This document discusses pneumonia, including its causes, types, symptoms, diagnosis, treatment and prevention. Pneumonia can be caused by bacteria, viruses or other pathogens. It defines pneumonia as an inflammation of the lung parenchyma, characterized by consolidation of the affected part. The document outlines typical and atypical bacterial organisms commonly responsible, and various viral pneumonias. It covers clinical features, examination findings, investigations, treatment approaches, potential complications and poor prognostic factors. Prevention methods like vaccines are also mentioned.

1. BY: RON CHRISTIANGAYANILO

2.  Introduction
 Aetiology
 Viral pneumonias
 Pathology
 Clinical features
 Examination findings
 Investigations
 Treatment
 Complications
 Poor prognostic factors
 Prevention

3.  Definition inflammation of the lung parenchyma,
which is characterized by consolidation of the
affected part and a filling of the alveolar air
spaces with exudate, inflammatory cells, and
fibrin
 Community acquired or Health care associated.
 Lobar /Focal/ nonsegmental pneumonia
 Multifocal/lobular (bronchopneumonia)
 Interstitial (focal diffuse)
 Important cause of morbidity and mortality
worldwide.
 Usually acquired through inhalation or aspiration
of pulmonary pathogenic organisms into a lung
segment or lobe less common is the haematogenous
route

4.  Typical or atypical organisms
 Typical organisms- commonest organisms
are Strep.
pneumoniae, H. influenzae, M.
catarrhalisaccount
for approximately 85 of CAP cases.
 Less common S. aureus, E.coli, K.
pneumoniae, S.
faecalis

5.  Most commonLegionella species,
Mycoplasma
pneumoniae, Chlamydophila spp.
 Less common viruses (influenza virus,
adenovirus, respiratory syncytial virus,
human
parainfluenza virus, measles, varicella zoster)
mycobacteria, parasites


6.  Can vary from a mild, self-limited illness to a
life-threatening disease.
 The commonest causes are influenza virus,
respiratory syncytial virus, adenovirus, and
parainfluenza virus. Less common are
varicella-zoster virus and measles virus.
 Routes include large-droplet spread over short
distances, hand contact with contaminated skin
and fomites with subsequent inoculation onto
the
nasal mucosa or conjunctiva, and small-particle
aerosol spread

7.  Pathogenesis of most viral pneumonias is not well
known.
 After contamination, viruses multiply in the
epithelium of the upper airway, destroy
respiratory cilia, cause disruption of the
respiratory epithelium, clearing the way for
bacterial infection
 Severe pneumonias may result in extensive
consolidation of the lungs
 They also generally cause impairment ofT cells,
macrophages, and neutrophil function and thus
increase risk of bacterial super-infection

8.  Incubation period depends on the specific
virus.
 Symptoms fever, chills, dry cough,
rhinitis/rhinorrhoea, myalgias, headache,
fatigue
 Travel history is important.
 With bacterial superinfection, symptoms last
longer, cough becomes productive of sputum
and
the patients becomes more ill.

9.  Fever and/or chills
 Cough
 Tachypnoea and/or dyspnoea
 Tachycardia or bradycardia
 Wheezing/ Rhonchi
 Crepitations
 Dullness to percussion
 Decreased breath sounds
 Hypoxia

10.  Full blood count anaemia, leucocytosis
(lymphocytosis or neutrophilia)
 Sputum for microscopy, culture, sensitivity
 Chest x-ray
 Rapid antigen detection on nasal swabs by ELISA
and immunofluorescence
 Serologic tests
 Gene amplification by RT-PCR
 Blood culture
 Examination of bronchoalveolar lavage samples
 Viral culture of tissue from the respiratory
tract, sputum, and samples obtained by
nasopharyngeal washing, bronchoalveolar lavage
 Lung biopsy for histopathologic studies and viral
culture


11.  General measures Oxygen, bed rest,
antipyretics, analgesics, fluids, respiratory
isolation

 Specific measures mechanical ventilation if
respiratory failure is present or impending,
antibiotics (if infiltrate is seen on the chest
radiograph)


12.  Acyclovir for varicella or herpes pneumonia
 Respiratory syncythial virus ribavirin,
immunoglobulin only for severe disease
 Adenovirus cidofovir
 Parainfluenza virus ribavirin
 Influenza virusAcyclovir,Oseltamivir,
Zanamir

13.  Complications of CAP include empyema,
cavitation,
precipitation of myocardial infarction or heart
failure and overwhelming pneumococcal
sepsis in
asplenic/hyposplenic patients.
 Viral pneumoniasSecondary bacterial
infections,
encephalitis, hepatitis

14.  Significant co-morbidity eg cardioresp disease
 Increased respiratory rate
 Hypotension
 Fever
 Anaemia
 Hypoxia
 Multilobar involvement
 Immunosuppression eg asplenia/hyposlenia
 Elderly patients
 Virulent organisms.


15.  INFvaccination zanamivir, oseltamivir,
amantadine
 RSVRSV immunoglobulin, Palivizumab
 Measlesintravenous Ig
 VZVVZV Ig

16.  PNEUMONIA IS TREATABLE, WITH
COMPLETE BED REST AND MEDICINE. THIS
STUDIES CONDUCTED BASED ON
CURRENT SITUATION WHERE COVID-19 IS
STILL ACTIVE AND MOST AFFECTED
PATIENTS WERE OLD PEOPLE AND IS
BASED ON THE REPORT OF C.H.O. –
CAUAYAN.