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.