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PNEUMONIA 
WAEL ALHALABI
• OUTLINES 
Introduction 
Etiology 
Epidemiology 
PATHOPHYSIOLOGY 
Signs and Symptoms 
Diagnosis 
Treatment 
Complications 
General Management
Pneumonia is an infection in one or both of your 
lungs. 
Characterized 
primarily by inflammation 
of the alveoli in the lungs 
(alveoli are microscopic sacs 
in the lungs that absorb 
oxygen).
TYPES OF PNEUMONIA 
Pneumonia affects your lungs in two 
Ways . 
According to areas involved : 
Lobar pneumonia : affects a 
section (lobe) of a lung. 
Bronchial pneumonia 
(Bronchopneumonia) : 
affects patches throughout both lungs.
LOBAR PNEUMONIA
ETIOLOGY 
• Community acquired, typical 
• 1. S. pneumoniae 
• 2. H. influenzae 
• Community acquired, atypical 
• 1. Chlamydia pneumoniae 
• 2. Legionella pneumophila 
• 3. Mycoplasma pneumoniae 
• Hospital acquired 
• 1. Pseudomonas aeruginosa 
• 2. S. aureus 
• 3. Enteric organisms 
• Immunocompromised host pneumonia 
• 1. M. tuberculosis 
• Ventilator acquired pneumonia 
• 1.aspiration 
• Viruses : Influenza virus, Adenoviruses, Rhinovirus
EPIDEMIOLOGY 
Overall incidence rate is 170 (per 10,000) and 
increases with age, with an incidence of 280 for those 
65 years of age or older
RISK FACTORS 
• Advanced age 
• chronic illnesses 
• Cigarette smoking 
• Dementia 
• Malnutrition 
• Previous episode of pneumonia 
• Splenectomy
PATHOPHYSIOLOGY 
• Aspiration of nasopharyngeal, oral, or gastric 
contents 
• Hematogenous spread 
• Direct inoculation (stab wounds, endotracheal 
tube)
SIGNS AND SYMPTOMS
SIGNS AND SYMPTOMS 
• Clinical findings of pneumonia depending on 
etiological agent : 
• 1- typical.p : 
• Agent : s.pneumonia , H.influensae. 
• Appearance: bad (toxic). 
• Symptom development: fast ( in hours or days). 
• Clinical findings: high fever , wet cough . 
• Lung sound : rales ,decrease lung sound , branchial 
sound .
Atypical.pneumonia 
• Agent: M.pneumonia , 
c.pne…. 
• Appearance: good 
• Clinical findings: 
subfebrile , dry cough, 
headache , myalgia, 
• Lung sound: rales , 
wheezing 
• Viruses 
• Good 
• Subfebrile ,running nose 
,dry cough . 
• Wheezing , rales
DIAGNOSIS 
• 1- CXR. 
• 2-CT scan. 
• 3- Bronchoscopy.
• Labs: 
• -Blood culture . 
• -sputume culture.
CRITERIA FOR ADMISSION 
• Age > 50 
• Fever > 39,5 
• Underlying chronic disease 
• Change in mental status 
• Tachypnea, tachycardia, or hypotension 
• PaO2 < 60 
• Pleural effusion
TREATMENT 
1-Antibiotic : 
• No risk factors: Macrolide (erythromycin, azithromycin) 
• Risk factors present (CHF, diabetes, etc.): Macrolide 
and 2nd-/3rdgeneration 
• cephalosporin or extended-spectrum quinolone alone 
• Hospital-acquired: Add Pseudomonas coverage (e.g., 
cefixime or 
• piperacillin–tazobactam). 
• Immunocompromised: Add PCP coverage 
(trimethoprim–sulfamethoxazole
• 2- treat the symptoms: 
• Hydration: - help to out of secretion 
• Give oxygen . 
• 3- CPT (chest physiotherapy).
COMPLICATIONS 
 Bacteria in the bloodstream (bacteremia) 
 Lung abscess. 
 Build up of fluid in the space between the lung and chest wall 
(pleural effusion). 
 Difficulty breathing. 
 Shock and respiratory failure 
 Septic arthritis 
 Endocarditis
GENERAL MANAGEMENT 
 Don't smoke. 
 Practice good hygiene. 
 Stay rested and fit. 
Wearing surgical masks by the sick may also prevent illness. 
