This document summarizes community acquired pneumonia, its types , causes, organisms, CRUB-65 score, difference with atypical pneumonia, investigations, treatment and prevention.
Pneumonia is a serious infection that inflames the air sacs in the lungs. It can cause symptoms such as coughing, chest pain, fever, and difficulty breathing. It's important to seek medical attention if you suspect you have pneumonia. Here are some notes for dear medical students, i hope it helps you..
Pneumonia is a serious infection that inflames the air sacs in the lungs. It can cause symptoms such as coughing, chest pain, fever, and difficulty breathing. It's important to seek medical attention if you suspect you have pneumonia. Here are some notes for dear medical students, i hope it helps you..
Pneumonia is an inflammation of the lung parenchyma caused by various microorganisms, including bacteria, mycobacteria, fungi, and viruses.
Pneumonitis is a more general term that describes the inflammatory process in the lung tissue that may predispose and Pneumonia is an inflammation of the lung parenchyma that is caused by a microbial agent.
place the patient at risk for microbial invasion.
Pneumonia is classified into four: community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP), pneumonia in the immunocompromised host, and aspiration pneumonia.
PNEUMONIA,
DEFINITION
Pneumonia is an infection of the pulmonary parenchyma.
To the pathologist, pneumonia is an infection of the alveoli ,distal airways, and interstitium of the lung that is manifested by increased weight of the lungs, replacement of normal lung’s sponginess by consolidation ,and alveoli filled with white blood cells ,red blood cells and fibrin .To the clinician, pneumonia is a constellation of symptoms and signs in combination with at least one opacity on CXR.
Epidemiology
Between 5 and 10 million cases of infectious pneumonia occur annually in the United States and result in more than 1 million hospitalizations.
Pneumonia is a leading cause of death worldwide, the sixth leading cause of death in the United States, and the most common lethal infectious disease.
Community Acquired Pneumonia and other types of pneumonia
for medical students
Detailed information on pneumonia including the following
Definition
Classification
Aetiology
Pathogenesis
Pathological states
Investigations
Treatment & follow up
Complications
Medication
Hospital acquired pneumonia and it’s treatment and management and prevention
Other types of pneumonia
And pneumonia in immune compromised patients
Pneumonia is an inflammation of the lung parenchyma caused by various microorganisms, including bacteria, mycobacteria, fungi, and viruses.
Pneumonitis is a more general term that describes the inflammatory process in the lung tissue that may predispose and Pneumonia is an inflammation of the lung parenchyma that is caused by a microbial agent.
place the patient at risk for microbial invasion.
Pneumonia is classified into four: community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP), pneumonia in the immunocompromised host, and aspiration pneumonia.
PNEUMONIA,
DEFINITION
Pneumonia is an infection of the pulmonary parenchyma.
To the pathologist, pneumonia is an infection of the alveoli ,distal airways, and interstitium of the lung that is manifested by increased weight of the lungs, replacement of normal lung’s sponginess by consolidation ,and alveoli filled with white blood cells ,red blood cells and fibrin .To the clinician, pneumonia is a constellation of symptoms and signs in combination with at least one opacity on CXR.
Epidemiology
Between 5 and 10 million cases of infectious pneumonia occur annually in the United States and result in more than 1 million hospitalizations.
Pneumonia is a leading cause of death worldwide, the sixth leading cause of death in the United States, and the most common lethal infectious disease.
Community Acquired Pneumonia and other types of pneumonia
for medical students
Detailed information on pneumonia including the following
Definition
Classification
Aetiology
Pathogenesis
Pathological states
Investigations
Treatment & follow up
Complications
Medication
Hospital acquired pneumonia and it’s treatment and management and prevention
Other types of pneumonia
And pneumonia in immune compromised patients
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3. INTRODUCTION
Pneumonia
Inflammation of the Pulmonary parenchyma in which the alveoli are filled with fluid.
This may cause a decrease in the amount of oxygen that blood can absorb from air
breathed into the lung.
