Pneumonia

• Pneumonia:

  • an infection which causes inflammation of the lung tissue
  • often begins with bronchitis
• Signs and symptoms:

  • productive cough with yellow/green sputum
  • difficulty breathing
  • tachycardia
  • pleuritic pain
  • crackles heard during chest auscultation
  • pyrexia
  • loss of appetite
  • sweating and shivering
  • headaches
  • muscular aches and pains
• Pathophysiology of Pneumonia:

  • the pathogens infect the lower respiratory system structures including the alveoli
  • the cells of the alveoli become flooded with white blood cells as they are trying to fight the pathogen
  • the cells become inflamed and fluid produces as the white blood cells kill the pathogen that sits inside the alveoli
  • gaseous exchange is more difficult when there is fluid present in the alveoli, resulting in low oxygen and high carbon dioxide levels
• Diagnostic tools:

  • CRB65 or CURB65 score
  • blood tests to detect the body's level of response to the infection
  • sputum sample and blood cultures to confirm pathogen type
  • urine tests to detect pneumococcal and legionella antigens
  • chest x-ray to visualise extent of infection
• Treatment:

  • antibiotics: start as soon as possible within 4 hours, or 1 hour of indicated sepsis
  • oral antibiotics if CRB65/CURB65 score is low
  • IV antibiotics if score is high
  • IV fluids to maintain BP if required
  • oxygen to maintain saturation
  • chest physio to encourage deep breathing and effective coughing