1) The document discusses community acquired pneumonia (CAP), including its definition, classification, etiology, clinical presentation, diagnosis, treatment and risk factors.
2) CAP is defined as an acute lung infection associated with symptoms of infection and infiltrates on chest x-ray, occurring in a patient not recently hospitalized. The most common causes are Streptococcus pneumoniae and atypical bacteria.
3) Diagnosis is based on symptoms, physical exam findings and chest x-ray showing consolidation. Treatment involves initial broad-spectrum antibiotics, later narrowed based on cultures. Factors like age, comorbidities and clinical signs determine hospitalization need.
1. A 25-year-old female was admitted with complaints of shortness of breath, loose stools, facial swelling and fever for a week and body pains. Chest X-ray showed consolidation in the right lung. She was diagnosed with pneumonia and pleural effusion, with a relapse of tuberculosis.
2. She was treated with oxygen, antibiotics including piperacillin-tazobactam and metronidazole, thoracentesis, and other supportive care. Her condition improved with treatment.
3. Pneumonia is classified based on location and cause. Risk factors, clinical presentation, diagnosis and management depend on whether it is community-acquired, hospital-acquired, or
Lrti punemococcal pneumonia and bordetella pertussisPrasad Gunjal
The document discusses lower respiratory tract infections (LRTIs) such as bronchitis, bronchiolitis, and pneumonia. It defines each condition and describes the typical causative agents, clinical manifestations, diagnosis, and treatment. Pneumonia can be lobar (typical) or interstitial (atypical) depending on the location in the lungs. Community-acquired pneumonia is usually caused by Streptococcus pneumoniae or Mycoplasma pneumoniae. Treatment involves antibiotics and is determined by severity using the CURB-65 scoring system.
The document discusses pneumonia, specifically lobar pneumonia. It describes the pathogenesis, morphological features, and stages of lobar pneumonia including congestion, red hepatization, grey hepatization, and resolution. Complications of untreated lobar pneumonia are also discussed, such as organization of exudate leading to fibrosis, pleural effusions, empyema, lung abscesses, and metastatic infection.
Chronic Pneumonia: Update on Clinical Manifestations, Diagnosis and Therapyiosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Pneumonia is an inflammation of the lung tissue that is commonly caused by a microbial infection. It can be classified based on its causative agent such as bacteria, viruses, or fungi. Common symptoms include cough, fever, shortness of breath, and chest pain. Diagnosis involves physical examination, sputum culture, chest x-ray, and other tests. Treatment focuses on relieving symptoms, using antibiotics if caused by bacteria, and preventing complications through rest and fluid intake.
Diagnosis of Upper and Lower Respiratory Tract InfectionsOluwatosin Ogunwola
The document discusses various aspects of respiratory tract infections including the anatomy and functions of the upper and lower respiratory tract. It describes common respiratory infections such as common cold, pharyngitis, pneumonia, and others; their causes, symptoms, diagnosis and treatment. Diagnostic methods for respiratory infections include microscopy, culture, biochemical tests, nucleic acid amplification tests and serology. Organisms that commonly cause respiratory infections including bacteria, fungi and viruses are also discussed. Radiographic features of tuberculosis and images of diagnostic kits are presented.
This document discusses various types of lower respiratory problems including acute bronchitis, pertussis, pneumonia, and tuberculosis. It provides information on the pathogenesis, clinical manifestations, risk factors, diagnostic testing, and nursing management of each condition. Key learning outcomes focus on comparing and contrasting the different problems, prioritizing nursing care, and describing collaborative treatment approaches.
Community acquired pneumonia (CAP) is an acute lung infection that develops outside of a hospital setting. It is caused by bacteria, viruses, fungi or protozoa. The most common bacteria that cause CAP include Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Moraxella catarrhalis. Risk factors for CAP include chronic health conditions, smoking, HIV, and medications that suppress the immune system. Symptoms typically include fever, cough, shortness of breath, and chest pain. Diagnosis involves chest x-ray and testing sputum or blood samples. Complications can include respiratory failure, organ damage,
1. A 25-year-old female was admitted with complaints of shortness of breath, loose stools, facial swelling and fever for a week and body pains. Chest X-ray showed consolidation in the right lung. She was diagnosed with pneumonia and pleural effusion, with a relapse of tuberculosis.
2. She was treated with oxygen, antibiotics including piperacillin-tazobactam and metronidazole, thoracentesis, and other supportive care. Her condition improved with treatment.
3. Pneumonia is classified based on location and cause. Risk factors, clinical presentation, diagnosis and management depend on whether it is community-acquired, hospital-acquired, or
Lrti punemococcal pneumonia and bordetella pertussisPrasad Gunjal
The document discusses lower respiratory tract infections (LRTIs) such as bronchitis, bronchiolitis, and pneumonia. It defines each condition and describes the typical causative agents, clinical manifestations, diagnosis, and treatment. Pneumonia can be lobar (typical) or interstitial (atypical) depending on the location in the lungs. Community-acquired pneumonia is usually caused by Streptococcus pneumoniae or Mycoplasma pneumoniae. Treatment involves antibiotics and is determined by severity using the CURB-65 scoring system.
The document discusses pneumonia, specifically lobar pneumonia. It describes the pathogenesis, morphological features, and stages of lobar pneumonia including congestion, red hepatization, grey hepatization, and resolution. Complications of untreated lobar pneumonia are also discussed, such as organization of exudate leading to fibrosis, pleural effusions, empyema, lung abscesses, and metastatic infection.
Chronic Pneumonia: Update on Clinical Manifestations, Diagnosis and Therapyiosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Pneumonia is an inflammation of the lung tissue that is commonly caused by a microbial infection. It can be classified based on its causative agent such as bacteria, viruses, or fungi. Common symptoms include cough, fever, shortness of breath, and chest pain. Diagnosis involves physical examination, sputum culture, chest x-ray, and other tests. Treatment focuses on relieving symptoms, using antibiotics if caused by bacteria, and preventing complications through rest and fluid intake.
