This document discusses pneumonia, including its pathogenesis, stages, classification, causative agents, and pre-disposing factors. Pneumonia is an inflammatory process of the lung parenchyma that is usually caused by bacteria, viruses, or other microorganisms entering the lungs. It affects the small air sacs (alveoli) of the lungs and can cause symptoms like cough, fever, and difficulty breathing. The document outlines the four stages of pneumonia and provides details on the various types based on location, duration, etiology, immunity, and source of infection. Common causative organisms are also identified based on patient age and immune status. Pre-disposing factors that increase risk include young age, preexisting lung conditions,
Pneumonia is an inflammatory condition of the lung affecting primarily the small air sacs known as alveoli. Typically symptoms include some combination of productive or dry cough, chest pain, fever, and trouble breathing. Severity is variable.
Pneumonia is usually caused by infection with viruses or bacteria and less commonly by other microorganisms, certain medications and conditions such as autoimmune diseases. Risk factors include cystic fibrosis, chronic obstructive pulmonary disease (COPD), asthma, diabetes, heart failure, a history of smoking, a poor ability to cough such as following a stroke, and a weak immune system. Diagnosis is often based on the symptoms and physical examination. Chest X-ray, blood tests, and culture of the sputum may help confirm the diagnosis. The disease may be classified by where it was acquired with community, hospital, or health care associated pneumonia.
Vaccines to prevent certain types of pneumonia are available. Other methods of prevention include handwashing and not smoking. Treatment depends on the underlying cause. Pneumonia believed to be due to bacteria is treated with antibiotics. If the pneumonia is severe, the affected person is generally hospitalized. Oxygen therapy may be used if oxygen levels are low.
Pneumonia affects approximately 450 million people globally (7% of the population) and results in about four million deaths per year. Pneumonia was regarded by William Osler in the 19th century as "the captain of the men of death". With the introduction of antibiotics and vaccines in the 20th century, survival improved. Nevertheless, in developing countries, and among the very old, the very young, and the chronically ill, pneumonia remains a leading cause of death. Pneumonia often shortens suffering among those already close to death and has thus been called "the old man's friend"
Pneumonia is an inflammatory condition of the lung affecting primarily the small air sacs known as alveoli. Typically symptoms include some combination of productive or dry cough, chest pain, fever, and trouble breathing. Severity is variable.
Pneumonia is usually caused by infection with viruses or bacteria and less commonly by other microorganisms, certain medications and conditions such as autoimmune diseases. Risk factors include cystic fibrosis, chronic obstructive pulmonary disease (COPD), asthma, diabetes, heart failure, a history of smoking, a poor ability to cough such as following a stroke, and a weak immune system. Diagnosis is often based on the symptoms and physical examination. Chest X-ray, blood tests, and culture of the sputum may help confirm the diagnosis. The disease may be classified by where it was acquired with community, hospital, or health care associated pneumonia.
Vaccines to prevent certain types of pneumonia are available. Other methods of prevention include handwashing and not smoking. Treatment depends on the underlying cause. Pneumonia believed to be due to bacteria is treated with antibiotics. If the pneumonia is severe, the affected person is generally hospitalized. Oxygen therapy may be used if oxygen levels are low.
Pneumonia affects approximately 450 million people globally (7% of the population) and results in about four million deaths per year. Pneumonia was regarded by William Osler in the 19th century as "the captain of the men of death". With the introduction of antibiotics and vaccines in the 20th century, survival improved. Nevertheless, in developing countries, and among the very old, the very young, and the chronically ill, pneumonia remains a leading cause of death. Pneumonia often shortens suffering among those already close to death and has thus been called "the old man's friend"
Bronchitis is an acute inflammation of the air passages within the lungs. It occurs when the trachea (windpipe) and the large and small bronchi (airways) within the lungs become inflamed because of infection or irritation from certain causes. Homeopathy is the best treatment with no side effects. For further information contact Ph. : +91-265-2250212,
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Bronchitis is an acute inflammation of the air passages within the lungs. It occurs when the trachea (windpipe) and the large and small bronchi (airways) within the lungs become inflamed because of infection or irritation from certain causes. Homeopathy is the best treatment with no side effects. For further information contact Ph. : +91-265-2250212,
(M) +91 97236 69210
Skype Id : cosmic1021
Email:
drmahavrat@homeopathyhealing.net
This ppt contains all information about epidemiology of Measles. It is useful for students of medical field learning preventive and social medicine, Swasthavritta (Ayurved), nursing and everyone who is interested in knowing about it.
