pneumonia , pertussis

• Pneumonia is the single cause of mortality in children under five and is major cause of child mortality in every region of the world
• Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus, causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.
• Pneumonia can range in seriousness from mild to life-threatening. It is most serious for infants and young children, people older than age 65, and people with health problems or weakened immune systems.
• Incubation period

  1. 3 days
• Causative agents of pneumonia in young children

  • Viruses
  • Respiratory syncytial virus
  • Parainfluenza viruses
  • Influenza viruses
  • Adenovirus
• Causative agents of pneumonia in adults

  • Bacteria
  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Staphylococcus aureus
• Pneumonia in older children and young adults

  Often caused by the bacteria-like Mycoplasma pneumoniae, the cause of pneumonia that is often called "walking" pneumonia
• Pneumocystis carinii


  Causes pneumonia in immunosuppressed individuals such as patients being treated with chemotherapy or people with AIDS
• Chlamydia psittaci

  Can be infective in some individuals, such as poultry farm workers, who have direct contact with bird droppings
• Pneumonia


  Classified according to the types of germs that cause it and where you got the infection
• Community-acquired pneumonia

  • Most common type of pneumonia
  • Occurs outside of hospitals or other health care facilities
• Causes of community-acquired pneumonia

  • Bacteria
  • Bacteria-like organisms
  • Fungi
  • Viruses, including COVID-19
• Bacterial pneumonia

  • Most common cause is Streptococcus pneumoniae
  • May affect one part (lobe) of the lung, a condition called lobar pneumonia
• Bacteria-like organism pneumonia

  • Mycoplasma pneumoniae
  • Typically produces milder symptoms than other types of pneumonia
  • Informal name is "walking pneumonia"
• Fungal pneumonia


  • Most common in people with chronic health problems or weakened immune systems
  • Caused by fungi found in soil or bird droppings, varies by geographic location
• Viral pneumonia

  • Most common cause of pneumonia in children younger than 5 years
  • Usually mild, but can become very serious in some cases
  • Coronavirus 2019 (COVID-19) may cause pneumonia, which can be severe
• Hospital-acquired pneumonia/nosocomial pneumonia

  • Occurs at least 48-72 hours after being admitted to the hospital for other illness
  • Can be serious because the bacteria causing it may be more resistant to antibiotics
  • People on breathing machines (ventilators) are at higher risk
• Healthcare-acquired pneumonia

  • Bacterial infection that occurs in people who live in long-term care facilities or receive care in outpatient clinics
  • Can be caused by bacteria resistant to antibiotics
• Aspiration pneumonia


  • Occurs when you inhale food, drink, vomit or saliva into your lungs
  • More likely if something disturbs your normal gag reflex, such as brain injury or swallowing problem, or excessive use of alcohol or drugs
• Risk factors for pneumonia

  • Children 2 years old or younger
  • People age 65 or older (most at risk)
  • Being hospitalized, especially in intensive care on a ventilator
  • Chronic diseases like asthma, COPD, or heart disease
  • Smoking
  • Weakened or suppressed immune system (e.g. HIV/AIDS, organ transplant, long-term steroids)
• Pneumonia


  Infection of the lungs that can cause mild to severe signs and symptoms, depending on factors such as the type of germ causing the infection, and your age and overall health
• Mild signs and symptoms of pneumonia are often similar to those of a cold or flu, but they last longer
• Signs and symptoms of pneumonia

  • Chest pain when you breathe or cough
  • Confusion or changes in mental awareness (in adults age 65 and older)
  • Cough, which may produce phlegm
  • Rusty sputum (S. Pneumoniae), gelatin/currant jelly (Klabsiella), Bavarian cream (S. aureus), clear (virus) and greenish (pseudomonas)
  • Fatigue
  • Fever, sweating and shaking chills
  • Lower than normal body temperature (in adults older than 65 and people with weak immune systems)
  • Nausea, vomiting or diarrhea
  • Shortness of breath/ difficulty breathing (dyspnea)
  • Fast breathing (tachypnea)
  • Stridor is a high pitched, wheezing sound (more often heard during inspiration) caused by disrupted airflow
  • Wheezes a whistling sound when you breathe (inhale and exhale)
  • Chest indrawing is an inward movement of the lower chest wall when the child breathes in, and is a sign of respiratory distress
• Newborns and infants may not show any sign of the infection. Or they may vomit, have fever and cough, appear restless, or tired without energy, or have difficulty breathing and eating
• Complications of pneumonia even with treatment

  • Bacteria in the bloodstream (bacteremia)
  • Difficulty breathing
  • Fluid accumulation around the lungs (pleural effusion)
  • Lung abscess
• Bacteremia

  Bacteria that enter the bloodstream from the lungs can spread the infection to other organs, potentially causing organ failure
• Difficulty breathing

  If pneumonia is severe or there are chronic underlying lung diseases, the patient may have trouble breathing in enough oxygen and may need to be hospitalized and use a breathing machine (ventilator) while the lung heals
• Pleural effusion


  Pneumonia may cause fluid to build up in the thin space between the layers of tissue that line the lungs and chest cavity (pleura). If the fluid becomes infected, it may need to be drained through a chest tube or removed with surgery
• Lung abscess


  An abscess occurs if pus forms in a cavity in the lung. It is usually treated with antibiotics, but sometimes surgery or drainage with a long needle or tube placed into the abscess is needed to remove the pus
• Diagnostic exams for pneumonia

  • Chest X-ray
  • Sputum exam
  • Sputum culture and sensitivity
• Chest X-ray


  To be able to see if there is lung consolidation or patchy infiltrates
• Inhalation therapy

  1. Steam inhalation (hot water + salt)

  2. Nebulization to liquefy secretions
• Antibiotic


  A type of medication used to treat bacterial infections
• Maintain patent airway

  Fowler position (the patient is seated in a semi-setting position 45-60 degrees and may have knees either bent or straight)
• Nursing care

  • Provide rest
  • Adequate nutrition
  • Comfort measures- splint chest wall on coughing (use pillow) and apply chest binder
• Prevention of pneumonia

  • Get vaccinated
  • Practice good hygiene- protect yourself against respiratory infections that sometimes lead to pneumonia, wash hands regularly or use an alcohol-based hand sanitizer
  • Don't smoke- smoking damages your lungs natural defenses against respiratory infections
  • Keep your immune system strong- get enough sleep, exercise regularly and eat a healthy diet
• Pertussis also known as whooping cough or 100-day cough  (Ubong dalahit: Tagalog) (Kaluykoy: Cebuano) is a highly contagious bacterial disease. It is characterized by repeated attacked of spasmodic coughing usually followed by vomiting It is highly contagious in early catarrhal stage, before paroxysmal cough. Incubation period is usually 7 days but it ranges from 5 to 15 days.

   
• Causes (Causative Agent): Bordetella Pertussis (common) and Hemophilus Pertussis. It is a gram negative bacteria, aerobic, encapsulated coccobacillus of the genus Bordetella. B. Pertussis is motile and expresses a flagellum-like structure.

   

   

  Mode of Transmission

  Acquired primarily through direct contact with discharges from respiratory mucus membranes of infected persons (The bacteria may be spread through droplets and indirect contact with articles freshly soiled with the discharges of infected persons.)
• Risk Factors

  • Pregnancy
  • Epidemic exposure
  • Lack of immunization
  • Close contact with an infected individual
• Signs and Symptoms

  • Cough persisting 2 or more weeks
  • Fits of coughing
  • Cough followed by vomiting