Diagnosis of Upper and Lower Respiratory Tract InfectionsOluwatosin Ogunwola
The document discusses various aspects of respiratory tract infections including the anatomy and functions of the upper and lower respiratory tract. It describes common respiratory infections such as common cold, pharyngitis, pneumonia, and others; their causes, symptoms, diagnosis and treatment. Diagnostic methods for respiratory infections include microscopy, culture, biochemical tests, nucleic acid amplification tests and serology. Organisms that commonly cause respiratory infections including bacteria, fungi and viruses are also discussed. Radiographic features of tuberculosis and images of diagnostic kits are presented.
This document discusses various types of lower respiratory problems including acute bronchitis, pertussis, pneumonia, and tuberculosis. It provides information on the pathogenesis, clinical manifestations, risk factors, diagnostic testing, and nursing management of each condition. Key learning outcomes focus on comparing and contrasting the different problems, prioritizing nursing care, and describing collaborative treatment approaches.
Community acquired pneumonia (CAP) is an acute lung infection that develops outside of a hospital setting. It is caused by bacteria, viruses, fungi or protozoa. The most common bacteria that cause CAP include Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Moraxella catarrhalis. Risk factors for CAP include chronic health conditions, smoking, HIV, and medications that suppress the immune system. Symptoms typically include fever, cough, shortness of breath, and chest pain. Diagnosis involves chest x-ray and testing sputum or blood samples. Complications can include respiratory failure, organ damage,
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.
This document provides an overview of lung abscess, including definitions, classifications, causes, microbiology, diagnosis and treatment. It defines lung abscess as necrosis of pulmonary tissue and formation of cavities containing necrotic debris or fluid caused by microbial infection. Abscesses can be acute (<4-6 weeks) or chronic. Primary abscesses result from infection in a healthy host, while secondary abscesses have an underlying condition. Treatment involves antibiotics targeting common pathogens like anaerobes. Imaging helps with diagnosis. Prognosis is generally good with medical management alone.
Bronchopneumonia is a type of pneumonia characterized by patchy lung inflammation and infection. It is often caused by aspiration of oropharyngeal bacteria. Community-acquired pneumonia is commonly seen in children and the elderly. Hospital-acquired pneumonia is a major complication for hospitalized patients, especially those on ventilators. Diagnosis involves clinical features, imaging, and microbiological testing of sputum or bronchial samples. Treatment focuses on oxygenation, fluid balance, and antibiotics tailored to likely causative organisms. Immunocompromised patients are at higher risk for opportunistic pathogens.
This document provides information on pneumonia and lung abscess from a seminar presentation. It begins with an introduction to pneumonia, defining it as an infection of the lungs. It then discusses the incidence of pneumonia globally and in various countries. Etiology, risk factors, pathophysiology, classification, signs and symptoms, complications, diagnosis, and management of pneumonia are explained. It also provides detail on lung abscess including definition, risk factors, pathophysiology, signs and symptoms, complications, diagnosis, and management. Surgical interventions for complications like empyema are also mentioned.
This document discusses pneumonia, including its definition, causes, risk factors, diagnosis, and treatment. Pneumonia is an inflammation of the lungs caused by an infectious agent. Microorganisms can gain access to the lungs through various routes like aspiration or inhalation. The lungs are vulnerable because of their gas exchange function. Clinical features include cough, dyspnea, fever, and chest pain. Pneumonia is diagnosed based on clinical symptoms and chest x-ray findings. Community-acquired pneumonia is the most common type and is usually bacterial in nature.
This document provides information on pneumonia caused by bacteria and viruses in different patient populations. It discusses the typical causes and treatment of community-acquired pneumonia (CAP) in both children and adults, as well as hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). The most common bacterial causes of CAP include Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, and respiratory viruses. HAP and VAP are often caused by more resistant hospital-acquired bacteria like Pseudomonas aeruginosa, Acinetobacter, and Klebsiella pneumoniae. Empiric antibiotic therapy and targeted treatment are outlined based on patient risk factors and pathogen susceptibility.
Pneumonia and its causes sign symptome treatmentwajidullah9551
This document provides an overview of pneumonia, including its definition, classification, epidemiology, etiology, pathophysiology, signs and symptoms, diagnosis, management, prevention, and complications. Pneumonia is a lung infection that can be caused by bacteria, viruses, fungi or parasites. It is classified into categories such as community-acquired (CAP), hospital-acquired (HAP), healthcare-associated (HCAP), and ventilator-associated (VAP) pneumonia. It affects hundreds of millions of people worldwide each year and is a major cause of death.
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.
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 acute lung infection that can affect the alveoli and interstitial tissue in different patterns. It is commonly caused by bacteria like Streptococcus pneumoniae and viruses. Risk factors include smoking, age, diseases like COPD, and immunosuppression. Symptoms include fever, cough, difficulty breathing. Diagnosis involves tests like CXR, sputum culture, blood tests. Treatment depends on severity and includes oxygen, fluids, and antibiotics chosen based on location and patient factors. Complications can include empyema, abscesses, and respiratory failure.
This document discusses various types of pulmonary infections (pneumonias). It begins by defining pneumonia as inflammation and consolidation of the lung parenchyma. It then describes different types of pneumonia including community-acquired bacterial pneumonia, atypical pneumonia, hospital-acquired pneumonia, aspiration pneumonia, and fungal and viral pneumonias. For each type, it discusses causative organisms, pathogenesis, clinical presentation, pathology, diagnosis and treatment. It provides detailed descriptions and microscopic images of different stages of lobar pneumonia, bronchopneumonia, and infectious processes like histoplasmosis, aspergillosis, and cryptococcosis.
Pneumonia is an inflammatory lung infection that can be caused by bacteria, viruses, or fungi. It has been described since 400 BC and was a major cause of death during the 1918 flu pandemic. Today, pneumonia is the 8th leading cause of death in the US, responsible for over 60,000 deaths annually. Pneumonia is diagnosed based on symptoms, physical examination, chest x-rays, and laboratory tests. Treatment involves antibiotics, oxygen, and fluid replacement depending on the severity and cause of the infection.