PNEUMONIA IS MAJOR CAUSE OF MORTALITY IN UNDER 5 YR OF AGE, IN THIS PPT I TRIED TO COVER ALL IMPORTANT FACTOR ABOUT PNEUMONIA, FOLLOW WHO PLAN FOR MANAGEMENT GOD WILL DO REST FOR BETTERMENT OF YOUR PT.
An inflammatory process in lung parenchyma usually associated with a marked increase in interstitial and alveolar fluid
the topic covers the
definition, etiology, Pathophysiology, Clinical manifestation, Diagnostic Evaluation, Medical Management, Nursing Management & nursing diagnosis.
Pneumonia is an infection of the lungs. The air sacs in the lungs (called alveoli) fill up with pus and other fluid, which makes it hard for oxygen to reach the bloodstream.
Someone with pneumonia may have a fever, cough, or trouble breathing.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
1. DIRECTED BY:DIRECTED BY: COMPLETEDBY:COMPLETEDBY:
DR.B.S.SHARMA MUKHTAR ALAMDR.B.S.SHARMA MUKHTAR ALAM
DR.ARTIMAL BAMS FINAL PROF.DR.ARTIMAL BAMS FINAL PROF.
ROLL.NO.74411ROLL.NO.74411
2014-20152014-2015
..
Project on:
Pneumonia
2. PneumoniaPneumonia
Pneumonia is an inflammatory process which involves the lungPneumonia is an inflammatory process which involves the lung
parenchyma.parenchyma.
Pathogenesis:Pathogenesis:
1.Anatomical defense mechanism1.Anatomical defense mechanism
Length of airways include nose,trachea,pharynxLength of airways include nose,trachea,pharynx
2.Mechanical defense mechanism2.Mechanical defense mechanism
Cough,sneezingCough,sneezing
3.Chemical defense mechanism
-Alfa 1 antitrypsin
-Lactoferron
-Lysozymes
-Interferon
3. 4.Immunological defense mechanism
Phagocytosis,Cell mediated and humoral
Entry of microorganismEntry of microorganism
VasodilationVasodilation
Leads to outpouring of exudates or fluidsLeads to outpouring of exudates or fluids
InflammationInflammation
(proliferation of bacteria .toxins released which cause inflammation )(proliferation of bacteria .toxins released which cause inflammation )
PhagocytosisPhagocytosis
MacrophagesMacrophages
Clearance of bacteria debrisClearance of bacteria debris
4. Four stagesFour stages::
1.Stage of congestion1.Stage of congestion
Entry of bacteriaEntry of bacteria
VasodilationVasodilation
OutpouringOutpouring
ProliferationProliferation
1-2 days upto onset1-2 days upto onset
2.Stage of Red hepatisation2.Stage of Red hepatisation
Infilteration of polymorph,RBC,fibrinInfilteration of polymorph,RBC,fibrin
2-4 days after onset2-4 days after onset
3.Stage of Grey hepatisation3.Stage of Grey hepatisation
Consolidation stageConsolidation stage
Active phagocytosisActive phagocytosis
4-8 days4-8 days
5. 4.Stage of resolution4.Stage of resolution
Activation of macrophagesActivation of macrophages
Inflammation subsideInflammation subside
Bacterial debris wash outBacterial debris wash out
Estabilishing normal parenchyma of lungEstabilishing normal parenchyma of lung
8-9 days8-9 days
Pneumonia results from-Pneumonia results from-
1.1. AspirationAspiration
2.2. Contiguous spread of virulent agents from upper airways.Contiguous spread of virulent agents from upper airways.
3.3. Secondary infection when there is disruption of protectiveSecondary infection when there is disruption of protective
mechanism.mechanism.
4.4. Haematogenous spreadHaematogenous spread
6. ClassificationClassification
A. AnatomicalA. Anatomical
1. Lobar or lobular pneumonia-1. Lobar or lobular pneumonia- Characterized by replacementCharacterized by replacement
of alveolar air with cellular exudates.of alveolar air with cellular exudates.
2. Interstitial pneumonia-2. Interstitial pneumonia- Characterized by massive proliferationCharacterized by massive proliferation andand
desquamation of alveolar cells.desquamation of alveolar cells.
