This document discusses different types of pneumonia including community acquired pneumonia, pneumococcal pneumonia, hospital acquired pneumonia, aspiration pneumonia, and pneumonia in immunocompromised patients. Community acquired pneumonia is most commonly caused by Streptococcus pneumoniae. Hospital acquired pneumonia refers to pneumonia developing 48 hours or more after admission and has different common pathogens than community acquired pneumonia such as Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus. Prevention of pneumonia involves vaccination against influenza and pneumococcus as well as good hygiene practices.

1. PNEUMONIA
Dr. Manu Mohan K
Associate Professor
Pulmonary Medicine

2. Community Acquired Pneumonia
 Most common
 Streptococcus pneumonia
 Common
 Staphylococcus aureus, Legionella pneumophila,
Mycoplasma pneumoniae
 Uncommon
 Haemophilus influenzae, Klebsiella pneumoniae,
Streptococcus pyogenes, Pseudomonas aeruginosa
 Rare
 Coxiella burnetti, Chlamydia psittacci, Actinomyces
israeli, viruses

4. Pneumococcal pneumonia
 Predisposing conditions
 Splenectomized state, functional
asplenia, chronic lung, heart, renal, liver
diseases, Diabetes mellitus
 Clinical features
 Physical signs
 Radiological examination

5. Supportive treatment
 Respiratory support
 Fluid and electrolyte replacement
 Other consideration
 Pleuritic pain
 Physiotherapy
 Corticosteroids
 Inotropic agents

6. Prevention
 Vaccination
 Influenza
 Pneumococcal

7. Hospital acquired pneumonia
 HAP is defined as pneumonia that occurs
48 hours or more after admission, which
was not incubating at the time of
admission

8. Hospital acquired pneumonia
 VAP refers to pneumonia that arises more
than 48–72 hours after endotracheal
intubation

9. Hospital acquired pneumonia
 HCAP includes any patient who was
 hospitalized in an acute care hospital for
two or more days within 90 days of the
infection;
 resided in a nursing home or long-term care
facility;
 received recent intravenous antibiotic
therapy, chemotherapy, or wound care
within the past 30 days of the current
infection; or
 attended a hospital or hemodialysis clinic

10. Hospital acquired pneumonia
 Common pathogens include
 aerobic gram-negative bacilli, such as P.
aeruginosa, Escherichia coli, Klebsiella
pneumoniae, and Acinetobacter species.
 Infections due to gram-positive cocci,
such as Staphylococcus aureus,
particularly methicillin resistant S. aureus
(MRSA)

11. Predisposing factors for HAP
 Reduced host defense
 Aspiration of nasopharyngeal or gastric
secretions
 Bacteria introduced into lower respiratory
tract
 Bacteremia

12. Hospital acquired pneumonia
 Clinical features
 Investigations
 Management
 Prevention
 Good hygiene
 Minimize aspiration
 limit stress ulcer prophylaxis

13. Aspiration Pneumonia
 Mainly oropharyngeal flora
 Nosocomial case – polymicrobial

14. Suppurative pneumonia –
clinical features
 Symptoms
 Cough with expectoration
 Pleural pain
 Sudden expectoration
 Clinical signs
 Fever
 Systemic upset
 Clubbing
 Signs of consolidation, rub

15.  Investigations
 Management

16. Pneumonia - immunocompromised
 Etiology
 Defective phagocytosis
 Defective cell-mediated immunity
 Defective antibody production
 Clinical features
 Investigation
 Treatment

17. Pneumonitis
 Radiation pneumonitis
 Chemical pneumonitis