A 44-year-old man presented with cough, breathlessness, night sweats and fever for four weeks. He recently developed blood-tinged sputum. Examination found a temperature of 37.8°C with no other abnormalities. Tests found elevated ESR and C-reactive protein, and a strongly positive Mantoux test. Chest X-ray showed bilateral upper and middle lobe haziness. Sputum smear was positive for acid-fast bacilli and culture grew Mycobacterium tuberculosis. The patient was diagnosed with pulmonary tuberculosis and started on anti-tuberculous treatment. His sputum became negative and chest X-ray improved, and he was discharged on continued treatment.
This document provides information about interstitial lung diseases (ILD). It begins with objectives of providing detailed knowledge about ILD and being able to define, classify, identify causes, signs/symptoms, risk factors, clinical manifestations and complications of various types of ILD. It then defines ILD, discusses types including idiopathic pulmonary fibrosis and hypersensitivity pneumonitis. Diagnostic studies and medical management including antibiotics, corticosteroids and lung transplant are covered. Nursing management focuses on improving breathing, promoting gas exchange, and providing health education.
Pneumonia is an infection of the lungs that is commonly caused by bacteria or viruses. It presents with symptoms like cough, fever, and chest pain. Pneumonia can be classified based on location in the lungs (lobar vs. bronchopneumonia) or cause (typical bacterial vs. atypical vs. viral). Common types include pneumococcal, mycoplasma, and viral pneumonia. Diagnosis involves chest x-ray, sputum culture, and clinical assessment. Treatment depends on severity but generally involves antibiotics and symptom relief. Complications can include lung abscesses or empyema if the infection spreads to the pleural space.
Lower respiratory tract infections affect the lungs and airways. They can be caused by viruses like influenza or bacteria such as Streptococcus. Symptoms range from mild cough and fever to difficulty breathing. Doctors diagnose based on exams, chest X-rays, and tests. Specific infections include bronchitis, which causes coughing and wheezing, and pneumonia, which inflames the air sacs in the lungs. Treatment depends on the infection but may include antibiotics, cough medicine, oxygen, or smoking cessation.
This document summarizes benign prostatic hyperplasia (BPH). It discusses the pathology and pathogenesis of BPH, including that it affects glandular epithelium, stromal cells, and causes increased growth. It also covers the symptomatology, evaluation, and various treatment options for BPH including watchful waiting, medical therapy, and prostatectomies. Surgical treatments discussed are transurethral resection of the prostate (TURP), retropubic prostatectomy (RPP), and transvesical prostatectomy (TVP).
This document provides an introduction to pathology. It defines pathology as the study of disease through scientific methods and examines the mechanisms of disease from etiology to clinical manifestation. The key points are:
1. Pathology studies the etiology, pathogenesis, morphologic changes, and functional derangements that result from disease processes.
2. Diseases are examined through diagnostic techniques including histopathology, cytopathology, and biochemical/immunological testing to identify structural and molecular alterations.
3. The natural course of a disease involves stages from initial exposure through biological onset, clinical onset, potential resolution or death.
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.
This document provides an overview of lung abscess, including definitions, classifications, causes, microbiology, diagnosis and treatment. It defines lung abscess as necrosis of pulmonary tissue and formation of cavities containing necrotic debris or fluid caused by microbial infection. Abscesses can be acute (<4-6 weeks) or chronic. Primary abscesses result from infection in a healthy host, while secondary abscesses have an underlying condition. Treatment involves antibiotics targeting common pathogens like anaerobes. Imaging helps with diagnosis. Prognosis is generally good with medical management alone.
Bronchopneumonia is a type of pneumonia characterized by patchy lung inflammation and infection. It is often caused by aspiration of oropharyngeal bacteria. Community-acquired pneumonia is commonly seen in children and the elderly. Hospital-acquired pneumonia is a major complication for hospitalized patients, especially those on ventilators. Diagnosis involves clinical features, imaging, and microbiological testing of sputum or bronchial samples. Treatment focuses on oxygenation, fluid balance, and antibiotics tailored to likely causative organisms. Immunocompromised patients are at higher risk for opportunistic pathogens.
This document provides information on pneumonia and lung abscess from a seminar presentation. It begins with an introduction to pneumonia, defining it as an infection of the lungs. It then discusses the incidence of pneumonia globally and in various countries. Etiology, risk factors, pathophysiology, classification, signs and symptoms, complications, diagnosis, and management of pneumonia are explained. It also provides detail on lung abscess including definition, risk factors, pathophysiology, signs and symptoms, complications, diagnosis, and management. Surgical interventions for complications like empyema are also mentioned.
This document discusses pneumonia, including its definition, causes, risk factors, diagnosis, and treatment. Pneumonia is an inflammation of the lungs caused by an infectious agent. Microorganisms can gain access to the lungs through various routes like aspiration or inhalation. The lungs are vulnerable because of their gas exchange function. Clinical features include cough, dyspnea, fever, and chest pain. Pneumonia is diagnosed based on clinical symptoms and chest x-ray findings. Community-acquired pneumonia is the most common type and is usually bacterial in nature.
This document provides information on pneumonia caused by bacteria and viruses in different patient populations. It discusses the typical causes and treatment of community-acquired pneumonia (CAP) in both children and adults, as well as hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). The most common bacterial causes of CAP include Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, and respiratory viruses. HAP and VAP are often caused by more resistant hospital-acquired bacteria like Pseudomonas aeruginosa, Acinetobacter, and Klebsiella pneumoniae. Empiric antibiotic therapy and targeted treatment are outlined based on patient risk factors and pathogen susceptibility.
Pneumonia and its causes sign symptome treatmentwajidullah9551
This document provides an overview of pneumonia, including its definition, classification, epidemiology, etiology, pathophysiology, signs and symptoms, diagnosis, management, prevention, and complications. Pneumonia is a lung infection that can be caused by bacteria, viruses, fungi or parasites. It is classified into categories such as community-acquired (CAP), hospital-acquired (HAP), healthcare-associated (HCAP), and ventilator-associated (VAP) pneumonia. It affects hundreds of millions of people worldwide each year and is a major cause of death.
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.
