Pneumonia
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Transcript of Pneumonia
W A E L A L H A L A B I
PNEUMONIA
•OUTLINESIntroduction
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.