cough, fever, and difficulty breathing. Treatment involves antibiotics, with drug choice depending on severity and likely causative organisms based on location and other risk factors. Complications can include parapneumonic effusions, empyema, or systemic infection. Prognosis depends on patient age and health, along with development of complications.
Pneumonia is an infection that causes inflammation in the lungs. There are two main types: lobar pneumonia, which affects one lung lobe, and bronchopneumonia, which causes patches throughout both lungs. Pneumonia is usually caused by bacteria or viruses and risks factors include age, smoking, and pre-existing medical conditions. Symptoms may include fever, cough, and difficulty breathing. Diagnosis involves chest x-rays and cultures. Treatment focuses on antibiotics and symptom relief. Complications can include lung abscesses or fluid in the chest cavity.
Pneumonia is a leading cause of illness and death in Nepal, particularly among young children and the elderly. This PowerPoint presentation provides a comprehensive overview of pneumonia in Nepal, including the causes, symptoms, risk factors, and treatment options.
Through powerful images and personal stories, we showcase the impact of pneumonia on individuals, families, and communities in Nepal. We highlight the challenges of accessing healthcare in remote and impoverished areas, the lack of awareness and education about the disease, and the importance of early diagnosis and treatment.
The presentation provides detailed information about the various types of pneumonia and the risk factors associated with each. We also discuss the diagnostic procedures, including chest x-rays and blood tests, and the treatment options, such as antibiotics and oxygen therapy.
In addition, we explore the efforts being made to prevent and control pneumonia in Nepal. We highlight the importance of vaccination, particularly among children and high-risk groups, and the role of community-based interventions in improving access to healthcare and promoting healthy behaviors.
Through this PowerPoint presentation, we aim to raise awareness about pneumonia in Nepal and the importance of early diagnosis and treatment. We showcase the latest research and innovations in pneumonia prevention and treatment, and the importance of collaboration and partnership to address the disease.
We urge the audience to take action in the fight against pneumonia, whether it be through spreading awareness, supporting organizations working on the ground, or advocating for policy change. Let us come together to create a world where no one has to suffer from the devastating effects of pneumonia.
This document provides information about community-acquired pneumonia (CAP). It discusses the epidemiology, risk factors, etiology, pathogenesis, clinical features, diagnosis, and management of CAP. CAP results in over 1 million hospitalizations and 55,000 deaths annually in the United States. The most common causes are Streptococcus pneumoniae, Haemophilus influenzae, and respiratory viruses like influenza. Clinical features may include fever, cough, shortness of breath, and findings on physical exam like crackles and decreased breath sounds.
Pneumonia is an acute infection of the lungs that causes inflammation of the air sacs (alveoli) and fills them with fluid. It can be caused by viruses or bacteria. Symptoms include cough, fever, chills, and difficulty breathing. Chest x-rays are used to confirm pneumonia and determine its severity and location in the lungs. Treatment involves antibiotics, with choices depending on whether it was acquired in the community or hospital. Prevention involves vaccination, hand washing, and isolation of infected patients. Pneumonia has many risk factors and can occasionally be caused by unusual pathogens depending on a person's environment or medical history.
Pneumonia is inflammation of the lung parenchyma that can be caused by infectious or non-infectious etiologies. Streptococcus pneumoniae is the most common cause of bacterial pneumonia in children aged 3 weeks to 4 years. Pneumonia is the leading infectious cause of death in children under 5 years globally. Clinical manifestations include cough, increased respiratory rate, grunting, and fever. Chest x-ray and laboratory tests are used for diagnosis. Management involves oxygen therapy, fluid therapy, antibiotics, and admission is indicated for young infants or those with respiratory distress. Prevention includes vaccines for pathogens like Streptococcus pneumoniae, influenza, and RSV.
Bronchopneumonia is a type of pneumonia that causes inflammation in the bronchi and bronchioles. It can be classified based on origin (community acquired vs hospital acquired) or infecting organism (bacterial vs viral). Common causes include Streptococcus pneumoniae and Haemophilus influenzae. Clinical manifestations include fever, cough, and breathlessness. Chest x-ray often shows patchy areas of consolidation, particularly in the lung bases. Treatment involves antibiotics and supportive care, with hospitalization sometimes required depending on severity. Preventive measures include vaccination and smoking cessation.
Pneumonia is a common and potentially serious lung infection that can be caused by bacteria, viruses, or fungi. It is classified as community-acquired, hospital-acquired, or ventilator-associated based on where the infection was contracted. Common symptoms include cough, fever, and difficulty breathing. Treatment involves antibiotics, with drug choice depending on severity and likely causative organisms based on location and other risk factors. Complications can include parapneumonic effusions, empyema, or systemic infection. Prognosis depends on patient age and health, along with development of complications.
Pneumonia is an infection that causes inflammation in the lungs. There are two main types: lobar pneumonia, which affects one lung lobe, and bronchopneumonia, which causes patches throughout both lungs. Pneumonia is usually caused by bacteria or viruses and risks factors include age, smoking, and pre-existing medical conditions. Symptoms may include fever, cough, and difficulty breathing. Diagnosis involves chest x-rays and cultures. Treatment focuses on antibiotics and symptom relief. Complications can include lung abscesses or fluid in the chest cavity.
Pneumonia is a leading cause of illness and death in Nepal, particularly among young children and the elderly. This PowerPoint presentation provides a comprehensive overview of pneumonia in Nepal, including the causes, symptoms, risk factors, and treatment options.