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 acute lung infection that can affect the alveoli and interstitial tissue in different patterns. It is commonly caused by bacteria like Streptococcus pneumoniae and viruses. Risk factors include smoking, age, diseases like COPD, and immunosuppression. Symptoms include fever, cough, difficulty breathing. Diagnosis involves tests like CXR, sputum culture, blood tests. Treatment depends on severity and includes oxygen, fluids, and antibiotics chosen based on location and patient factors. Complications can include empyema, abscesses, and respiratory failure.
This document discusses various types of pulmonary infections (pneumonias). It begins by defining pneumonia as inflammation and consolidation of the lung parenchyma. It then describes different types of pneumonia including community-acquired bacterial pneumonia, atypical pneumonia, hospital-acquired pneumonia, aspiration pneumonia, and fungal and viral pneumonias. For each type, it discusses causative organisms, pathogenesis, clinical presentation, pathology, diagnosis and treatment. It provides detailed descriptions and microscopic images of different stages of lobar pneumonia, bronchopneumonia, and infectious processes like histoplasmosis, aspergillosis, and cryptococcosis.
Pneumonia is an inflammatory lung infection that can be caused by bacteria, viruses, or fungi. It has been described since 400 BC and was a major cause of death during the 1918 flu pandemic. Today, pneumonia is the 8th leading cause of death in the US, responsible for over 60,000 deaths annually. Pneumonia is diagnosed based on symptoms, physical examination, chest x-rays, and laboratory tests. Treatment involves antibiotics, oxygen, and fluid replacement depending on the severity and cause of the infection.
A 44-year-old man presented with cough, breathlessness, night sweats and fever for four weeks. He recently developed blood-tinged sputum. Examination found a temperature of 37.8°C with no other abnormalities. Tests found elevated ESR and C-reactive protein, and a strongly positive Mantoux test. Chest X-ray showed bilateral upper and middle lobe haziness. Sputum smear was positive for acid-fast bacilli and culture grew Mycobacterium tuberculosis. The patient was diagnosed with pulmonary tuberculosis and started on anti-tuberculous treatment. His sputum became negative and chest X-ray improved, and he was discharged on continued treatment.
This document provides information about interstitial lung diseases (ILD). It begins with objectives of providing detailed knowledge about ILD and being able to define, classify, identify causes, signs/symptoms, risk factors, clinical manifestations and complications of various types of ILD. It then defines ILD, discusses types including idiopathic pulmonary fibrosis and hypersensitivity pneumonitis. Diagnostic studies and medical management including antibiotics, corticosteroids and lung transplant are covered. Nursing management focuses on improving breathing, promoting gas exchange, and providing health education.
Pneumonia is an infection of the lungs that is commonly caused by bacteria or viruses. It presents with symptoms like cough, fever, and chest pain. Pneumonia can be classified based on location in the lungs (lobar vs. bronchopneumonia) or cause (typical bacterial vs. atypical vs. viral). Common types include pneumococcal, mycoplasma, and viral pneumonia. Diagnosis involves chest x-ray, sputum culture, and clinical assessment. Treatment depends on severity but generally involves antibiotics and symptom relief. Complications can include lung abscesses or empyema if the infection spreads to the pleural space.
Lower respiratory tract infections affect the lungs and airways. They can be caused by viruses like influenza or bacteria such as Streptococcus. Symptoms range from mild cough and fever to difficulty breathing. Doctors diagnose based on exams, chest X-rays, and tests. Specific infections include bronchitis, which causes coughing and wheezing, and pneumonia, which inflames the air sacs in the lungs. Treatment depends on the infection but may include antibiotics, cough medicine, oxygen, or smoking cessation.
This document summarizes benign prostatic hyperplasia (BPH). It discusses the pathology and pathogenesis of BPH, including that it affects glandular epithelium, stromal cells, and causes increased growth. It also covers the symptomatology, evaluation, and various treatment options for BPH including watchful waiting, medical therapy, and prostatectomies. Surgical treatments discussed are transurethral resection of the prostate (TURP), retropubic prostatectomy (RPP), and transvesical prostatectomy (TVP).
This document provides an introduction to pathology. It defines pathology as the study of disease through scientific methods and examines the mechanisms of disease from etiology to clinical manifestation. The key points are:
1. Pathology studies the etiology, pathogenesis, morphologic changes, and functional derangements that result from disease processes.
2. Diseases are examined through diagnostic techniques including histopathology, cytopathology, and biochemical/immunological testing to identify structural and molecular alterations.
3. The natural course of a disease involves stages from initial exposure through biological onset, clinical onset, potential resolution or death.
This document provides an overview of preeclampsia and eclampsia. It begins with an introduction and outlines risk factors and classifications. It then describes clinical features such as hypertension and proteinuria. The pathophysiology section explains how abnormal placentation leads to reduced blood flow and imbalance of prostaglandins. Complications are also discussed, including renal failure, pulmonary edema, and intrauterine growth restriction. The document provides information on diagnosis and management of preeclampsia and eclampsia.
This seminar presentation discusses hypersensitivity reactions, which are exaggerated or inappropriate immune responses to benign antigens. It covers the objectives, mechanisms, classification, complications, and references related to hypersensitivity reactions. There are four main types of hypersensitivity reactions: Type I involves IgE antibodies and mast cell degranulation, Type II involves antibody-mediated cell cytotoxicity, Type III involves immune complex formation and deposition, and Type IV involves T-cell mediated reactions. The presentation provides examples and details of each type of hypersensitivity reaction and their clinical implications.
This document discusses inflammation. It defines inflammation as the body's local response to injury or infection aimed at eliminating the cause of injury and initiating repair. The cardinal signs of inflammation are redness, swelling, heat, pain, and loss of function. The early response involves vasodilation and increased permeability, causing swelling. The late response involves neutrophils in acute inflammation and macrophages in chronic cases, which work to destroy pathogens and initiate healing. Understanding inflammation is important for diagnosing conditions like appendicitis and treating diseases.
This document provides an overview of hyaline membrane disease (HMD), also known as respiratory distress syndrome (RDS), for nursing students. It defines RDS as a lack of pulmonary surfactant, outlines its pathophysiology and risk factors. The document discusses the clinical presentation of RDS, including respiratory distress, radiographic findings and laboratory abnormalities. It also covers diagnosis, differential diagnoses, treatment including surfactant replacement and supportive care, complications and prevention of RDS through antenatal corticosteroids.