3. Bronchopneumonia-3. Bronchopneumonia- Characterized by spreading inflammation ofCharacterized by spreading inflammation of
the terminal bronchioles.the terminal bronchioles.
4. Multi lobar Pneumonia4. Multi lobar Pneumonia
B. Based on duration of symptomsB. Based on duration of symptoms
1. Persistent pneumonia-1. Persistent pneumonia- persistence of symptoms andpersistence of symptoms and xx--
abnormalities for more than 4 weeks.abnormalities for more than 4 weeks.
2. Recurrent pneumonia-2. Recurrent pneumonia- two episodes of pneumonia in 1 year ortwo episodes of pneumonia in 1 year or
more than three episodes at any time withmore than three episodes at any time with xx-ray clearance between two-ray clearance between two
episodes of illness.episodes of illness.
C. Based f Etiological factorsC. Based f Etiological factors
1.1. Infective-Infective- Pneumonia occurs as a result of invasion of lungs due toPneumonia occurs as a result of invasion of lungs due to
micro-organisms such as bacteria and ruses.micro-organisms such as bacteria and ruses.
2.2. Non-infective-Non-infective- ChemicalChemical
7. Causative Agents in PneumoniaCausative Agents in Pneumonia
Infective Pneumonia
Bacterial
Atypical Pneumonia
Viral Pneumonia
Etiological Agents
Streptococcus pneumonia
H. influenza
Staphylococcus aureus
M. Tuberculosis
Chlamydia
Mycoplasma
Legionella
Respiratory syncytial virus
Para influenza virus
Influenza virus
Rhinovirus
Adenovirus
8. Difference between viral and bacterial pneumonia
Features Bacterial Pneumonia Viral Pneumonia
Onset Abrupt Gradual
Epidemic Not Seen Common
Associated Conditions Infectionate other sites, Associated with URI, coryza
septicemia
Fever High grade May be absent
Toxemia Common Absent
Respiratory Distress Common Common in infants
Lung signs Crackles ++ Wheeze ++
Chest x-ray Confluent infiltrates Diffuse in Peripheral areas
Pleural involvement May be seen Not common
Prognosis Complications such as Self-limiting, usually resolve in
empyema, pneumatoidal about a week. Hyperinflation
septicemia may be seen seen in RSV infection.
9. D.D. Based of ImmunityBased of Immunity
1. Primary Pneumonia-1. Primary Pneumonia- It is caused by organisms of high purulent andIt is caused by organisms of high purulent and
as such, it even affects those with good immunity.as such, it even affects those with good immunity.
2. Secondary Pneumonia-2. Secondary Pneumonia- this occurs with organisms of lowthis occurs with organisms of low
virulence. Either the immunity of host is diminished or somevirulence. Either the immunity of host is diminished or some
predisposing factor is present such as aspiration.predisposing factor is present such as aspiration.
E.E. Based on Source of InfectionBased on Source of Infection
1.1. Community acquired pneumonia-Community acquired pneumonia- is caused by organisms presentis caused by organisms present
in the community in children who have not been hospitalized in thein the community in children who have not been hospitalized in the
recent past.recent past.
2.2. Hospital acquired pneumonia-Hospital acquired pneumonia- is caused by organisms present inis caused by organisms present in
hospital. It occurs after at least 48-72 hours of being admitted in thehospital. It occurs after at least 48-72 hours of being admitted in the
hospital.hospital.
3.3. Opportunistic pneumonia-Opportunistic pneumonia- is seen in children with decreasedis seen in children with decreased
immunity and is caused by organisms which usually do not causeimmunity and is caused by organisms which usually do not cause
pneumonia.pneumonia.