Through powerful images and personal stories, we showcase the impact of pneumonia on individuals, families, and communities in Nepal. We highlight the challenges of accessing healthcare in remote and impoverished areas, the lack of awareness and education about the disease, and the importance of early diagnosis and treatment.
The presentation provides detailed information about the various types of pneumonia and the risk factors associated with each. We also discuss the diagnostic procedures, including chest x-rays and blood tests, and the treatment options, such as antibiotics and oxygen therapy.
In addition, we explore the efforts being made to prevent and control pneumonia in Nepal. We highlight the importance of vaccination, particularly among children and high-risk groups, and the role of community-based interventions in improving access to healthcare and promoting healthy behaviors.
Through this PowerPoint presentation, we aim to raise awareness about pneumonia in Nepal and the importance of early diagnosis and treatment. We showcase the latest research and innovations in pneumonia prevention and treatment, and the importance of collaboration and partnership to address the disease.
We urge the audience to take action in the fight against pneumonia, whether it be through spreading awareness, supporting organizations working on the ground, or advocating for policy change. Let us come together to create a world where no one has to suffer from the devastating effects of pneumonia.
This document provides information about community-acquired pneumonia (CAP). It discusses the epidemiology, risk factors, etiology, pathogenesis, clinical features, diagnosis, and management of CAP. CAP results in over 1 million hospitalizations and 55,000 deaths annually in the United States. The most common causes are Streptococcus pneumoniae, Haemophilus influenzae, and respiratory viruses like influenza. Clinical features may include fever, cough, shortness of breath, and findings on physical exam like crackles and decreased breath sounds.
Pneumonia is an acute infection of the lungs that causes inflammation of the air sacs (alveoli) and fills them with fluid. It can be caused by viruses or bacteria. Symptoms include cough, fever, chills, and difficulty breathing. Chest x-rays are used to confirm pneumonia and determine its severity and location in the lungs. Treatment involves antibiotics, with choices depending on whether it was acquired in the community or hospital. Prevention involves vaccination, hand washing, and isolation of infected patients. Pneumonia has many risk factors and can occasionally be caused by unusual pathogens depending on a person's environment or medical history.
PNEUMONIA,
DEFINITION
Pneumonia is an infection of the pulmonary parenchyma.
To the pathologist, pneumonia is an infection of the alveoli ,distal airways, and interstitium of the lung that is manifested by increased weight of the lungs, replacement of normal lung’s sponginess by consolidation ,and alveoli filled with white blood cells ,red blood cells and fibrin .To the clinician, pneumonia is a constellation of symptoms and signs in combination with at least one opacity on CXR.
Epidemiology
Between 5 and 10 million cases of infectious pneumonia occur annually in the United States and result in more than 1 million hospitalizations.
Pneumonia is a leading cause of death worldwide, the sixth leading cause of death in the United States, and the most common lethal infectious disease.
Pneumonia lecture,Describe the common pathogenesis and pathogens of pneumonia
Discuss diagnosis and initial management of community acquired pneumonia (CAP)
Understand features of the Pneumonia PORT Severity Index
Discuss the IDSA/ATS guidelines and recommendations for final antibiotic choice
Understand issues in basic management for pneumonia in children, nursing home patients, and immunocompromised patients.
Pneumonia is an inflammatory lung condition caused by infection that can be fatal. It has many types depending on location in the lungs and cause. Risk factors include age, smoking, and medical conditions. Symptoms include cough, fever, and difficulty breathing. Diagnosis involves physical exam, labs, imaging and microbiology tests. Complications can include empyema or lung abscess if not treated with antibiotics, oxygen, breathing exercises, and posture changes.
1. Pneumonia is an infection of the lungs that can be caused by bacteria, viruses, or fungi. It leads to inflammation of the small air sacs in the lungs called alveoli.
2. Pneumonia is common, affecting over 450 million people per year worldwide and resulting in over 1 million deaths in 2010. Major risk factors include age over 65, smoking, and chronic health conditions.
3. Pneumonia is usually classified as either community-acquired or hospital-acquired. Common causative organisms vary depending on the classification and may include Streptococcus pneumoniae, Haemophilus influenzae, or Pseudomonas aeruginosa.
Pneumonia is an infection of the lungs that can be caused by bacteria, viruses, or other pathogens. Common symptoms include cough, fever, shortness of breath, and chest pain. Pneumonia is usually spread through airborne droplets from coughing or sneezing. Treatment involves antibiotics if bacterial or antivirals if viral. Prevention strategies include vaccination, reducing indoor smoke and pollution, and improving nutrition and primary healthcare access.
Pneumonia is a common and potentially serious lung infection that can have varying severity and causes. Key steps in managing pneumonia include assessing severity using a scoring system, empirically treating with antibiotics based on local resistance patterns, and determining the specific pathogen causing the infection. Common causes of pneumonia include bacteria like Streptococcus pneumoniae, viruses like influenza, and atypical bacteria like Mycoplasma pneumoniae. Treatment involves antibiotics targeted to likely pathogens, with hospitalization sometimes needed for severe cases.
Streptococcus pneumoniae is the most common cause of community-acquired pneumonia. Pneumonia causes inflammation in the lungs and can range from mild to life-threatening. Risk factors include age, smoking, chronic illnesses. Typical pneumonia is often bacterial while atypical pneumonia can be caused by Mycoplasma, Legionella, or viruses. Symptoms depend on the pathogen but may include fever, cough, chest pain. Treatment involves antibiotics but severity assessment is needed to determine inpatient versus outpatient management. Prevention involves vaccination against influenza and Streptococcus pneumoniae.