1. Acute inflammation is rapid in onset and short in duration, characterized by fluid and protein exudation and neutrophil accumulation. Chronic inflammation is slower in onset and longer lasting, characterized by mononuclear cell infiltration, ongoing tissue destruction, and attempts at repair through fibrosis.
2. The key features of acute inflammation are vasodilation, increased vascular permeability, and recruitment of leukocytes from the blood vessels to the site of injury. Chronic inflammation features mononuclear cell infiltration, persistent tissue damage, and attempts to repair through fibrosis and angiogenesis.
3. Granulomatous inflammation is a pattern of chronic inflammation seen with certain infections, featuring focal collections of activated macrophages that develop an epithelial-like appearance known
Cellular injury can result in adaptation, reversible injury, irreversible injury leading to necrosis or apoptosis, or intracellular accumulation. The outcome depends on the injurious agent and cell type. Adaptations include hypertrophy, hyperplasia, atrophy, and metaplasia. Reversible injury includes fatty changes and pigment accumulation. Necrosis is cell death resulting from hypoxia, free radicals, membrane damage, or calcium influx. There are several types of necrosis including coagulative, liquefactive, fat, caseous, and gangrenous. Apoptosis is programmed cell death that does not cause inflammation.
This document discusses pelvic inflammatory disease (PID) and ectopic pregnancy. It defines PID as an infection of the upper female genital tract that spreads to involve the uterus, fallopian tubes, and ovaries. Common causes are Neisseria gonorrhoeae, Chlamydia trachomatis, and bacterial vaginosis. Risk factors include multiple sexual partners and past gynecological procedures. Symptoms can range from mild to severe abdominal pain. Diagnosis involves clinical exams and tests. Complications include infertility and ectopic pregnancy. Ectopic pregnancy is defined as implantation outside the uterus, most commonly in the fallopian tube. Causes may include anatomical obstructions or abnormalities in the fallop
The document discusses acid-base balance and disturbances. It defines the two main buffer systems - metabolic (kidneys) and respiratory (lungs) - that work to maintain blood pH between 7.35-7.45. Five primary acid-base imbalances are described: metabolic acidosis, metabolic alkalosis, respiratory acidosis, respiratory alkalosis, and mixed disturbances. Diagnosis involves blood tests including arterial blood gases and electrolytes to classify the disturbance based on pH, PCO2, and bicarbonate levels. Treatment focuses on addressing the underlying cause rather than just the pH effect.
This document provides an overview of autoimmune diseases. It defines autoimmune diseases as conditions where the immune system mistakenly attacks and destroys healthy body tissue. The causes include genetic factors, environmental triggers like infections, and defects in immunologic tolerance. Some specific autoimmune diseases discussed are rheumatoid arthritis, type 1 diabetes, Hashimoto's thyroiditis, Graves' disease, myasthenia gravis, and systemic sclerosis. The mechanisms, clinical features, pathology, and treatment options are described for each condition.
Patient safety is a fundamental principle of healthcare. Adverse events may result from problems in practice, products, procedures or systems. Improving patient safety demands a complex, system-wide effort involving performance improvement, risk management, infection control, safe clinical practices, and a safe environment of care. Unsafe injections expose millions of people to infections worldwide each year. Ensuring single-use injection devices and safety boxes are available in every healthcare facility can prevent reuse and unsafe waste disposal.
The document discusses integumentary disorders and provides information on the anatomy and functions of the skin. It describes common skin conditions like eczema, acne, and psoriasis. Eczema is characterized by redness, dryness, and itching. Acne presents as inflamed papules and pustules on the face and back. Psoriasis causes thickened red patches covered with silvery scales. The document outlines signs, causes, and management approaches for various dermatological disorders and skin lesions.
A nebulizer converts liquid medication into a mist that can be inhaled directly into the lungs, allowing for rapid onset of medication effects. There are different types of nebulizers that administer medication via mouthpiece or mask. Nebulizers are commonly used to treat conditions involving airflow obstruction like asthma. Proper use involves preparing equipment and medication, positioning the patient, administering the treatment, and monitoring for side effects.
This document provides an overview of the endocrine system, including the major glands and hormones. It describes the hypothalamus and pituitary glands which regulate many other endocrine glands. Other glands covered include the thyroid, parathyroid, adrenal, pancreas, ovaries, testes, thymus, and pineal. The document outlines how to assess endocrine disorders and lists some common laboratory studies. It also provides details on diabetes mellitus, describing the main types of diabetes including type 1, type 2, and gestational diabetes.
This document provides guidance on performing a cardiac and abdominal examination. It outlines the objectives, symptoms, and physical examination techniques for assessing the cardiovascular and abdominal systems. The cardiovascular section covers inspection of the jugular veins, palpation of pulses, auscultation of heart sounds, and measurement of blood pressure. The abdominal section reviews inspection, auscultation, percussion and palpation techniques. Proper examination order and identification of normal versus abnormal findings are emphasized.
This document summarizes several endocrine system disorders including hyperthyroidism, hypothyroidism, hyperparathyroidism, hypoparathyroidism, Cushing's syndrome, Conn's syndrome, Addison's disease, and pituitary adenomas. It provides epidemiological data on certain disorders and describes associated symptoms, diagnostic evaluations, and medical management approaches. Multiple endocrine neoplasia syndromes are also briefly discussed.
This document provides guidance on effectively breaking bad news to patients. It discusses the importance of this communication skill for healthcare professionals. The document outlines best practices for setting, perception checking, invitation, knowledge sharing, exploring the patient's response, and summarizing. Key aspects include ensuring privacy, empathy, clarity, and allowing time for the patient's questions and reactions. The SPIKES protocol is presented as a framework for structuring the discussion. Examples of both best practices and things to avoid are also highlighted.
2 Assessment of patient with respiratory disorder.pptxMohammedAbdela7
This document provides guidelines for performing a physical examination of the thorax and lungs. It begins by outlining the session objectives and general examination guidelines. It then discusses pertinent history data to obtain, such as cough characteristics and sputum type/color. The physical exam involves inspection, palpation, percussion, and auscultation of the chest. Inspection evaluates breathing patterns, respiratory distress signs, and overall appearance. Palpation assesses tracheal position, chest expansion, tactile fremitus, and tenderness. Percussion and auscultation are also performed to evaluate the lungs. Proper equipment, patient positioning, and exam techniques are emphasized throughout.