Appropriately treating underlying illnesses (such as HIV/AIDS, 
diabetes mellitus, and malnutrition) can decrease the risk of 
pneumonia. 
 Get a Pneumonia Vaccination.
Pneumonia

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Pneumonia

  • 2. • OUTLINES Introduction Etiology Epidemiology PATHOPHYSIOLOGY Signs and Symptoms Diagnosis Treatment Complications General Management
  • 3. Pneumonia is an infection in one or both of your lungs. Characterized primarily by inflammation of the alveoli in the lungs (alveoli are microscopic sacs in the lungs that absorb oxygen).
  • 4. TYPES OF PNEUMONIA Pneumonia affects your lungs in two Ways . According to areas involved : Lobar pneumonia : affects a section (lobe) of a lung. Bronchial pneumonia (Bronchopneumonia) : affects patches throughout both lungs.
  • 6.
  • 7. ETIOLOGY • Community acquired, typical • 1. S. pneumoniae • 2. H. influenzae • Community acquired, atypical • 1. Chlamydia pneumoniae • 2. Legionella pneumophila • 3. Mycoplasma pneumoniae • Hospital acquired • 1. Pseudomonas aeruginosa • 2. S. aureus • 3. Enteric organisms • Immunocompromised host pneumonia • 1. M. tuberculosis • Ventilator acquired pneumonia • 1.aspiration • Viruses : Influenza virus, Adenoviruses, Rhinovirus
  • 8. EPIDEMIOLOGY Overall incidence rate is 170 (per 10,000) and increases with age, with an incidence of 280 for those 65 years of age or older
  • 9. RISK FACTORS • Advanced age • chronic illnesses • Cigarette smoking • Dementia • Malnutrition • Previous episode of pneumonia • Splenectomy
  • 10. PATHOPHYSIOLOGY • Aspiration of nasopharyngeal, oral, or gastric contents • Hematogenous spread • Direct inoculation (stab wounds, endotracheal tube)
  • 12. SIGNS AND SYMPTOMS • Clinical findings of pneumonia depending on etiological agent : • 1- typical.p : • Agent : s.pneumonia , H.influensae. • Appearance: bad (toxic). • Symptom development: fast ( in hours or days). • Clinical findings: high fever , wet cough . • Lung sound : rales ,decrease lung sound , branchial sound .
  • 13. Atypical.pneumonia • Agent: M.pneumonia , c.pne…. • Appearance: good • Clinical findings: subfebrile , dry cough, headache , myalgia, • Lung sound: rales , wheezing • Viruses • Good • Subfebrile ,running nose ,dry cough . • Wheezing , rales
  • 14. DIAGNOSIS • 1- CXR. • 2-CT scan. • 3- Bronchoscopy.
  • 15.
  • 16. • Labs: • -Blood culture . • -sputume culture.
  • 17. CRITERIA FOR ADMISSION • Age > 50 • Fever > 39,5 • Underlying chronic disease • Change in mental status • Tachypnea, tachycardia, or hypotension • PaO2 < 60 • Pleural effusion
  • 18. TREATMENT 1-Antibiotic : • No risk factors: Macrolide (erythromycin, azithromycin) • Risk factors present (CHF, diabetes, etc.): Macrolide and 2nd-/3rdgeneration • cephalosporin or extended-spectrum quinolone alone • Hospital-acquired: Add Pseudomonas coverage (e.g., cefixime or • piperacillin–tazobactam). • Immunocompromised: Add PCP coverage (trimethoprim–sulfamethoxazole
  • 19. • 2- treat the symptoms: • Hydration: - help to out of secretion • Give oxygen . • 3- CPT (chest physiotherapy).
  • 20. COMPLICATIONS  Bacteria in the bloodstream (bacteremia)  Lung abscess.  Build up of fluid in the space between the lung and chest wall (pleural effusion).  Difficulty breathing.  Shock and respiratory failure  Septic arthritis  Endocarditis
  • 21. GENERAL MANAGEMENT  Don't smoke.  Practice good hygiene.  Stay rested and fit. Wearing surgical masks by the sick may also prevent illness. Appropriately treating underlying illnesses (such as HIV/AIDS, diabetes mellitus, and malnutrition) can decrease the risk of pneumonia.  Get a Pneumonia Vaccination.