Pneumonia is an inflammation of the lung parenchyma caused by a microbial agent. It can be caused by bacteria, viruses, fungi or parasites. There are different classifications including community-acquired pneumonia (CAP), hospital-acquired pneumonia, and pneumonia in immunocompromised hosts. CAP is usually caused by Streptococcus pneumoniae or Haemophilus influenzae. Hospital-acquired pneumonia has a higher risk of drug-resistant organisms. Clinical manifestations include fever, cough, shortness of breath and chest pain.
This document discusses bronchitis and pneumonia. It defines bronchitis as an inflammatory disease of the bronchi that can be acute or chronic. The main forms of acute bronchitis are described. Pneumonia is defined as an acute infectious inflammatory disease involving the lungs. Pneumonia is classified and various forms are outlined. Criteria for diagnosing bronchitis and pneumonia are provided. Treatment approaches for bronchitis and pneumonia are also summarized including mucolytics, bronchodilators, antibiotics, antivirals, and other drugs.
This document discusses respiratory disorders such as pneumonia and tuberculosis. Pneumonia is an inflammation of the lungs caused by microbial infection. Factors like smoking, age, and medical conditions can predispose individuals to pneumonia. Clinical manifestations include fever, cough, and signs of lung consolidation. Diagnosis involves physical exam, chest x-ray, and sputum tests. Treatment involves antibiotics and rest. Tuberculosis is caused by the bacterium Mycobacterium tuberculosis and can affect the lungs or other organs. Symptoms vary depending on whether it is a primary infection or reactivation. Diagnosis involves skin tests, imaging, and sputum/tissue cultures. Treatment involves antibiotic therapy.
This document discusses respiratory disorders such as pneumonia and tuberculosis. Pneumonia is an inflammation of the lungs caused by microbial infection. Factors like smoking, age, and medical conditions can predispose individuals to pneumonia. Clinical manifestations include fever, cough, and signs of lung consolidation. Diagnosis involves physical exam, chest x-ray, and sputum tests. Treatment involves antibiotics and rest. Tuberculosis is caused by the bacterium Mycobacterium tuberculosis and can affect the lungs or other organs. Symptoms vary depending on whether it is a primary infection or reactivation. Diagnosis involves skin tests, imaging, and sputum/tissue cultures. Treatment involves antibiotic therapy.
Streptococcus pneumoniae is the most common cause of community-acquired pneumonia. Pneumonia has several classifications including lobar, bronchopneumonia, and interstitial pneumonia. Typical bacteria that cause pneumonia include Streptococcus pneumoniae, Staphylococcus aureus, and Klebsiella pneumoniae. Atypical bacteria include Mycoplasma pneumoniae, Legionella pneumophila, and Chlamydophila pneumoniae. Risk factors include age, smoking, and comorbidities. Diagnosis involves physical exam, chest x-ray, sputum culture, and pneumonia severity assessment to determine treatment approach. Antibiotics are selected based on suspected pathogen and severity of illness.
Pneumonia is an infection that inflames the air sacs in one or both lungs. Th...ssusera41f5e
Pneumonia is an infection of the alveoli that can be caused by viruses or bacteria. It can present as lobar pneumonia, with involvement of an entire lung lobe, or bronchopneumonia, with patchy involvement. Complications of pneumonia include empyema, where pus accumulates in the pleural space, and lung abscesses, where pus forms within the lung tissue. Factors like airway obstruction, ciliary dysfunction, epithelial injury, and impaired immunity can allow bacteria and viruses to colonize the lungs and cause pneumonia.
Pneumocystis jirovecii is a fungus that causes pneumonia in immunocompromised patients. It is diagnosed through microscopic visualization of the organism in samples obtained through induced sputum or bronchoscopy with bronchoalveolar lavage. Real-time PCR assays have increased sensitivity over conventional staining but may produce false positives. Risk factors include HIV/AIDS with CD4 count <200 cells/uL, use of immunosuppressive drugs, hematologic malignancies, and organ transplantation. Presentation involves fever, cough, and dyspnea. Treatment involves trimethoprim-sulfamethoxazole.
This document discusses various respiratory infections, including influenza, pneumonia, bronchiolitis, and metapneumovirus. Influenza often presents with fever, malaise, and cough. Complications can include primary or secondary pneumonia. Treatment involves rest, fluids, and antivirals. Bronchiolitis most often affects young children and is usually caused by respiratory syncytial virus. Metapneumovirus was discovered in 2001 and can cause bronchiolitis or influenza-like illness. Multiple respiratory viruses are now tested for via PCR from throat or lung samples.
SARS stands for severe acute respiratory syndrome . caused by a corona virus . major outbreak in south china in 2002 with fatality of about 10% and 800 deaths in a single outbreak.
This document discusses lower respiratory tract infections, including the types of pneumonia (community-acquired, hospital-acquired, ventilator-associated), common causative agents, pathogenesis, diagnosis and treatment. It provides details on bacterial pathogens that commonly cause pneumonia like Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Klebsiella pneumoniae. It also discusses atypical pneumonia from Mycoplasma or Legionella, as well as tuberculosis and fungal pneumonia. Sputum analysis, culture and sensitivity are important tools for diagnosis. Risk factors for hospital-acquired pneumonia include medical interventions like intubation and underlying illness.