This document provides an overview of critical thinking, evidence-based medicine, and how to practice evidence-based medicine. It defines critical thinking as the process of conceptualizing and evaluating information to guide beliefs and actions. Evidence-based medicine is defined as integrating the best research evidence with clinical expertise and patient values/circumstances. The history of evidence-based medicine is discussed, from Cochrane's work in the 1970s highlighting gaps between research and practice, to Guyatt coining the term "evidence-based medicine" in 1991 and Sackett explaining the combination of research, expertise, and patient factors in 1996. The five steps to practice evidence-based medicine are described as developing questions, finding evidence, appraising evidence, integrating
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
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Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
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Mercurius is named after the roman god mercurius, the god of trade and science. The planet mercurius is named after the same god. Mercurius is sometimes called hydrargyrum, means ‘watery silver’. Its shine and colour are very similar to silver, but mercury is a fluid at room temperatures. The name quick silver is a translation of hydrargyrum, where the word quick describes its tendency to scatter away in all directions.
The droplets have a tendency to conglomerate to one big mass, but on being shaken they fall apart into countless little droplets again. It is used to ignite explosives, like mercury fulminate, the explosive character is one of its general themes.
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These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
The Nervous and Chemical Regulation of Respiration
CAP SEMINAR PRESENTSTION.pptx
1. .
INSTITUTE OF HEALTH SCIENCE
DEPARTMENT OF NURSING AND MIDWIFERY
PROGRAM OF ADULT HEALTH NURSING
Community Acquired Pneumonia (CAP)
BY AHN MSc student’s
Aug ,2022
Wollega
Ethiopia
2/5/2023 1
2. Group members
S/No Students name Track ID NO
1 Ashenafi Tesfaye AHN 1400225
2 Demiso Geneti AHN 1400227
3 Kidane Dinku AHN 1400228
4 Mulata Kanate AHN 1400283
5 Nasira Jamal AHN 1400229
6 Takele Mitiku AHN 1400230
7 Zewude Mulatu AHN 1400231
2/5/2023 2
3. Objectives of the presentation
At the end of the presentation the students will be
able to:-
2/5/2023 3
4. Pneumonia
• Pneumonia refers to acute inflammation of the distal
lung-terminal airways, alveolar spaces, and interstitial.
• Common illness which occurs in all age group
• Leading cause of M&M in Infants and Older People
& people who are chronically & terminal ill.
• Occur in 7% (450 million) of global population per
year.
• One of top 10 outpatient & inpatient Dx.
• Results in 4 million deaths in developing world
2/5/2023 4
5. Pneumonia….
Normally, lungs are well protected
For pneumonia to occur, at least one of the following
three conditions must occur:
1. Failure or defect in host defenses
2. Exposure to very virulent pathogens
3. Exposure to an overwhelming load of pathogens
2/5/2023 5
6. Predisposing factors
Decrease level of consciousness
Tracheal intubation
Malnutrition
Alcohol
Cigarette smoking, air pollution, viral URTIs
Advanced age
Immunosuppressive disease &/or therapy
Advanced age
2/5/2023 6
7. Classification
Primary benefit of classification schemes is to
guide appropriate management and empiric
treatment
Based on causative agent
A. Bacterial:- Typical and atypical pneumonia
B. Viral
C. Fungal
Pneumonia may be either infectious or non-
infectious
2/5/2023 7
8. Classification….
According to the X-ray appearance (anatomic
classification)
1. Lobar pneumonia- Typically involves an entire lobe
of a lung, homogeneous consolidation of one or more
lung lobes
2. Bronchopneumonia- characterized by multiple-
patchy consolidation. Exudate tends to remain
primarily in the bronchi and bronchioles.
3. Interstitial pneumonia- the inflammatory process
primarily involves the interstitium: the alveolar walls
and connective tissue supporting the bronchial tree.
2/5/2023 8
10. Classification …
According to the setting or clinical and environment in
the past, pneumonia was typically classified as :-
1. Community-acquired pneumonia
2. Hospital-acquired pneumonia
Because of vast presence of patients with multidrug
resistant (MDR) pathogens, hospital-acquired
pneumonia revised to medical care-associated
pneumonia
2/5/2023 10
11. Classification …
Medical care-associated pneumonia encompasses three
forms of pneumonia:
1. Hospital-associated pneumonia:- acquired during or
after hospitalization -at least 48 hours after admission.
2. Ventilator-associated pneumonia :- refers to pneumonia
that occurs more than 48 hours after endotracheal
intubation.
3. Healthcare-associated pneumonia :- occurs in a non-
hospitalized pts, due to frequent contact with health
care environment.
2/5/2023 11
13. Community-acquired pneumonia (CAP)
CAP is commonly defined as an acute infection of the
pulmonary parenchyma that is associated with at least
some symptoms of acute infection and is accompanied
by the presence of an acute infiltrate on a CXY or
auscultator findings consistent with pneumonia
CAP occurs in a patient who is not hospitalized or
residing in a long term care facility for > 14 days before
the onset of symptoms
2/5/2023 13
14. CAP………
Infectious pneumonia in a person who has not
recently been hospitalized & within the first
48 hours after hospitalization.
Common type of pneumonia.
Infection usually spread by droplet inhalation.
2/5/2023 14
15. Cont…
The clinical presentation and the etiology vary greatly
depending on the:-
Patient’s age
Immune status of the patient
Presence of comorbid conditions
Sites the infection has involved
Place of acquisition of infection
2/5/2023 15
16. Etiology of CAP
Streptococcus pneumoniae :- is the most common cause
Accounted for over 80 % of cases of CAP.
May associated with viral URTI in winter season
The atypical bacteria:- Legionella ( in elderly and smokers),
Mycoplasma pneumoniae & Chl. Pneumonia account for 10-20 %
of all cases of pneumonia.
