Brief presentation on community acquired pneumonia for nurses and medical students

1. COMMUNITY ACQUIRED
PNEUMONIA
FOMBA Michael (MD)

2. OUTLINE

3. PLAN
• INTRODUCTION
• ETIOLOGIES
• SIGNS AND SYMPTOMS
• DIAGNOSIS
• TREATMENT
• COMPLICATIONS

4. OBJECTIVES
• Define pneumonia and community acquired pneumonia
• State the most frequent pathogens involved in CAP
• State the signs and symptoms of CAP
• List investigations used to confirm diagnosis of CAP
• State and precise the treatment goals of CAP

5. INTRODUCTION
• Pneumonia is an acute inflammation of the lungs of infectious cause
• It is the most widespread cause of death due to infections in developing
countries
• The initial diagnoses is based upon clinical signs and chest X-ray
• The cause, symptoms, treatment, preventive measures and prognosis
depend on whether the infection
1. is bacterial, mycobacterial, viral, fungal or parasitic
2. was acquired in the community or hospital
3. Was developed by a patient; under mechanical ventilation, immune-
compromised or immune-competent

6. ETIOLOGIES
• Community acquired pneumonia is pneumonia acquired out of the hospital
setting.
• Most frequently identified pathogenous agents include;
1. Bacterial
1. Typical germs: Streptoccocus pneumoniae, Hemophilus influenzae,
2. Atypical germs: Chlamydia pneumoniae, Mycoplasma pneumonia
2. Viral: Coronavirus, Syncytial respiratory virus, adenovirus, influenza virus,
parainfluenza virus
3. Fungal: Histoplasma capsulatum, Coccidiodes immitis, pneumocystis
jirovecii (HIV patients)

7. SIGNS AND SYMPTOMS
• Symptoms: may vary depending on age and immune status
1. Fever and chills
2. Cough (productive or not)
3. Difficulties in breathing (dyspnea)
4. Thoracic pain: adjacent to infected lung region
5. Digestifs symptoms: nausea, vomiting, diarrhea, abdominal pain
may be present.
• Signs: Fever, tachycardia, tachypnea, lung crackles during
auscultation…

8. INVESTIGATIONS
• Chest X-ray: visualizes infiltrated lung parenchyma
• Sputum culture and analysis: identifies pathogenous agent
• Blood cultures : identifies pathogenous agent
• Detection of antigens in urine: for legionella and pneumoccocus
• Covid-19 test: by PCR on respiratory secretions
• FBC : raised WBC count
• Urea: sign of severity if elevated

9. TREATMENT PRINCIPLES
• Depend on severity score (ambulatory or ICU)
• Goals:
• Restore vital functions : with fluids, oxygen…
• Relieve symptoms: antipyretics and analgesics
• clear infection: antibiotics (penicillin A, cephalosporins,
fluroquinolones and macrolides) for bacteria pneumonia
• prevent complications and relapse: respiratory physiotherapy, early
mobilization, anticoagulants, Vaccinations, quitting smoking

10. COMPLICATIONS
• Septicemia and septic shock
• Severe hypoxia
• Death