Lung abscess is a localized area of lung destruction caused by infection, typically by aspiration of oropharyngeal bacteria. It appears on imaging as a cavity containing air-fluid levels. The infection can start as necrotizing pneumonia that progresses to microabscesses and larger cavitary lesions over time. Risk factors include dental/sinus infections, impaired swallowing, or pre-existing lung disease. Treatment involves antibiotics targeting common aerobic and anaerobic bacteria. Therapy typically lasts 4-6 weeks until imaging shows resolution, though surgery may be needed for large or resistant abscesses. Complications can include empyema, bronchopleural fistula, or distant infections if not properly treated.
Pneumonia Symposia presented at Hôpital Sacré Coeur in Milot, Haiti, 2011.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
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PNEUMONIA,
DEFINITION
Pneumonia is an infection of the pulmonary parenchyma.
To the pathologist, pneumonia is an infection of the alveoli ,distal airways, and interstitium of the lung that is manifested by increased weight of the lungs, replacement of normal lung’s sponginess by consolidation ,and alveoli filled with white blood cells ,red blood cells and fibrin .To the clinician, pneumonia is a constellation of symptoms and signs in combination with at least one opacity on CXR.
Epidemiology
Between 5 and 10 million cases of infectious pneumonia occur annually in the United States and result in more than 1 million hospitalizations.
Pneumonia is a leading cause of death worldwide, the sixth leading cause of death in the United States, and the most common lethal infectious disease.
Pneumonia lecture,Describe the common pathogenesis and pathogens of pneumonia
Discuss diagnosis and initial management of community acquired pneumonia (CAP)
Understand features of the Pneumonia PORT Severity Index
Discuss the IDSA/ATS guidelines and recommendations for final antibiotic choice
Understand issues in basic management for pneumonia in children, nursing home patients, and immunocompromised patients.
Pneumonia is an inflammatory lung condition caused by infection that can be fatal. It has many types depending on location in the lungs and cause. Risk factors include age, smoking, and medical conditions. Symptoms include cough, fever, and difficulty breathing. Diagnosis involves physical exam, labs, imaging and microbiology tests. Complications can include empyema or lung abscess if not treated with antibiotics, oxygen, breathing exercises, and posture changes.
1. Pneumonia is an infection of the lungs that can be caused by bacteria, viruses, or fungi. It leads to inflammation of the small air sacs in the lungs called alveoli.
2. Pneumonia is common, affecting over 450 million people per year worldwide and resulting in over 1 million deaths in 2010. Major risk factors include age over 65, smoking, and chronic health conditions.
3. Pneumonia is usually classified as either community-acquired or hospital-acquired. Common causative organisms vary depending on the classification and may include Streptococcus pneumoniae, Haemophilus influenzae, or Pseudomonas aeruginosa.
Pneumonia is an infection of the lungs that can be caused by bacteria, viruses, or other pathogens. Common symptoms include cough, fever, shortness of breath, and chest pain. Pneumonia is usually spread through airborne droplets from coughing or sneezing. Treatment involves antibiotics if bacterial or antivirals if viral. Prevention strategies include vaccination, reducing indoor smoke and pollution, and improving nutrition and primary healthcare access.
Pneumonia is a common and potentially serious lung infection that can have varying severity and causes. Key steps in managing pneumonia include assessing severity using a scoring system, empirically treating with antibiotics based on local resistance patterns, and determining the specific pathogen causing the infection. Common causes of pneumonia include bacteria like Streptococcus pneumoniae, viruses like influenza, and atypical bacteria like Mycoplasma pneumoniae. Treatment involves antibiotics targeted to likely pathogens, with hospitalization sometimes needed for severe cases.
Streptococcus pneumoniae is the most common cause of community-acquired pneumonia. Pneumonia causes inflammation in the lungs and can range from mild to life-threatening. Risk factors include age, smoking, chronic illnesses. Typical pneumonia is often bacterial while atypical pneumonia can be caused by Mycoplasma, Legionella, or viruses. Symptoms depend on the pathogen but may include fever, cough, chest pain. Treatment involves antibiotics but severity assessment is needed to determine inpatient versus outpatient management. Prevention involves vaccination against influenza and Streptococcus pneumoniae.
Pneumonia is an inflammation of the lung parenchyma caused by a microbial agent. It can be caused by bacteria, viruses, fungi or parasites. There are different classifications including community-acquired pneumonia (CAP), hospital-acquired pneumonia, and pneumonia in immunocompromised hosts. CAP is usually caused by Streptococcus pneumoniae or Haemophilus influenzae. Hospital-acquired pneumonia has a higher risk of drug-resistant organisms. Clinical manifestations include fever, cough, shortness of breath and chest pain.
This document discusses bronchitis and pneumonia. It defines bronchitis as an inflammatory disease of the bronchi that can be acute or chronic. The main forms of acute bronchitis are described. Pneumonia is defined as an acute infectious inflammatory disease involving the lungs. Pneumonia is classified and various forms are outlined. Criteria for diagnosing bronchitis and pneumonia are provided. Treatment approaches for bronchitis and pneumonia are also summarized including mucolytics, bronchodilators, antibiotics, antivirals, and other drugs.
This document discusses respiratory disorders such as pneumonia and tuberculosis. Pneumonia is an inflammation of the lungs caused by microbial infection. Factors like smoking, age, and medical conditions can predispose individuals to pneumonia. Clinical manifestations include fever, cough, and signs of lung consolidation. Diagnosis involves physical exam, chest x-ray, and sputum tests. Treatment involves antibiotics and rest. Tuberculosis is caused by the bacterium Mycobacterium tuberculosis and can affect the lungs or other organs. Symptoms vary depending on whether it is a primary infection or reactivation. Diagnosis involves skin tests, imaging, and sputum/tissue cultures. Treatment involves antibiotic therapy.