Mycoplasma pneumoniae among hospitalized adults with CAP
ranges from 1-8 %, and it is much higher for young adults who
are treated as outpatients
2/5/2023 16
17. Etiology of CAP….
Other bacteria commonly encountered in cultures of
expectorated sputum are:-
H.influenzae, Staph. aureus, and gram-negative bacteria
(mainly in alcoholics & during aspiration), Moraxella
catarrhalis, Strep. pyogenes, & Neisseria meningitides
H. influenza - frequently affects elderly people and those
with comorbid illnesses e.g., COPD, alcoholism, D/M.
2/5/2023 17
18. Etiology of CAP…
Viral agents :- account for 2 to 15 % of cases,
Most common causative organisms in elderly adults and
children
Most commonly influenza virus ,para influenza virus and
adenovirus.
Tuberculosis usually accounts for 1 to 2 % of cases
Legionella is 1 to 5 % of hospitalized adults with CAP
2/5/2023 18
19. Pathophysiology of CAP
Routes of infection:
1. Aspiration from the oropharynx (commonest)
Gross aspiration (Post op, CNS abnormality)
Micro aspiration (inhaled droplet -commonest )
2. Hematogenous spread (endocarditis, UTI)
3. Direct (from pleura, mediastinum)
2/5/2023 19
20. Pathophysiology of CAP…..
Once inside, bacteria may invade the spaces b/n cells
and b/n alveoli through connecting pores.
Invasion triggers the immune system to send
neutrophils
Neutrophils & macrophages engulf and kill the
offending organisms
The alveolar macrophages also initiate the
inflammatory response
2/5/2023 20
21. Pathophysiology of CAP…..
It releases cytokines, causing a general activation of
the immune system.
Neutrophils, bacteria and fluid from surrounding blood
vessels fill the alveoli.
As alveoli and respiratory bronchioles fill with
exudate, blood cells, fibrin and bacteria, consolidation
(solidification) of lung tissue occurs.
Interrupt normal oxygen transportation and venous
blood entering the lungs passes through the under
ventilated area.
2/5/2023 21
22. Pathophysiology of CAP…..
Bacteria often travel from an infected lung into the
bloodstream, causing serious or even fatal illness
such as septic shock
Bacteria can also travel to the area between the lungs
and the chest wall (the pleural cavity) causing a
complication called an empyema
2/5/2023 22
23. Pathophysiology of CAP…..
• Four stage of pathophysiological change occur due to
pneumonia
1. Congestion: - occurs during the first 24 hrs
Out pouring of fluid from tissue to alveoli- b/se of
inflammatory process.
Only a few neutrophils are seen at this stage.
2/5/2023 23
24. Pathophysiology of CAP…..
2. Red hepatization:- Lungs look like the liver
There is massive capillary dilation
Characterized microscopically by the presence of many
RBC, neutrophils, micro-organisms, fibrins in the
alveolar spaces
2/5/2023 24
25. Pathophysiology of CAP…..
3. Gray hepatization
The lung is dry, friable and gray-brown to yellow as a
consequence of a persistent fibrino-purulent exudates
WBC and fibrin consolidate the alveoli and lung
Second and third stages last for 2 to 3 days each
2/5/2023 25
26. Pathophysiology of CAP…..
4. Resolution
Characterized by enzymatic digestion of the alveolar
exudate
Resorption, phagocytosis or coughing up of the
residual debris and
Restoration of the pulmonary architecture
2/5/2023 26
27. Clinical manifestations
Cough producing greenish or yellow sputum
High fever that may be accompanied by shaking chills
Shortness of breath
Tachypnea
Pleuritic chest pain
Headaches
2/5/2023 27
28. Clinical manifestations…
Sweaty and clammy (moist) skin,
Loss of appetite
Fatigue
Blueness of the skin
Nausea, vomiting
Joint pains or muscle aches
2/5/2023 28
29. Clinical manifestations…
Typical
Acute onset of fever,
Cough with purulent sputum,
Pleuritic chest pain, dyspnea
Signs of consolidation on CXR
Fatigue
E.g. . S.pneumoniae,
H.influenzae
Atypical
Culture negative
Insidious onset of dry cough,
Extra-pulmonary symptoms :-
diarrhea, headache, myalgia,
sore throat
Patchy interstitial pattern on
CXR
E.g.. Mycoplasma, Chlamydia,
Legionella, viral
2/5/2023 29
30. Diagnosis
Diagnosis is based on combination of clinical findings,
physical examination and CXR
History ( CAP Clinical + CXR )
Characteristic symptoms and physical findings:
Fever(acute onset ), chills, productive cough,
Pleuritic chest pain, dyspnea & BBS with
Percussive dullness and egophony.
Signs of Consolidation on CXR
2/5/2023 30
31. Diagnosis ….
Physical examination
Inspection
Increase respiratory rate
Cyanosis, may be use of accessory muscle
Palpation
Increase tactile fremitus
Decrease chest expansion in affected side
2/5/2023 31
33. Diagnosis….
Chest x-ray:-this is the cardinal investigation.
Chest x-rays can reveal areas of opacity (seen as white)
which represent consolidation.
Area of consolidation on chest x-ray makes the diagnosis,
but x-ray is a poor guide to the likely pathogen.
Chest CT scan :- to distinguish pneumonia from other illness.
PCR for specific viruses (e.g.SARSCOV 2):in the right
epidemiologic setting.
2/5/2023 33
34. Figure of CXR
Pneumonia as seen on chest x-ray A: Normal chest x-ray. B: Abnormal chest x-ray 34
35. Sputum microscopy and culture
• There is debate about the value of sputum samples in
diagnosis of CAP.
• Oral flora rather than the offending pathogen may
dominate a sputum Gram stain and culture.
• Nevertheless, we believe that an attempt should be
made to obtain a sputum sample before beginning
antibiotic therapy, as this is sometimes the best
opportunity to identify pathogens that need special
treatment.
