It is an infection of one or both lungs parenchyma caused by bacteria, viruses, or fungi.
Bacterial and viral pneumonia they can spread by the inhalation of arosolized droplets neucle from other infected patient through sneezing, cough or contact with surfaces or objects that are contaminated with pneumonia causing bacteria or viruses.
Fungal Pneumonia does not spread from person to person.
CLASSIFICATION
- A. Classification by mode of acquiring:
- a. Community acquired pneumonia(CAP)* Streptococcus pneumoniae, Haemophilus influenzae
- b. Health care associated pneumonia*
- Hospital-acquired pneumonia or Nosocomial Aerobic gram-ve bacilli, abaerobes
- Ventilation-associated pneumonia (VAP)
- c. Atypical pneumonia* – A group of pneumonia which do not behave like typical or pneumococcal pneumonia and do not respond to penicillin, mainly legionella, microplasma
- B. Classification based off the area of the lungs it’s affecting:
Broncho pneumonia- Cause by
- Staphylococcus
- Streptococci
- Haemophilus influenzae
- Pseudomonas
- E. Coli
- Klebsiella pneumoniae
Here Consolidation occurs of multiple lobe usually bilateral ( bronchus, bronchiole). Here no clearcut demarcation of stage of inflammation and severity less. Sputum is Purulent and non Haemorrhagic (Sputum Haemorrhagic – Lober pneumonia)
Lober Pneumonia – It is an acute bacterial infection of a part of a lobe, entire lobe or even two lobes of one or both lungs.
- •Cause by:
- Streptococcus pneumoniae Or Pneumococci (80-90%)
- Staphylococcus aureus
- Streptococcus pyogenes
- Haemophilus influenzae
- E.coli
- Klebsiella pneumoniae
- Stages:
It is divided into *4* distinct stages
- Stage of Congestion
- Stage of Red Hepatization ( stage of Consolidation)
- Stage of Grey Hepatization ( stage of Consolidation)
- Stage of Resolution
Here involvement the part of lobe Or entire lobes ( alveoli, lobes), four distinct stages present mention above, severity more and sputum is purulent and haemorrhagic.
CAUSES
- Streptococcus pneumoniae (80-90%)
- Staphylococcus aureus
- Streptococcus pyogenes
- Haemophilus influenzae
- E.coli
- Klebsiella pneumoniae
SYMPTOMS
- Fever
- Breathlessness
- Cough with Rusty color sputum
- Chest pain due to dry pleurisy
- weakness, lathargy
- Headache
- Abdominal pain, nausea and vomiting
- Loss of appetite
RISK FACTOR
° Alcoholism
° Smoking
° COPD
° Stroke
° Cystic fibrosis
° Asthma
° HIV
° Immune suppression
° Liver Disease
° Kidney Disease
° Dementia
° Corticosteroid therapy
° Perkinson’s Disease
° Diabetes
° Heart Failure
COMPLICATION
- Pleural Effusion
- Lung abscess
- Delay resolution
- Meningitis
- Empyema
- Pericarditis
- Pneumothorax
- ARDS
- Mental confusion
- Cerebral abscess
- Respiratory failure
- Hyperpyrexia
- Renal failure
- Multiple organ failure
INVESTIGATION
- A. Blood
Full blood count
- WBC count very high or low, marker of severity
- Neutrophil Leucocytosis
- Haemolytic anaemia
Liver Function Test
- Hypoalbuminaemia – When condition is very severe
Urea and electrolytes
- Hyponatraemia – when condition is very severe
- Urea level high
B.Sputum
- Gram stain, culture and antimicrobial sensitivity testing
- C. Urine
Pneumococcal Or Legionella antigen present
- D. Chest X-Ray
- Patchy opacity present into homogenous consolidation
- Air bronchogram present
- Patchy and segmental shadow present in Bronchopneumonia
- E. Fluid sample
Test can help to identify the cause of your infection
- F. HRCT of Lung
Provide a clear details picture of your lung
- G. Puls Oximeter
Puls oximetry measures Spo2 level in you blood
- H. Pulmonary Function Test
TREATMENT
- Amoxicillin
- Clarithromycin Or Ertthromycin if patient allergic to penicillin, Mycoplasma or Legionella is suspected
- Flucloxacillin if Staphylococcus is suspected
- Clarithromycin or Erythromycin, Co-amoxiclav or Ceftriaxone or Cefuroxime, Amoxicillin, Flucloxacillin if the condition is very severe
INDICATION FOR EARLY HOSPITAL ADMISSION
- Severe Hypoxia
- Respiratory more than 30/ min
- Elderly patient more than 65 yr of old
- Cerebral Cyanosis
- Circulatory Shock
- Severe acidosis
- Reduced conscious level
- Progressive Hypercapnia