This document discusses respiratory disorders such as pneumonia and tuberculosis. Pneumonia is an inflammation of the lungs caused by microbial infection. Factors like smoking, age, and medical conditions can predispose individuals to pneumonia. Clinical manifestations include fever, cough, and signs of lung consolidation. Diagnosis involves physical exam, chest x-ray, and sputum tests. Treatment involves antibiotics and rest. Tuberculosis is caused by the bacterium Mycobacterium tuberculosis and can affect the lungs or other organs. Symptoms vary depending on whether it is a primary infection or reactivation. Diagnosis involves skin tests, imaging, and sputum/tissue cultures. Treatment involves antibiotic therapy.
Streptococcus pneumoniae is the most common cause of community-acquired pneumonia. Pneumonia has several classifications including lobar, bronchopneumonia, and interstitial pneumonia. Typical bacteria that cause pneumonia include Streptococcus pneumoniae, Staphylococcus aureus, and Klebsiella pneumoniae. Atypical bacteria include Mycoplasma pneumoniae, Legionella pneumophila, and Chlamydophila pneumoniae. Risk factors include age, smoking, and comorbidities. Diagnosis involves physical exam, chest x-ray, sputum culture, and pneumonia severity assessment to determine treatment approach. Antibiotics are selected based on suspected pathogen and severity of illness.
Pneumonia is an infection that inflames the air sacs in one or both lungs. Th...ssusera41f5e
Pneumonia is an infection of the alveoli that can be caused by viruses or bacteria. It can present as lobar pneumonia, with involvement of an entire lung lobe, or bronchopneumonia, with patchy involvement. Complications of pneumonia include empyema, where pus accumulates in the pleural space, and lung abscesses, where pus forms within the lung tissue. Factors like airway obstruction, ciliary dysfunction, epithelial injury, and impaired immunity can allow bacteria and viruses to colonize the lungs and cause pneumonia.
Pneumocystis jirovecii is a fungus that causes pneumonia in immunocompromised patients. It is diagnosed through microscopic visualization of the organism in samples obtained through induced sputum or bronchoscopy with bronchoalveolar lavage. Real-time PCR assays have increased sensitivity over conventional staining but may produce false positives. Risk factors include HIV/AIDS with CD4 count <200 cells/uL, use of immunosuppressive drugs, hematologic malignancies, and organ transplantation. Presentation involves fever, cough, and dyspnea. Treatment involves trimethoprim-sulfamethoxazole.
This document discusses various respiratory infections, including influenza, pneumonia, bronchiolitis, and metapneumovirus. Influenza often presents with fever, malaise, and cough. Complications can include primary or secondary pneumonia. Treatment involves rest, fluids, and antivirals. Bronchiolitis most often affects young children and is usually caused by respiratory syncytial virus. Metapneumovirus was discovered in 2001 and can cause bronchiolitis or influenza-like illness. Multiple respiratory viruses are now tested for via PCR from throat or lung samples.
SARS stands for severe acute respiratory syndrome . caused by a corona virus . major outbreak in south china in 2002 with fatality of about 10% and 800 deaths in a single outbreak.
This document discusses lower respiratory tract infections, including the types of pneumonia (community-acquired, hospital-acquired, ventilator-associated), common causative agents, pathogenesis, diagnosis and treatment. It provides details on bacterial pathogens that commonly cause pneumonia like Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Klebsiella pneumoniae. It also discusses atypical pneumonia from Mycoplasma or Legionella, as well as tuberculosis and fungal pneumonia. Sputum analysis, culture and sensitivity are important tools for diagnosis. Risk factors for hospital-acquired pneumonia include medical interventions like intubation and underlying illness.
Lung abscess is a localized area of lung destruction caused by infection, typically by aspiration of oropharyngeal bacteria. It appears on imaging as a cavity containing air-fluid levels. The infection can start as necrotizing pneumonia that progresses to microabscesses and larger cavitary lesions over time. Risk factors include dental/sinus infections, impaired swallowing, or pre-existing lung disease. Treatment involves antibiotics targeting common aerobic and anaerobic bacteria. Therapy typically lasts 4-6 weeks until imaging shows resolution, though surgery may be needed for large or resistant abscesses. Complications can include empyema, bronchopleural fistula, or distant infections if not properly treated.
Pneumonia Symposia presented at Hôpital Sacré Coeur in Milot, Haiti, 2011.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
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1. Pneumonia
Mazin Barry, MD, FRCPC, FACP, DTM&H
Assistant Professor of Medicine and
Consultant Infectious Diseases
2. Terminology
• Merriam Webster Dictionary
– pneu·mo·nia noun nu̇-mō-nyə, nyu̇-
• Origin of PNEUMONIA
– New Latin, from Greek, from pneumōn lung,
alteration of pleumōn
– First Known Use: 1603
3. Historical Points
• Referred to pneumonia as a
disease "named by the
ancients."
• “If sweats come out about
the neck and head, for such
sweats are bad, as
proceeding from the
suffocation, rales, and the
violence of the disease
which is obtaining the
upper hand”
Hippocrates Ancient Greek
Physician known as the “Father of
Medicine” (c. 460 BC – 370 BC)
4. Historical Points
• “the most widespread
and fatal of all acute
diseases, pneumonia, is
now Captain of the Men
of Death.”
