This document provides information on pneumonia including:
1. Pneumonia is defined as an inflammation of the lung parenchyma that can be caused by microorganisms or non-infectious causes. Pneumonia is classified based on location (lobar, bronchopneumonia, interstitial), source (community acquired, hospital acquired, ventilator associated), and causative agent (bacterial, viral, fungal).
2. Common bacterial causes include Streptococcus pneumoniae, Mycoplasma pneumoniae, and Chlamydia pneumoniae. Viral causes include influenza, RSV, and parainfluenza. Predisposing factors include age, underlying diseases, environment, drugs
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"
Dr. Md. Khairul Hassan Jessy
Associate Professor, Respiratory Medicine
National Institute of Diseases of the Chest and Hospital (NIDCH), Mohakhali, Dhaka.
Acknowledment:
Davidson’s Principles and Practice of Medicine
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"
Dr. Md. Khairul Hassan Jessy
Associate Professor, Respiratory Medicine
National Institute of Diseases of the Chest and Hospital (NIDCH), Mohakhali, Dhaka.
Acknowledment:
Davidson’s Principles and Practice of Medicine
Bronchiectasis is a chronic, irreversible dilation of the bronchi and bronchioles. Or •Bronchiectasis is characterized by permanent, abnormal dilation of one or more large bronchBronchiectasis.
Pneumonia (Pathophysiology and management) by Sunil Kumar Dahasunil kumar daha
Please find the power point on Management and pathophysiology of Pneumonia . I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Bronchiectasis is a chronic, irreversible dilation of the bronchi and bronchioles. Or •Bronchiectasis is characterized by permanent, abnormal dilation of one or more large bronchBronchiectasis.
Pneumonia (Pathophysiology and management) by Sunil Kumar Dahasunil kumar daha
Please find the power point on Management and pathophysiology of Pneumonia . I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.
Pneumonia can range in seriousness from mild to life-threatening. It is most serious for infants and young children, people older than age 65, and people with health problems or weakened immune systems.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
2. Pneumonia is: an inflammation of the gas exchanging part
of the lung (parenchyma of the lung). Most cases of
pneunomia are caused by microorganism.
Pneumonitis is: an inflammation of the gas exchanging
part of the lung due to non infectious causes including
aspiration of food or gastric acid foreign bodies, chemicals
and lipoid substances. Hypersensitivity reaction and drug or
radiation induced pneumonitis.
PNEUMONIA, Definition
3. 1 : Anatomical classification.
A – Lobar pneumonia .Where the consolidation involves all or part
of the lobe.
B – Bronchopneumonia: The consolidation involves scattered
lobules
C - Interstitial pneumonia: Inflammatory infiltrate involve mainly
interstitial tissue between alveoli as in viral pneumonia.
.
PNEUMONIA, Classification
4. PNEUMONIA, Classification
•Community acquired pneumonia (CAP):
•Pneumonia which occurred in the community , ambulant
patient
•Hospital acquired and health care acquired pneumonia (HAP):
•Pneumonia occurred after 48 hours of hospital admission, or
frequent visits of health care facilities (e.g. hemodialysis
patients).
•Ventilator associated pneumonia (VAP):
•Pneumonia occurred after 48 hours of intubation and/ or
mechanical ventilation.
5. 2 : Etiological classfication.The cause of pneumonia is
often difficult to determine because culture of lung
secretions is invasive and rarely performed.
• Culture obtained from upper respiratory tract or sputum
generally not accurate and usually reflect contamination
rather than true pathological organism.
PNEUMONIA, Classification
6. PNEUMONIA
Bacterial.Common.
• Streptococcus pneumoniae, Group B streptococci, Group A
streptococci .
• Mycoplasma pneumoniae.
• Chlamydia pneumoniae Adolescent.
• Chlamydia trachomatis Infant.
• Mixed anaerobes Aspiration pneumonia.
• Gram-negative enteric bacilli. E coli,
PNEUMONIA, Classification
11. PNEUMONIA, Predisposing factors
Item Example
Age Extremes of age (neonates, old age)
Diseases DM, renal, hepatic, cardiac, immunocompromised
Bad ventilation Poor housing , over crowded places
Drugs Long term corticosteroid, immunosuppressive drugs
Weather
changes
Very cold or very hot weather
Poor hygene Dental cares, bad oral hygene
Local defense
abnormality
Impaired consciousness, sedative drugs , epilepsy
13. PNEUMONIA, etiology
Disorders of cilia
• Immotile cilia syndrom
• Kartagener syndrom
Anatomic disorder
•Sequestration
•Lobar emphysema
•Esophageal reflux
•Foreign body
•Tracheo esophageal fistula ( H type )
•Gastroesophageal reflux
•Bronchietasis
•Aspiration ( oro pharyngeal in coordination )
14. PNEUMONIA
• Pathogenesis, The lower respiratory tract is normally sterile by
•Physiologic defense mechanisms including
•Mucociliary clearance
•Normal secretion such as secretory immunoglobulin A
IgA
•Clearing of air way by coughing
•Immunologic defense mechanism of lung limit invasion
by pathogenic organisms, including macrophages are
present in alveoli and bronchioles secretory IgA
and others immunoglobulins
15. PNEUMONIA, pathology
Viral pneumonia :
Usually result from spread of infection along the airway.
Accompanied by direct injury of respiratory epithelium resulting in air way
obstruction from swelling abnormal secretion and cellular debris small calibar
of air way in young infant makes them particularly susceptible to sever
infection.
Viral infection predispose to secondary bacterial infection by disturbing
normal host defense mechanism altering secretion and modifying bacterial
flora.