10. Types of Pneumonia Causative Agent
Community Acquired
- Typical
Atypical
S. Pneumoniae
H. Infleunzae
S. Aureus
Mycoplasma
Chlamydia
Legionella
Hospital Acquired E. coli
Proteins
Klebsiella
S. aureus
Pseudomonas
Opportunistic P. Carinii
Cytomegalouirus (CMV)
Varicella Zoster
11. Organisms Neonates 1 month to 5years Above 5 years
Bacteria Group B
Streptococci
E. Coli
Listeria
S. Aureus
S. pneumoniae
S. aureus
H. influenza
Group A
Streptococus
Klebsiella
Pseudomonas
M. Tuberculosis
S. Pneumonia
S. Aureus
H. Influenzae
M. Tuberculosis
Viruses CMV
Herpes
CMV
RSV
Influenza virus
Adenovirus
Influenza Virus
Varicella
Atypical Organisms Chlamydia Mycoplasma Mycoplasma
Legionella
Chlamydia
12. AETIOLOGYAETIOLOGY
The causative organism depends on the following factors-The causative organism depends on the following factors-
1. Age1. Age
2. Congenital anomalies2. Congenital anomalies such as cleft palate and tracheo-such as cleft palate and tracheo-
oesophageal fistula predispose to aspiration pneumonia by organismsoesophageal fistula predispose to aspiration pneumonia by organisms
present in oral cavity.present in oral cavity.
3. Immunity status-3. Immunity status- Klabsiella infection is common isKlabsiella infection is common is
immunocompromised children.immunocompromised children.
4. Underlying lung disease-4. Underlying lung disease- S. auceus, H. influenzae and P.S. auceus, H. influenzae and P.
aeruginosa are the three most common organisms causing lungaeruginosa are the three most common organisms causing lung
infections in cystic fibrosis patients.infections in cystic fibrosis patients.
5. H/o exposure to infection-5. H/o exposure to infection- When one of the family member isWhen one of the family member is
infected with an organism, the possibility of the same infection in otherinfected with an organism, the possibility of the same infection in other
child become more.child become more.
13. Common Organisms causing Pneumonia in ImmunoCommon Organisms causing Pneumonia in Immuno
compromised Children.compromised Children.
Protozoa Bacteria Viral Fungal
P. Carinii Gram + ve
- S.
Pneumoniae
- S. Aureus
Gram – Ve
- Klebsiella
- Pseudomonas
- H. influenza
- Legionella
CMV
Varicella zoster
Measles giant
cell pneumonia
RSV
Hespes simplex
HIV
Candidiasis
Aspergillus
14. Pre-Disposing FactorsPre-Disposing Factors
1.1. Age-below 6 monthsAge-below 6 months
2.2. Neonatal factors – preterm, low birth weight babies.Neonatal factors – preterm, low birth weight babies.
3.3. Congenital defects (may predispose to aspiration)- cleft palate, toCongenital defects (may predispose to aspiration)- cleft palate, to
Fistula, ciliary dyskinesia.Fistula, ciliary dyskinesia.
4.4. Bad child hearing practices- bottles feeding, lack of breast-feeding.Bad child hearing practices- bottles feeding, lack of breast-feeding.
5.5. Nutritional factors- protein energy malnutrition vit. A deficiency (severe),Nutritional factors- protein energy malnutrition vit. A deficiency (severe),
iron deficiency anemia, zinc deficiency and so on.iron deficiency anemia, zinc deficiency and so on.
Systemic factorsSystemic factors
Cardiovascular causes- congenital heart diseases, left to right shunts.