The Principles and Practice of Medicine;
4th ed. New York, Appleton, 1901
Sir William Osler
5. What is Pneumonia?
• Pneumonia is an
inflammatory condition of the
lung
• characterized by
inflammation of the
parenchyma of the lung
(alveoli)
• Abnormal alveolar filling with
fluid causing Air space disease
(consolidation and exudation)
6.
7. Pneumonia: Definitions
• Community-acquired pneumonia (CAP)
Cough/fever/sputum production + infiltrate, related to community
• Healthcare-associated pneumonia (HCAP)
Pneumonia that develops within 48 hours of admission in pts with:
– Hospitalization in acute care hospital for >2 d in past 90 d
– Residence in NH or LTC facility
– Chronic dialysis within 30 days
– Home IV therapy, home wound care in past 30 days
– Family member with MDR pathogen
• Hospital-acquired pneumonia (HAP)
Pneumonia > 48 hours after admission
• Ventilator-associated pneumonia (VAP)
pneumonia > 48 hours after intubation
8. Epidemiology
• Unclear Few population-based statistics on the
condition alone
• Pneumonia & influenza = 6th leading causes of death in
the world
• Single most common cause of infection-related
mortality
• Age-adjusted death rate = 22 per 100,000 per year
• Mortality rate: 1-5% out-Pt, 12% In-Pt, 40% ICU
• Death rates increase with comorbidity and age
• Affects race and sex equally
9. Pathogenesis
• Inhalation, aspiration and hematogenous
spread are the 3 main mechanisms by which
bacteria reaches the lungs
• Primary inhalation: when organisms bypass
normal respiratory defense mechanisms or
when the Pt inhales organisms that colonize
the upper respiratory tract or respiratory
support equipment
10. Pathogenesis
• Aspiration: occurs when the Pt aspirates
colonized upper respiratory tract secretions
– Stomach: reservoir of GNR that can ascend,
colonizing the respiratory tract.
• Hematogenous: originate from a distant
source and reach the lungs via the blood
stream.
11. Pathogenesis
• Microaspiration from nasopharynx: S. Pneumonia
• Inhalation: TB, viruses, Legionella
• Aspiration: anaerobes
• Bloodborne: Staph endocarditis, septic emboli
• Direct extension: trauma
12. Pathogens
• CAP usually caused by a single organism
• Even with extensive diagnostic testing, most
investigators cannot identify a specific etiology
for CAP in ≥ 50% of patients.
• Caused by a variety of Bacteria, Viruses, Fungi
• Streptococcus pneumoniae is the most
common pathogen 60-70% of the time
15. Clinical Signs Positive LR Negative LR
General appearance
Cachexia 4.0 NS
Abnormal mental status 2.2 NS
Vital signs
Temp >37.9 C 2.2 0.7
RR > 28/min 2.2 0.8
HR >100 bpm 1.6 0.7
Lung findings
Percussion dullness 3.0 NS
Reduced breath sounds 2.3 0.8
Bronchial breath sounds 3.3 NS
Aegophony 4.1 NS
Crackles 2.0 0.8
Wheezes NS NS
NS= not significant. LR= Likelihood Ratio
From McGee S, Evidence-based physical diagnosis, 2nd edition. St Louis: Saunders, 2007.
16. Triaging Patients with Pneumonia
• Febrile respiratory illness (FRI) should be
placed on droplet and contact precautions
(Single room, use mask, gown and gloves)
• Upgrade to Airborne Infection Isolation (AII)-
Negative pressure room with HEPA-Filter, with
use of fit-tested respirator (e.g. N-95), in
addition to contact precautions for:
– Sick patients anticipating intubation
– Aerosolizing procedures e.g. suctioning,
nebulization
18. Clinical Diagnosis: CXR
• Demonstrable infiltrate by CXR or other
imaging technique
– Establish Dx and presence of complications
(pleural effusion, multilobar disease)
– May not be possible in some outpatient settings
– CXR: classically thought of as the gold standard
19. Infiltrate Patterns
Pattern Possible Diagnosis
Lobar S. pneumo, Kleb, H. flu,
GN
Patchy Atypicals, viral, Legionella
Interstitial Viral, PCP, Legionella
Cavitary Anaerobes, Kleb, TB, S.
aureus, fungi
Large effusion Staph, anaerobes, Kleb
20. A chest X-ray showing a very prominent wedge shaped pneumonia in the right lung
24. Empiric outpt Management in Previously
Healthy Pt
• Organisms: S. pneumoniae, Mycoplasma pneumoniae,
viral, Chlamydophila pneumoniae, H.influenzae
• Recommended abx:
– Advanced generation macrolide (azithromycin or
clarithromycin); or doxycycline
• If abx within past 3 months:
– Respiratory quinolone (moxifloxacin, levofloxacin), OR
– Advanced macrolide + amoxicillin, OR
– Advanced macrolide + amoxicillin-clavulanate
IDSA/ATS Guidelines 2007
25. Empiric outpt Management in Pt with
comorbidities
• Comorbidities: cardiopulmonary dz or
immunocompromised state
• Organisms: S. pneumoniae, viral, H. ifluenzae, aerobic
GN rods, S.aureus
• Recommended Abx:
– Respiratory quinolone, OR advanced macrolide
• Recent Abx:
– Respiratory quinolone OR
– Advanced macrolide + beta-lactam
IDSA/ATS Guidelines 2007
26. Empiric Inpt Management-Medical
Ward
• Organisms: all of the above plus polymicrobial
infections (+/- anaerobes), Legionella
• Recommended Parenteral Abx:
– Respiratory fluoroquinolone, OR
– Advanced macrolide plus a beta-lactam
• Recent Abx:
– As above. Regimen selected will depend on nature of
recent antibiotic therapy.
