Details about pneumonia, its demographics, classification, types, common symptoms, pathophysiology, brief introduction to different types of pneumonia

1. DEMOGRAPHICS
 Pneumonia is the leading infectious cause of death in
children worldwide, accounting for 15% of all deaths of
children under 5 years old.
 Pneumonia killed an estimated 9,35,000 children under
the age of five in 2013.
 Pneumonia caused by bacteria can be treated with
antibiotics, but only one third of children with
pneumonia receive the antibiotics they need.

2. PNEUMONIA
 Pneumonia is a breathing (respiratory) condition
in which there is an infection of the lung.

3.  The lungs are made up of small sacs called alveoli,
which fill with air when a healthy person breathes.
 When an individual has pneumonia, the alveoli are filled
with pus and fluid, which makes breathing painful and
limits oxygen intake.

5. CAUSES
 Streptococcus pneumoniae
 Haemophilus influenzae type b (Hib)
 Pneumocystis jiroveci (in infants infected with HIV)

6. COMMON SYMPTOMS
 Shaking chills
 Fever
 Dry cough
 Muscle aches
 Nausea/vomiting
 Rapid breathing
 Rapid heartbeat
 Difficulty breathing
 Chest pain

7. CLASSIFICATION OF PNEUMONIA
LOBAR PNEUMONIA
 Occurs due to acute bacterial infection of part of a lobe
or complete lobe.
 Commonly Streptococcus pneumoniae, Staphylococcus
aureus and less commonly Haemophilus influenzae,
Klebsiella pneumoniae are responsible

8. BRONCHOPNEUMONIA
 Acute bacterial infection of the terminal bronchioles
characterized by purulent exudates.
 Extends into surrounding alveoli through endobronchial
route resulting into patchy consolidation.
 Commonly Streptococci, Staphylococcus aureus,
Haemophilus influenzae, Klebsiella pneumonia and
Pseudomonas are responsible

9. INTERSTITIAL PNEUMONIA
 Patchy inflammatory changes
 Mostly confined to the interstitial tissue of the lung
without alveolar exudates.
 Characterised by alveolar septal oedema and
mononuclear infiltrates.
 Commonly Mycoplasma pneumoniae, Respiratory
syncytial virus, Influenza virus, adenoviruses, and
uncommonly Chlamydia and Coxiella are responsible

10. PATHOLOGICAL STAGES OF LOBAR
PNEUMONIA

11. A. STAGE OF CONGESTION
 Represents early acute inflammatory response.
 Affected lobe becomes red and heavy due to vascular
congestion.
 Proteinaceous fluid, abundant neutrophils and many
bacteria can be seen in the alveoli.
 Lasts for 1 to 2 days.

12. B. STAGE OF RED HEPATISATION
 Affected lobe becomes red, firm and acquires liver like
consistency.
 Proteinaceous fluid transforms into fibrin strands with
marked cellular exudates of neutrophils.
 Extravasation of red cells which give red colour to
consolidated lung.
 Lasts for 2 to 4 days.

13. C. STAGE OF GRAY HEPATISATION
 Affected lobe becomes dry, firm and gray due to
lysed red cells.
 Neutrophilic cellular exudates decreases due to
breakdown of inflammatory cells and macrophages
are now seen.
 Micro organism load also reduces.
 Lasts for 4 to 7 days.

14. D. STAGE OF RESOLUTION
 Due to enzymatic action, fibrinous matter is liquefied
and the lung aeration is re-establish gradually.
 Macrophages are the major cells in the alveoli.
 There is progressive reduction of fluid and cellular
exudates from the alveoli by way of expectoration and
lymphatic drainage leading to normal lung parenchyma
in over 3 weeks.

15. http://www.slideshare.net/vmshashi/pathology-of-pneumonia

16. LOBAR PNEUMONIA
Etiology
 Staphylococcal pneumonia: Staphylococcus aureus
 Streptococcal pneumonia: β-haemolytic streptococci
 Pneumonia by gram-negative aerobic bacteria:
Haemophilus influenzae, Klebsiella pneumoniae
 Pneumococcal pneumonia: caused by Streptococcus
pneumoniae

17. CLINICAL FEATURES
 Shaking,
 Chills
 Fever
 malaise with pleuritic chest pain
 Dyspnoea
 Cough with expectoration.
 The common physical findings are fever, tachycardia and
sometimes cyanosis if the patient is severely
hypoxaemic.

18. BRONCHOPNEUMONIA
Etiology
 Staphylococci
 Streptococci
 Pneumococci
 Haemophilus influenzae
 Klebsiella pneumonia
 gram-negative bacilli like Pseudomonas and coloniform
bacteria.

19. CLINICAL FEATURES
 Chronic debility
 Aspiration of gastric contents or upper respiratory
infection
 Neutrophillic leukocytosis.

20. INTERSTITIAL PNEUMONIA
Etiology
 Respiratory syncytial virus (RSV)
 Mycoplasma pneumonia
 Influenza and parainfluenza viruses, adenoviruses,
rhinoviruses, coxsackieviruses and cytomegaloviruses
(CMV).
 Occasionally, psittacosis (Chlamydia) and Q fever
(Coxiella) are also associated

21. CLINICAL FEATURES
 Fever
 Headache and muscle aches
 A few days later appears dry, hacking, non-productive
cough with retrosternal burning
 Neutrophilic leukocytosis