Chronic lung diseases- asthma, cystic fibrosis
Others- measles, diarrhoea, sinusitis, otitis media
7. Immunological status- immunosuppressed states
8. Malignancy
9. Iatrogenic – anesthesia
10. Trauma
15. Environmental FactorsEnvironmental Factors
1.1. OvercrowdingOvercrowding
2.2. Number of siblings (order of birth)Number of siblings (order of birth)
3.3. Indoor air pollutionIndoor air pollution
4.4. SanitationSanitation
5.5. Passive smokingPassive smoking
6.6. Educational statusEducational status
Clinical FeaturesClinical Features
SymptomsSymptoms
1.1. Fever with chillsFever with chills
2.2. Fast and difficult breathingFast and difficult breathing
3.3. CoughCough
4.4. Chest painChest pain
5.5. Abdominal painAbdominal pain
6.6. Poor feedingPoor feeding
7.7. IrritabilityIrritability
8.8. Excessive sleepinessExcessive sleepiness
16. SignsSigns
1.1. TachypnoeaTachypnoea
2.2. Chest retractionChest retraction
3.3. Grunting and stridorGrunting and stridor
4.4. Nasal flaringNasal flaring
5.5. CyanosisCyanosis
6.6. Dullness on percussionDullness on percussion
7.7. Diminished breath sounds, wheeze and crackles onDiminished breath sounds, wheeze and crackles on
auscultationauscultation
8.8. May be associated with meningismus, paralytic ileus.May be associated with meningismus, paralytic ileus.
9.9. Right lower lobe pneumonia causes diaphragmatic irritationRight lower lobe pneumonia causes diaphragmatic irritation
which may present as hiccoughswhich may present as hiccoughs
17. InvestigationsInvestigations
1.Chest radiography- PA and lateral view1.Chest radiography- PA and lateral view
2.Total and differential blood count, haemoglobin2.Total and differential blood count, haemoglobin
3.3. Tests to identify organismsTests to identify organisms
(a)(a) Microscopic examination – gMicroscopic examination – g
ram staining and AFB stainingram staining and AFB staining
(b)(b) Serological tests for bacteria and virusesSerological tests for bacteria and viruses
(c)(c) Urinary antigen tests for bacterial and viral antigensUrinary antigen tests for bacterial and viral antigens
(d)(d) Rapid antigen detection tests such as direct fluorescent antibody testRapid antigen detection tests such as direct fluorescent antibody test
(e)(e) Polymerase chain reaction for mycobacteriumPolymerase chain reaction for mycobacterium
(f)(f) Culture studies in sputum and blood.Culture studies in sputum and blood.
Specimens to identify the organisms are taken from nasopharyngealSpecimens to identify the organisms are taken from nasopharyngeal
aspirate, the oat swab, bronchoalveolar lavage and lung aspirates.aspirate, the oat swab, bronchoalveolar lavage and lung aspirates.
18. Indications for AdmissionIndications for Admission
1.1. Severe malnutritionSevere malnutrition
2.2. ImmunodeficiencyImmunodeficiency
3.3. Severe anaemiaSevere anaemia
4.4. disseminated infection, septicemia and shockdisseminated infection, septicemia and shock
5.5. Drowsiness and altered senosoriumDrowsiness and altered senosorium
6.6. Decreased ODecreased O22 saturationsaturation
7.7. Leucopenia or leucocytosisLeucopenia or leucocytosis
8.8. Culture and sensitivity tests- result growth of staphylococcusCulture and sensitivity tests- result growth of staphylococcus
aureusaureus
19. Supportive TreatmentSupportive Treatment