IDSA/ATS Guidelines 2007
27. Complications of Pneumonia
• Bacteremia
• Respiratory and circulatory failure
• Pleural effusion (Parapneumonic effusion),
empyema, and abscess
– Pleural fluid always needs analysis in setting of
pneumonia (do a thoracocentisis)
– Always needs drainage: Chest tube, surgical
28. Streptococcus pneumonia
• Most common cause of CAP
• Gram positive diplococci
• “Typical” symptoms (e.g. malaise, shaking
chills, fever, rusty sputum, pleuritic chest pain,
cough)
• Lobar infiltrate on CXR
• 25% bacteremic
29. Risk factors for S.pneumonia
• Splenectomy (Asplenia)
• Sickle cell disease, hematologic diseases
• Smoking
• Bronchial Asthma and COPD
• HIV
• ETOH
30. S. Pneumonia Prevention
• Pneumococcal conjugate vaccine (PCV) is a vaccine used to
protect infants and young children
– 13 serotypes of Streptococcus
• Pneumococcal polysaccharide vaccine (PPSV)
– 23 serotypes of Streptococcus
• For both children and adults in special risk categories:
– Serious pulmonary problems, eg. Asthma, COPD
– Serious cardiac conditions, eg., CHF
– Severe Renal problems
– Long term liver disease
– DM requiring medication
– Immunosuppression due to disease (e.g. HIV or SLE) or treatment (e.g.
chemotherapy or radio therapy, long-term steroid use
– Asplenia
31. Haemophilus influenzae
• Nonmotile, Gram negative rod
• Secondary infection on top of Viral disease,
immunosuppression, splecnectomy patients
• Encapsulated type b (Hib)
– The capsule allows them to resist phagocytosis
and complement-mediated lysis in the
nonimmune host
• Hib conjugate vaccine
32. Specific Treatment
• Guided by susceptibility testing when available
• S. pneumonia:
– β-lactams Cephalosporins, eg Ceftriaxone,
Penicillin G
– Macrolides eg.Azithromycin
– Fluoroquinolone (FQ) eg.levofloxacin
– Highly Penicillin Resistant: Vancomycin
• H. influenzae:
– Ceftriaxone, Amoxocillin/Clavulinic Acid
(Augmentin), FQ, TMP-SMX
33. CAP: Influenza
• More common cause in children
– RSV, influenza, parainfluenza
• Influenza most important viral cause in adults,
especially during winter months
• Preventable with annual vaccination
• Inhale small aerosolized particles from coughing, sneezing1-4
day incubation ‘uncomplicated influenza’ (fever, myalgia,
malaise, rhinitis)Pneumonia
• Adults > 65 account for 63% of annual influenza-associated
hospitalizations and 85% of influenza-related deaths
.
34. CAP: Influenza
• First worlwide pandemic of H1N1 Influenza A (2009-2010)
• Ongoing epidemic in Saudi Arabia
• H1N1 risk factors
– pregnant, obesity, cardipulmonary disease, chronic renal disease,
chronic liver disease
• CXR findings often subtle, to full blown ARDS
• Respiratory (or Droplet) isolation for suspected or
documented influenza (Wear mask and gloves)
• NP swab for, Rapid Ag test Influ A,B. H1N1 PCR RNA
• Current Seasonal Influenza Vaccine prevents disease (given
every season)
• Bacterial pnemonia (S. pneumo, S. aureus) may follow viral
pneumonia
35. Influenza: Therapy
Neuraminidase
inhibitors
Oseltamivir /
Tamiflu
75mg po bid Influenza A, B
Zanamivir /
Relenza
10mg (2 inhalations) BID
Adamantanes Amantadine /
Symmetrel
100mg po bid Influenza A
Rimantadine /
Flumadine
100mg po qd
• H1N1 resistant to Adamantanes
• Neuraminidase inhibitors:
– 70-90% effective for prophylaxis
– Give within 48h of symptom onset to reduce duration/severity of
illness, and viral shedding
– Osteltamivir dose in severe disease 150mg bid
36. CAP: MERS-CoV
• New novel Corona Virus first described in September 2012 in Saudi
Arabia
• Titled Middle East Respiratory Syndrome Corona Virus (MERS-CoV)
• Causes severe disease, with high mortality rate reaching 40%
• Clinically indistinguishable from any other FRI
• 1643 laboratory-confirmed cases with 702 deaths (in KSA alone)
• Mostly related to hospital outbreaks
– Early recognition and immediate placement on airborne and contact
isolation vital in controlling spread of disease
• Camels well established as reservoirs of virus
37.