2/5/2023 35
36. Blood chemistry and hematology
• All patients with CAP being assessed in emergency
departments or admitted to hospital should have Oxymetry,
measurement of serum electrolytes and urea levels, and a
full blood count to assist in assessing severity (CBC may
show a high WBC count)
• Blood gas measurement is also recommended, as it provides
prognostic information pH and Pao2 and chronic Paco2
2/5/2023 36
37. Blood culture
Blood cultures are the most specific diagnostic test for
the causative organism, but are positive in only around
10% of patients admitted to hospital with CAP.
The more severe the pneumonia, the more likely blood
cultures are to be positive.
We recommend that blood be cultured from all patients,
except those well enough to be managed at home with
oral antibiotics
2/5/2023 37
38. Risk Group
Factors that increase risk of CAP are
COPD, dementia, HF, immunosuppressant,
Age over 50, asthma, alcoholism,
Indigenous background institutionalization,
Seizure disorders, smoking, stroke
2/5/2023 38
39. Risk…..
Factors that increased risk of death from CAP are:
Hypothermia (temperature 370C),
Hypotension (SBP<100mmhg)
More than one lobe involved on chest x-ray,
Tachypnea (RR > 20 bpm),
Existing neoplastic disease, leukopenia, confusion
Neurological disease and bacteremia.
2/5/2023 39
40. Medical Treatment
Combination antibiotic therapy achieves a better outcome
compared with monotherapy,
Identify high risk patients for CAP and require
hospitalization:-
Outpatients with co morbidities
Previous antibiotic therapy
Nursing home patients with CAP, hospitalized patients
2/5/2023 40
41. Medical Treatment….
Objectives of treatment
Achieve clinical cure
Prevent complications and associated morbidity and
mortality.
2/5/2023 41
42. .CURB-65 criteria
The CURB-65 scoring systems decided to evaluate
the prognosis and determine subsequent management
of patient with CAP.
2/5/2023 42
C Confusion - 1 point
U Uremia BUN >19mg/dl 1 point
R Respiratory rate RR >= 30/min 1 point
B Blood pressure BP <=90/60 1 point
65 Age > =65 Age >65 1 point
46. Medical management…
Pharmacologic
Initially be treated with a broad-spectrum antibiotic
regimen aimed at covering all likely bacterial
pathogen
This regimen should subsequently be narrowed,
according to the result of culture
2/5/2023 46
47. Empiric antibiotic
Two parameters before starting empiric antibiotic
1.Look for risk factors include of MRSA (Methicillin
Resistant Staphylococcus aureus) or P.aeruginosa
Recent hospitalization
Receipt of parenteral antibiotics in the last 90days
Prior isolation of the organisms from the respiratory
samples
2.Comorbidities:- Organ failure, D/M, Ca, alcoholism
2/5/2023 47
48. Empiric antibiotic…..
The duration of antibiotic therapy is generally 5 to 7
days; however, it needs to be guided by clinical
response as well
The antibiotic should be continued until the patient
achieves stability but for no less than a total of 5days.
2/5/2023 48
49. New Treatment Paradigm
Hit hard and early with appropriate antibiotic &
Short Rx. Duration; De-escalate where possible
Appropriate Duration of Therapy
Minimum of 5 days
Afebrile for at least 48 to 72hr
Longer duration of therapy- If initial therapy was
not active against the identified pathogen or
complicated by extra pulmonary infection
2/5/2023 49
50. For CAP ambulatory(Outpatient) patient
Mild pneumonia
No recent antibiotics use
No co-morbidities/previously healthy;
No risk factors for drug-resistant & S. pneumoniae, H.Influenza
Clarithromycin 500mg P.O., BID for 5-7 days OR 2nd line
Azithromycin 500mg P.O first day then 250mg P.O for 4days OR
Doxycycline 100mg P.O., BID for 7-10 days
Amoxicillin 500mg Po TID/5-7day ---1st line
2/5/2023 50
51. For CAP ambulatory(Outpatient) patient…
If recent antibiotic use within 3months:
Out patient with co-morbidities
Clarithromycin, 500mg P.O. BID for 5-7 days OR
Azithromycin,500mg PO first day then 250mg P.O for 4d.
PLUS
Amoxicillin, 1000mg P.O., TID for 5 to 7 days. OR
Amoxicillin-clavulanate, 625mg P.O., TID for 5-7days
2/5/2023 51
52. For CAP hospitalized (severe pneumonia)
Non-Drug treatment:
Bed rest
Frequent monitoring of temperature, B/P and PR.
Give attention to fluid & nutritional replacements.
Administer Oxygen
Analgesia for chest pain
2/5/2023 52
53. CAP for hospitalized patients mgt
• The Antibiotic choice should be aimed at the most
likely causative agent.
• Empiric treatment for pneumonia due to common
organisms:
2/5/2023 53
54. CAP for hospitalized mgt…
For Gram positive and negative and
Atypical microorganism
Ceftriaxone, 1g I.V or I.M every 12-24 BID/7days OR
Benzyl penicillin, 2-3 million IU I.V. QID for 7-10 days.
PLUS
Azithromycin, 500mg on day 1 followed by 250mg/day on
day 2 – 5 OR
Clarithromycin, 500mg P.O., BID for 7-10 days
2/5/2023 54
55. CAP for hospitalized mgt…
For Coverage MRSA and P. aeruginosa
For P.aeruginosa coverage:
Cefepime 2g IV 8-12 hours
Ceftazidime 2g Iv q 6-8 hours
For MRSA coverage:
Vancomycin 1g IV BID
2/5/2023 55
57. Nursing intervention
Encourage increased fluid intake (at least 2 L/day)
Lung expansion maneuvers- deep breathing, direct coughing
Administers oxygen therapy as prescribed.
Limited activity and encourage rest
Teaching good health habits; such as proper diet & hygiene
Frequent monitoring schedule for population at risk.
2/5/2023 57
58. Prevention CAP
In addition to treating any underlying illness , also
Smoking cessation, because cigarette smoke interferes
with many of the body’s natural defenses against CAP.
Vaccination is important in both children and adults,
against H. influenza and S.pneumoniae
Other infection prevention measures
2/5/2023 58
60. References
1. Standard treatment guideline for general Hospitals in
Ethiopia 4thedition, 2021
2. Community Acquired Pneumonia by Sonia Akter,
ETL.March 21, 2015
2/5/2023 60