In mild cases it should be givenIn mild cases it should be given
AntihistaminicAntihistaminic
AntipyreticAntipyretic
Anti allergicAnti allergic
There is no role in antibiotic in viralThere is no role in antibiotic in viral
1.1. OxygenOxygen
2.2. Intra venous fluidIntra venous fluid
3.3. Good nutritionGood nutrition
4.4. If fever is present then tepid sponging should be given ParacetamolIf fever is present then tepid sponging should be given Paracetamol
will also be helpfulwill also be helpful
5.5. Predisposing factors should be avoidedPredisposing factors should be avoided
6.6. PhysiotherapyPhysiotherapy
20. Management:Management:
1.Severe pneumonia1.Severe pneumonia
O2 inhalation ,Maintain good hydration, good nutrition with antibioticO2 inhalation ,Maintain good hydration, good nutrition with antibiotic
therapytherapy
2.Viral pneumonia2.Viral pneumonia
-vomiting (no antiemetics)-vomiting (no antiemetics)
-loose motion (no intervention)-loose motion (no intervention)
lathouh-lathouh- in case of feverin case of fever
Anand bherav rasaAnand bherav rasa-in-in cace of loose motioncace of loose motion
Laxmivilas rasaLaxmivilas rasa ––acute corhyzaacute corhyza
Kafketu rasaKafketu rasa--productive corhyzaproductive corhyza
RoutinelyRoutinely
1.Laxmivilas rasa ,Kafketu rasa1.Laxmivilas rasa ,Kafketu rasa
2.Vishan bhasm and shring bhasm –in2.Vishan bhasm and shring bhasm –in parshv shoolparshv shool
3.Kwath3.Kwath-Gojihvvadi,Panchkoiladi,Laookqe Sapista-Gojihvvadi,Panchkoiladi,Laookqe Sapista
4.Nasal decongestant4.Nasal decongestant-Ajvain fumes inhalation-Ajvain fumes inhalation
55..Talishadi churnaTalishadi churna
21. General Protocol:General Protocol:
1.Luke warm water-shunthi/aadrak sidhh1.Luke warm water-shunthi/aadrak sidhh
2.Haldi,aadrak,tulsi ptra,kalimirch-tea/kwath2.Haldi,aadrak,tulsi ptra,kalimirch-tea/kwath
3.Pind khajoor,adrak,pipli-chhir paka3.Pind khajoor,adrak,pipli-chhir paka
4.Local fomentation4.Local fomentation
3.Bacterial pneumonia3.Bacterial pneumonia
1.Makardhavaj/Rasasindoor1.Makardhavaj/Rasasindoor
2.Trilokya chintamani swaras not used in shirap awastha2.Trilokya chintamani swaras not used in shirap awastha
3.vrihat kasturi bherav rasa3.vrihat kasturi bherav rasa
4.bramhmi vati4.bramhmi vati
4.Severe stage convulsions4.Severe stage convulsions
Mukta pishti,godanti-protect vital partsMukta pishti,godanti-protect vital parts
Sitopladi churna-brinhan hetuSitopladi churna-brinhan hetu
Balchaturbhadra churna-if diarrheaBalchaturbhadra churna-if diarrhea
Kshir pak-Kshir pak-
MunakkaMunakka
Anjir,Kesar ,Shunthi,pipaliAnjir,Kesar ,Shunthi,pipali
22. PreventionPrevention
1.Immunization1.Immunization
2.Health education to mother2.Health education to mother
3.Proper implementation of ART Control programme3.Proper implementation of ART Control programme
4.High risk factors should be avoided4.High risk factors should be avoided
Recurrent and Persistent PneumoniaRecurrent and Persistent Pneumonia
Etiology of recurrent and persistent PneumoniaEtiology of recurrent and persistent Pneumonia
Causes Conditions
Congenital
Infections
CMV
Non-infections Cleft palate
To fistula
Gastro-oesophageal reflux
Sickle cell anaemia
Acquired Infections Otitis media, sinusitis, bronchietasis,
CMV infection
Non-infections Recurrent aspiration foreign body
aspiration Asthma
23. Typical PneumoniaTypical Pneumonia