16. PNEUMONIA
•Bacterial infection
In bacterial infection pathologic process varies according
to the invading organism :
M . Pneumoniae attaches to the respiratory epithelium inhibit ciliary action and
Lead to cellular destruction and an inflammatory response in the submucosa
as the infection progresses sloughed cellular debris inflammatory cell and mucus
cause airway obstruction with spread of infection occuriang along the bronchial
Tree as in viral pneumoia.
- S . Pneumoniae
Produce local edema that aids in the proliferation of organism and their spread
Into adjacent portion of lung often resulting in the characteristic focal lobar
Involvement
17. PNEUMONIA
-Grop A . Streptococcus
pathology Includes necrosis of tracheobronchial mucosa formation
-of large
amount of exudate edema and local hemorrhage with extension into the
Interalveolar septa and involvement of lymphatic vessel and pleura.
-S – aureus pneumonia
produces Toxin and enzymes as hemolysin coagulase and
-staphylo kinase. It causes broncho pneumonia often unilateral characterized by
prensence of hemorrhagic necrosis and irregular areas of cavitation of
,lung parenchyma
•Resulting in pneumatoceles empyema or broncho pulmonary fistula
Pyopneumothorax.
18. PNEUMONIA
Following changes stages:
1- congestion alveoli are failed with edema fluid and organism.
2- red hepatization alveoli contain polymorph RBCs fibrin edema and organism.
3-grey hepatization deposition of fibrin over the pleural surface phagocytosis
starts inside the alveoli which are now filled with polymorph and fibrin.
4-resolution: neutrophil degenerate fibrin thread and remaining bacteria and
digested and removed by phagocyte
Clinical Manifestation
Viral & bacterial pneumonia are often preceded by several day of symptoms
of URTI typically rhinitis and cough.
In viral pneumonia:
fever is usually present lower than in bacteria.
Tachypnea increased work of breathing accompanied by intercostal, subcostal
and suprasternal retraction nasal flaring and use of accessory muscle.
Severe infection accompanied by cyanosis and respiratory fatigue in infant.
Auscultation of chest wheezing and crackle
20. PNEUMONIA
In bacterial pneumonia:
Sudden shaking chill followed high fever, cough, grunting, chest pain,
drowsiness, rapid respiration, dry cough, anxiety circumoaral cyanosis.
Physical finding:
Depends on the stage of pneumonia diminished breath sound scattered crackels
and rhonchi over affected lung.
Increasing consolidation or complication.
As effusion empyema or pyopneumothorax dullness on percussion and breath
Sound.
Diminished abdominal distension because of gastric dilation from swallowed
air or ileus. Abdominal pain in lower lobe pneumonia
Liver may seem enlarged because downward of diaphragm secondary to hyper
inflation of lung
Neck rigidity without meningitis in right upper lobe.
21. PNEUMONIA, Diagnosis:
Chest X-ray
•Diagnosis of pneumonia may indicate complication pleural
effusion or empyema.
•Viral pneumonia X-ray hyper inflation with bilateral interstitial infiltrate.
•Pneumococcal pneumonia lobar consolifation
repeat chest x-ray are not required for proof of cure for patient with
uncomplicated pneumonia.
WBC can differentiating viral from bacterial (normal in viral
pneumonia or elevated in bacterial pneumonia)
-Atypical pneumonia due to C.pneumoniae or M.pneumoniae is difficult to
distinguish from pneumococal pneumonia by X-ray and other lab.
Sputum cultur and sensitivity, for guidance of antibiotic
treatment.
CT and fibrooptic bronchoscope may be required in certain
cases
22. PNEUMONIA
• Hospitalization of children with pneumonia
-Age < 6 month
- Sickle cell anemia with acute chest syndrome.
- Multiple lobe involvement.
-Immunocompromised
-Toxic appearance.
-Sever respiratory distress
-Requirement for supplemental oxygen.
-Dehydration
-Vomiting.
-No response to oral antibiotic.
-Non compliant parent.
23. PNEUMONIA, Treatment:
Treatment based on the cause and site of occurrence.
CAP without comorbidity
-Amoxicillin clavulente ( 80-90mg/kg/24 hrs ) OR
- Cefuroxime.(2nd
generation cephalosporin) OR
-Macrolide antibiotic such as azilhromjcin .
HAP with other comorbidity
ceftriaxone plus
Macrolide antibiotic such as azilhromjcin
Fluroquinolone ( levofloxacin, moxifloxacin, gemifloxacin)
HAP
ceftriaxone plus
Macrolide antibiotic such as azilhromjcin
Fluroquinolone ( levofloxacin, moxifloxacin, gemifloxacin).
VAP, consider anti-pseudomonal , anti-staph
Piperacillin, Ciprofloxacin, Vancomycin or clindamycin
.
24. PNEUMONIA
Deterioration in clinical status antibiotic therapy should be initiated
Response to treatment:
Patient with uncomplicated bacterial pneumonia respond to therapy with improvement
in clinical symptom (fever, cough, tachypnea, chest pain) within 48-96 hrs.
Slowly resolving pneumonia
1- complication as empyema.
2- bacterial resistance.
3- non bacterial etiology as viruses and aspiration of foreign bodies or food.
4- bronchial obstruction from endobronchial lesion foreign body or mucus plug.
5- pre-existing diseases such as immunodeficiencies- ciliary dyskinesia- cysticfibrosis
pulmonary sequestration cystic adenomatoid malformation.
6- non infectious causes:
- bronchoilitis obliterans.
- hypersensitivity pneumonitis
- eosinophils pneumonia
- aspiration
- wegener granulomatosis
25. PNEUMONIA
Complication:
•Usually result of direct spread of bacterial infection within thoracic cavity.
(pleural effusion- empyema- pericarditis) .
•Bacteremia and hematologic spread meningitis suppurative arthritis osteomyelitis.
•
•Respiratory failure.
•Lung abcess.
•Bronchiactasis
•