2. Pneumonia
• PULMONARY INFECTION
It can be
• Sinus sinusitis Lung parenchyma
• Larynx laryngitis
• Pharynx phaynitis pneumonia
upper respiratory tract Lower resiratory tract infection
3. PATHOPHYSIOLOGY
• Occurs when local and systemic defense is weak
1. Local factors
• Loss or suppression of cough reflex coma ,anesthesia
,drug,chest pain
• Dysfunction of mucociliary apparatus-smoking ,inhalation of
toxic gases ,viral disease,genetic disorder
• Accumulation of thick secretion-cystic fibrosis
• Interferance with phagocytic function-alcohol tobacco
,smoking
• Pulmonary congestion and edema
4. 2. Systemic factors
• Defect in innate immunity-neutrophils,macrophage,complement deficiency
• Defect in humoral (antibody)
• Defectin MY-88 gene-control toll like recepyors gene
• Defect in cell mediated immune response
3.Other reason
• Flu candems other infection supervenes
• Infection from other routes - hematogenous
• Transmission
• Most commanly transmitted by droplet spred fron close contact with source
• Incudtion period typically 1-3 days
5. Due to any cause eg bacteria ,viral,other
Inflammation in alveoli
Mast cells activate and release histamines
Due to histamines release,fluid shift to extracellular space(capillary permeablity)
Alveoli fluid with fluid
consoliadation
Decrease oxygen saturation in body
hyoxemia /hypoxia
6. Classification of Pneumonias
According to involment of lungs-
1. Lobar pneumonia-when entire lobe is affected
2. Bronchopneumonia-Patchy involved in lower lobes
According to clinical setting-
1. Community acquired pneumonia(CAP)
2. Hospital Acquird pneumonia (HAP)
According to microscpy-
1. Typical pneumonia
2. Atypical pneumonia
8. Hospital acquired pneumonia-
Etiology-pseudomonas,acinetobactor
-Enterobacteriacae
-Staphaureus
According to involment of lungs-
1. Lobar pneumonia-diffuse inflammation affecting the part or the
entire lobe
-usally develops in healthy indviduals
-stages of pneumonia –
1.congestion-alveolar fluid with bacteria and neutrophils
2.red hepatization- rbc,wbc,fibrin,solid consistency of lung
3.gray hepatization-lysis of rbc,fibrin
4.resolution-neutrophils/macrophage
-comman caustive orgnisms-pneumococci,pnerumoniae
9. Bronchopneumonia-patchy area of acute suppurative infection of terminal bronchioles
-comman in infants and old age
-usally develop in infants and old age
-usally accompany pre exitisg diseases
pathological features – patchy consolidation,bronchi,bronchiolesand
adjacent alveolar spaces are filled with exudates rich in neutrophils
-comman causative organism-pseudomonas,haemophilusi nfluenza
10. According to microscopy
Typical pneumonia-
-involment of alveoli
-etiology-bacteria
-clinical feature- productive cough,sputum present
-ausculation-finding wheeze ,bronchial sound
-on chest x ray- consolidation(solidifiction)
-wbc count-increase
-treatment-antibiotics
Atypical pneumonia-
-involment of alveoli and interstitium
-etiology-viral,chlamydia,mycoplasma
-clinical features—small amount of sputu,
-ausculation-less finding wheeze ,bronchial sound
-on chest x ray-no finding
-wbc count- normal
-treatment-supportive treatment antiviral
14. Medical management-
1. Oxygen therapy
2. Use of antibiotic therapy for treatment-
ampicillan,erythromycin
3.Bronchodilators –allow the airway to widan and
makesbreath easiear
4. Analgesics – use to reduce chest pain
5. Prevention of pneumonia by vaccination