It is also known as 'walking pneumonia'. The children with theseIt is also known as 'walking pneumonia'. The children with these
infections present with atypical symptoms.infections present with atypical symptoms.
Features Typical pneumonia A typical pneumonia
Causative organisms S. Pneumoniae
S. dureus
H. influenza
M. Pneumonae
Chlmyadia Pneumoniae
Legionella
Onset Sudden Gradual
Age Any age Usually > 5 years, except
chlamyetia which
commonly occurs without
first 6 months.
Fever common may be present
cough productive dry
symptoms pulmonary systemic
x-ray chest findings localised diffuse
24. Radiological findings in various types of pneumoniaRadiological findings in various types of pneumonia
Radiological Changes Type of Pneumonia
1. Lobar involvement Pneumococcal pneumonia
2. Right middle lobe
pneumonia
Aspiration pneumonia
3. Upper lobe pneumonia,
cavitations, bronchopneumonia
with hilar lymphadenopathy
Tuberculosis pneumonia
4. Lower lobe pneumonia Chemical pneumonia
5. Multiple abscesses staphylococcal / klebsiella
pneumonia
6. Bilateral interstitial
pneumonia
Viral pneumonia
7. B/L interstitial pneumonia Pneumocystic carinric
25. Classification of Pneumonia according WHOClassification of Pneumonia according WHO
Classification Clinical Features
No proumonia Cough & No fast breathing
No chest indrawing & Feeding well
Pneumonia Cough & No chest in drawing & Able to
drink Fast breathing
Severe pneumonia Lower chest in drawing present & Able to
drink
Fast breathing & Other signs may be
present – nasal flaring, grunting, cyanosis
Very severe pneumonia Not able to drink & Cyanosis
Striders in calm child
severe respiratory distress or grunting
lethargy, excessive drowsiness
convulsions
26. ComplicationsComplications
System Complications
1. Respiratory
Pulmonary Suppurative lung diseases & Collapse
Bronchiectasis
Pleural Parapneumonic effusion & empyema
Pneum othorax & Pyopneumothorax
2. Cardiovascular Acute circulatory failure due to
bacteraemia
Pericarditis & Endocarditis
Miscellaneous Meningism & Shock due to bacteriaemia
Multiorgan failure
27. mRQqfYydkmRQqfYydk
mRQqfYydk 'kh"kZd ls O;kf/k&o.kZu ;ksxjRukdj esa fd;k x;kmRQqfYydk 'kh"kZd ls O;kf/k&o.kZu ;ksxjRukdj esa fd;k x;k
gSA ;Fkk&gSA ;Fkk&
vkèekuokrlEiqQYyh n{kdq{kkS f'k'kksHkZosr~AvkèekuokrlEiqQYyh n{kdq{kkS f'k'kksHkZosr~A
mYQqfYydk lk fo[;krk 'okl'p;FkqlÄïmYQqfYydk lk fo[;krk 'okl'p;FkqlÄï°°ykAAykAA
¼;ks-j-ck-jks-fp-i`- 456½¼;ks-j-ck-jks-fp-i`- 456½
ckyd ds nkfgus dqf{k esa vkèeku gksdj ok;q ls lEQqYyckyd ds nkfgus dqf{k esa vkèeku gksdj ok;q ls lEQqYy
¼Qwyk ;k 'kksFk gks tkrk gS rFkk 'okl gks vkrk gS vkSj¼Qwyk ;k 'kksFk gks tkrk gS rFkk 'okl gks vkrk gS vkSj
'okluyh esa Hkh 'kksFk gks tkrk gSA bls mRQqfYydk O;kf/k'okluyh esa Hkh 'kksFk gks tkrk gSA bls mRQqfYydk O;kf/k
dgrs gSaAdgrs gSaA
vk/kqfud vk;qosZn euhf"k;ksa us bl O;kf/k dks 'Pneumonia'vk/kqfud vk;qosZn euhf"k;ksa us bl O;kf/k dks 'Pneumonia'
ds led{k ekuk gSA fo}kuksa esa ;ksxjRukdj ds iwoZ dsds led{k ekuk gSA fo}kuksa esa ;ksxjRukdj ds iwoZ ds
xzUFkksa esa 'ys"eksYc.k fo"ke lfÂikrt Toj dh laKk nh gSAxzUFkksa esa 'ys"eksYc.k fo"ke lfÂikrt Toj dh laKk nh gSA
vkpk;Z pjd us bl O;kf/k dh e;kZnk 12 fnu ¼p-fp-vkpk;Z pjd us bl O;kf/k dh e;kZnk 12 fnu ¼p-fp-
3@53&54½dh dgh gSA3@53&54½dh dgh gSA
28. fpfdRlkn'kZ esa ia- jkts'oj nÙk 'kkL=h us blsfpfdRlkn'kZ esa ia- jkts'oj nÙk 'kkL=h us bls