38. CAP: Atypicals
• Mycoplasma pneumoniae, Chlamydophila pneumoniae, Legionella;
Coxiella burnetii (Q fever), Francisella tularensis (tularemia),
Chlamydia psittaci (psittacosis)
• Approximately 15% of all CAP
• ‘Atypical’: not detectable on gram stain; won’t grow on standard
media
• Unlike bacterial CAP, often extrapulmonary manifestations:
– Mycoplasma: otitis, nonexudative pharyngitis, watery diarrhea, erythema
multiforme, increased cold agglutinin titre
– Chlamydophila: laryngitis
• Most don’t have a bacterial cell wall Don’t respond to β-lactams
• Therapy: macrolides, tetracyclines, quinolones (intracellular
penetration, interfere with bacterial protein synthesis)
39. Q fever
• Coxiella burnetti
• Exposure to farm animals or parturient cats
• Epidemic in Middle east, recent large outbreaks in
Iraq, and Occupied territories (Israel)
• Acute Pneumonia, severe headache, hepatitis
• Diagnosis: complement fixation, new NAAT
• Chronic: endocarditis, FUO, granuloma in liver
• Treatment: Doxycycline, Rifampin,
hydroxychloroquine
42. Who is at risk for Pseudomonal
Pneumonia?
• Immunocompromised pts (HIV, solid organ or bone marrow
transplant, neutropenic, chronic oral steroids)
• Alcoholics
• Frequent prior antibiotic use
• Recent hospital admission
• Structural lung abnormalities
– Cystic fibrosis, bronchiectasis, severe COPD
– Prophylaxis with tobramycin nebs
• Rare in previously healthy pts
**Gram stain/sputum culture (if good quality) is usually
adequate to exclude need for empiric coverage
*** Treatment: Ceftazidime, cefepime, pip/tazo, amikacin,
tobramycin, aztreonam, ciprofloxacin, carbapenems,
Polymixin B
43. Who is at risk for Acinetobacter
Pneumonia?
• CAP
– Alcoholics
– Smoking
– Chronic lung disease
– DM
– Residence in tropical developing country
• HAP
– Admission to burns unit or ICU
– Mechanical ventilation
– Length of hospital stay
– Surgey
– Wounds
– Previous infection (independent of previous Abx use)
– Fecal colonization with Acinetobacter
– Treatment with broad spectrum antibiotics
– Indwelling central intravenous or urinary catheters
– Parenteral nutrition
• Treatment: Polymixin B (colistin), tigecycline
44. Who is at risk for which pathogens?
• Pnemonia in nursing home/long term care
facility residents similar to pneumonia in
hospitalized pts:
– Pseudomonas, Acinetobacter, MRSA
• Chronic hemodialysis:
– Increased risk of MRSA (not Pseudomonas or
Acinetobacter)
• COPD:
– Increased risk for Pseudomonas (not MRSA)
45. Remember these associations:
• Asplenia: Strep pneumo, H. influ.
• Alcoholism: Strep pneumo, oral anaerobes, K. pneumo.,
Acinetobacter, MTB
• COPD/smoking: H. influenzae, Pseudomonas, Legionella,
Strep pneumo, Moraxella catarrhalis, Chlamydophila
pneumoniae
• Aspiration: Klebsiella, E. Coli, oral anaerobes
• HIV: S. pneumo, H. influ, P. aeruginosa, MTB, PCP, Crypto,
Histo, Aspergillus, atypical mycobacteria
• Recent hotel, cruise ship: Legionella
• Structural lung disease (bronchiectasis): Pseudomonas
aerogenosa, Burkholderia cepacia, Staph. aureus
46. Pneumonia: Outpatient or Inpatient?
• CURB-65
– 5 indicators of increased mortality: confusion, BUN >7, RR
>30, SBP <90 or DBP <60, age >65
– Mortality: 2 factors9%, 3 factors15%, 5 factors57%
– Score 0-1outpt. Score 2inpt. Score >3ICU.
• Pneumonia Severity Index (PSI)
– 20 variables including underlying diseases; stratifies pts
into 5 classes based on mortality risk
• No RCTs comparing CURB-65 and PSI
47. Pneumonia: Medical floor or ICU?
• 1 major or 3 minor criteria= severe CAPICU
• Major criteria:
– Invasive ventilation, septic shock on pressors
• Minor criteria:
– RR>30; multilobar infiltrates; confusion; BUN >20;
WBC <4,000; Platelets <100,000; Temp <36,
hypotension requiring aggressive fluids,
PaO2/FiO2 <250.
• No prospective validation of these criteria
48. CAP Inpatient therapy
• General medical floor:
– Respiratory quinolone OR
– IV β-lactam PLUS macrolide (IV or PO)
• β-lactams: cefotaxime, ceftriaxone, ampicillin; ertapenem
• May substitute doxycycline for macrolide
• ICU:
– β-lactam (ceftriaxone, cefotaxime, Amox-clav) PLUS EITHER
quinolone OR azithro
– PCN-allergic: respiratory quinolone PLUS aztreonam
• Pseudomonal coverage :
– Antipneumococcal, antipseudomonal β-lactam (pip-tazo,
cefepime, imip, mero) PLUS EITHER (cipro or levo) OR
(aminoglycoside AND Azithro) OR (aminoglycoside AND
respiratory quinolone)
• CA-MRSA coverage: Vancomycin or Linezolid
49. CAP Inpatient Therapy: Pearls
• Give 1st dose Antibiotics in ER (no specified time frame)
• Switch from IV to oral when pts are hemodynamically
stable and clinically improving
• Discharge from hospital:
– As soon as clinically stable, off oxygen therapy, no active medical
problems
• Duration of therapy is usually 10-14 days:
– Treat for a minimum of 5 days
– Before stopping therapy: afebrile for 48-72 hours,
hemodynamically stable, RR <24, O2 sat >90%, normal mental
status
– Treat longer if initial therapy wasn’t active against identified
pathogen; or if complications (lung abscess, empyema)