1. Community acquired peumonia (CAP)
2. Hospital acquired peumonia (HAP)
3. Health care associated pneumonia (HCP)
4. Ventilator associated pneumonia (VAP)
Community acquired pneumonia (CAP) is acute infection of pulmonary
parenchyma that develops in outpatient setting or with 48 hours of hospital admission.
4. PATHOPHYSIOLOGY
1. Infection to the lung by bacteria or viruses
2. Inflammatory response initiated
3. Alveolar edema + Exudate formation
4. Alveoli And respiratory bronchioles Fills with serous exudate ,
Blood cells , fibrin , bacteria
5. Consolidation of lung tissue
STAGES OF PNEUMONIAE
• Stage of congestion
• Stage of red hepatization
• Stage lf grey hepatization
• Stage of resolution
5. RISK FACTORS
• Cigarette smoking
• Upper respiratory infection
• Old age
• Alcohol
• Recent influenza infection
• Preexisting lung disease
• Glucocorticoid therapy
• Indoor air pollution
• Altered mental status
• HIV
7. MODE OF TRANSMISSION
Ways you can get pneumonia include:
• Inhaling the infection (Droplet infection)
• Through the mouth or eyes
• Food particles and irritants from the intestinal tract can also cause aspiration pneumonia and
can occur when a person accidentally inhales these substances.
• Fungal pneumonia typically develops when people inhale microscopic particles of fungus from
the environment.
8. CLINICAL FEATURES
Typical CAP
Symptoms
• Acute onset of fever with rigors and chills
• Productive cough with mucopurulent sputum
• Pleuritic chest pain
• Dyspnea
Signs
• Tachycardia , tachypnea
• Dullness on percussion
• Inspiratory crackels , bronchial breath sounds,
increased vocal resounce
Atypical CAP
Symptoms
• Insidious onset , fever ( chills are
uncommon)
• Dry cough
• Headache, sore throat, fatigue, myalgia
Signs
• Pulse temperature dissociation
• Wheezing , ronchi , crackles
• Diffuse reticulonodular infiltrates on CXR
13. INVESTIGATIONS
• CBC
• Urea and electrolytes
• Gram staining and culture of sputum
• ESR/CRP
• Serum procalcitonin level
• ABGs(if severe)
• Viral PCR
• LFTs
• Blood culture
• Oropharyngeal swab
• Urine antigen assay for legionella
• Pleural Tap
• Bronchoscopy
14. MANAGEMENT
• Oxygen therapy ( Oxygen should be administered to all patients with tachypnoea, hypoxaemia,
hypotension or Acidosis .The aim of maintaining the PaO2 at or above 60mmHg or the SaO2 at
or above 92%.High concentrations (35% or more), preferably humidified, should be used in all
patients who do not have hypercapnia associated with COPD. )
• Fluid balance (These should be considered in patients with severe illness, older patients and
those who are vomiting. Otherwise, an adequate oral intake of fluid should be encouraged.
Inotropic support may be required in patients with shock)
• Antibiotic treatment
• Antipyretics
• Treatment of pleural pain ( paracetamol, Codeine, NSAIDS)
• Physiotherapy ( May help expectoration in those who suppress cough because of pleural pain.)
15.
16. COMPLICATIONS
• Para-pneumonic effusion
• Empyema
• Lobar collapse( due to retention of sputum)
• Deep vein thrombosis and pulmonary embolism
• Pneumothorax (staphylococcus aureus)
• Lung abcess
• ARDS, Multiorgan failure
• Ectopic abcess formation
17. PREVENTION
• Avoid smoking
• Improve housing conditions
• Immunization ( influenza and
pneumococcal vaccine)
• Frequent hand washing
• Wearing surgical masks
• Practice good hygiene
18. Q: A person with Legionella pneumophila can be best treated with:
A | Vancomycin.
B | linezolid.
C | Erythromycin.
D | ceftazidime.
19. Q: All of the following can be used to diagnose atypical CAP EXCEPT?
A | ESR and CRP
B | Xray
C | Gram stain.
D | All the above apply
20. REFERENCE
• Davidson's Principles and Practice of Medicine - 24th Edition
• Harrison’s Principal of Internal Medicine 20th Edition
• www.radiopaedia.org