okr&'ys"eksYc.k lfÂikr Toj ;k 'olud Toj dh laKk nh gSAokr&'ys"eksYc.k lfÂikr Toj ;k 'olud Toj dh laKk nh gSA
ckyxzgksa esa fir`xzg ds y{k.kksa dk vR;f/d lkeatL;ckyxzgksa esa fir`xzg ds y{k.kksa dk vR;f/d lkeatL;
U;qeksfu;k ds y{k.kksa ls feyrk gSA ;fn le; ij mfpr mipkj uU;qeksfu;k ds y{k.kksa ls feyrk gSA ;fn le; ij mfpr mipkj u
fd;k tk; rks 'kS'koh; e`R;q dk dkj.k Hkh curk gSAfd;k tk; rks 'kS'koh; e`R;q dk dkj.k Hkh curk gSA
okr'ys"eksYc.k lfuikr Toj esa ia- jkts'oj nÙk 'kkL=kh th usokr'ys"eksYc.k lfuikr Toj esa ia- jkts'oj nÙk 'kkL=kh th us
fuEu fpfdRlk dgh g kfuEu fpfdRlk dgh g k
1- f=HkqoudhfrZ] J`axjkHkz J`axHkLe] 'k)q ujlkj ,oa jlflUnwj1- f=HkqoudhfrZ] J`axjkHkz J`axHkLe] 'k)q ujlkj ,oa jlflUnwj
dk ;ksx o;kuqlkj cukdj fnu esa 6 ckj iku] lsagq.Mi=&Lojldk ;ksx o;kuqlkj cukdj fnu esa 6 ckj iku] lsagq.Mi=&Lojl
rFkk e/qk ls nsaArFkk e/qk ls nsaA
2-2- 'oklÑPNª gksus ij lkSHkkX; oVh] 'okldklfpUrkef.k]'oklÑPNª gksus ij lkSHkkX; oVh] 'okldklfpUrkef.k]
eYypUnzksn; J`axHkLe dk ;ksx fnu esa 6 ckjeYypUnzksn; J`axHkLe dk ;ksx fnu esa 6 ckj
dkdM+kJ`axh ,oa eqysBh pw.kZ ls rFkk e/qk ls nsaAdkdM+kJ`axh ,oa eqysBh pw.kZ ls rFkk e/qk ls nsaA
3-3- dSjkrkfn DokFk dk iz;ksx djsaAdSjkrkfn DokFk dk iz;ksx djsaA
4-4- fiIiY;fn pw.kZ ¼;ks-j-½ Vad.kkfn ;ksx ¼fl-Hks-e-ek-½]fiIiY;fn pw.kZ ¼;ks-j-½ Vad.kkfn ;ksx ¼fl-Hks-e-ek-½]
fgaXkqykfn oVh dk iz;ksx mRQqfYydk esa fd;k tk;AfgaXkqykfn oVh dk iz;ksx mRQqfYydk esa fd;k tk;A
29. mYQqfYydk dh 'kkL=kh; fpfdRlkmYQqfYydk dh 'kkL=kh; fpfdRlk
f'k'kq dh fpfdRlkf'k'kq dh fpfdRlk
^fu% lkj;sTtykSdkHkh jDra p tBjkÙknk*^fu% lkj;sTtykSdkHkh jDra p tBjkÙknk*
1 f'k'kq ds mnj esa tykSdk yxkdj jDreks{k.k djsaA1 f'k'kq ds mnj esa tykSdk yxkdj jDreks{k.k djsaA
2 ckyd ds mnj ij vfXu ls Losnu djsaA2 ckyd ds mnj ij vfXu ls Losnu djsaA (hast sweda upto 6(hast sweda upto 6
months)months)
ekrk dh fpfdRlkekrk dh fpfdRlk
11 LrU; 'kks/kuLrU; 'kks/ku
ddksZV] 'kq.Bh] eqLrk] dadksy ,oa vfrfo"kk leHkkx ysdjddksZV] 'kq.Bh] eqLrk] dadksy ,oa vfrfo"kk leHkkx ysdj
pw.kZ dj nw/k ds vuqiku ls ekrk ;k ?kk=h dks fiykdj nw/kpw.kZ dj nw/k ds vuqiku ls ekrk ;k ?kk=h dks fiykdj nw/k
dks 'kq) dj nsaAdks 'kq) dj nsaA
vfXuuk Losn;s}kvfXuuk Losn;s}kvvfi nkg;sPp 'kykd;kAfi nkg;sPp 'kykd;kA
tBsj fcUnqdkdkja i`"BHkkxs ;Fkk /qzoea~AAtBsj fcUnqdkdkja i`"BHkkxs ;Fkk /qzoea~AA
2 ckyd ds mnj ij vfXu ls Losnu djsa ;k mnj ij vkSj ihB ij2 ckyd ds mnj ij vfXu ls Losnu djsa ;k mnj ij vkSj ihB ij
'kykdk dj fcUnq ds vkdkj dk nkg djsaA'kykdk dj fcUnq ds vkdkj dk nkg djsaA
31. BIBLIOGRAPHYBIBLIOGRAPHY
1.Kaumarbhritya –Prof.Devendranath Mishra1.Kaumarbhritya –Prof.Devendranath Mishra
Chowkhamba publicationChowkhamba publication
2.Bailey and Love – A short text book of Surgery2.Bailey and Love – A short text book of Surgery
3.Human Anatomy – B.D.Chaurasia3.Human Anatomy – B.D.Chaurasia
4.Human Physiology – Prof.A.K.Jain4.Human Physiology – Prof.A.K.Jain
5.Hutchison’s Clinical Methods5.Hutchison’s Clinical Methods
6.A Text Book Of pathology – William Boyd6.A Text Book Of pathology – William Boyd
7.WWW.GOOGLE.COM7.WWW.GOOGLE.COM
8.Meharban Singh paediatrics8.Meharban Singh paediatrics
9. OP Ghai Textbook of pediatrics9. OP Ghai Textbook of pediatrics
10.Medsape10.Medsape
11.11. ¼;ks-j-ck-jks-fp-i`- 456½¼;ks-j-ck-jks-fp-i`- 456½
12.12. ¼p-fp- 3@53&54½¼p-fp- 3@53&54½