13- pneumonia pt.1

• Pneumonia

  Inflammation of the substance of the lungs, usually caused by bacteria
• Pneumonia

  • Can be classified anatomically (e.g. lobar and bronchopneumonia)
  • Can be classified according to the setting where infection contracted (community versus hospital acquired)
  • Can be classified by etiology
• Types of pneumonia

  • Community acquired pneumonia
  • Hospital acquired pneumonia
• Community acquired pneumonia

  Occurs in community or within first 48 hours of hospitalization, can be typical or atypical, most common bacteria is streptococcus pneumonia
• Hospital acquired pneumonia

  Occurs during hospitalization after first 48 hours, most common pathogens are gram-negative (E. coli and pseudomonas) and staph. aures
• Symptoms & signs of pneumonia

  • Fever, rigors (if swinging may indicate empyema)
  • Cough with sputum
  • Pleurisy, chest pain
  • Shortness of breath
  • Signs of consolidation (reduced expansion, dull to percussion, bronchial breathing, increase vocal resonance)
  • Pleural effusion, and plural rub may also be present
• Risk factors for pneumonia

  • Extremes of age (less than 16, more than 65)
  • Underlying lung disease
  • Smoking, alcohol, IV drugs
  • Immunosuppressive drugs, prolonged steroids, HIV, DM, CKD, malnutrition
  • Recent viral resp infection
• Causes of community acquired pneumonia

  • Strept. pneumoniae
  • Viruses
  • Typical:
  • H.influenzae
  • Moraxellacatarrhalis
  • Staph aureus
  • Aerobic gram – (E. coli, klebsiella)
  • Anaerobes (associated with aspiration)
  • Atypical:
  • Mycoplasma pneumoniae
  • Legionella
  • Chlamydia pneumonia
  • Chlamydia psittaci
  • Coxiella burnetti