Transcript PNEUMONIA - unizg.hr

Nikola Blažević
Mentor: A. Žmegač Horvat
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inflammation of the lungs caused by infection
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many different causes: bacteria, viruses, fungi, idiopathic
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damages ALVEOLI > exudate (fluid) > consolidates > lack of oxygen
NORMAL ALVEOLI 
PNEUMONIA
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DIAGNOSIS
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Symptoms (dyspnea, cough)
Physical examination
X-ray (not always reliable)
Blood test (high white cell count >
inflammation)
Sputum cultures
CT (most reliable)
COMBINED FINDINGS
Prediction rule for the frequency of inflammation:
Temperature > 100 degrees F (37.8 degrees C)
Pulse > 100 beats/min
Crepitations
Decreased breath sounds
Absence of asthma
Probability of inflammation based on the number of findings:
5 findings - 84% to 91% probability
4 findings - 58% to 85%
3 findings - 35% to 51%
2 findings - 14% to 24%
1 finding - 5% to 9%
0 findings - 2% to 3%
Classification
Early classification schemes:
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Anatomical: 1. lobar pneumonia(streptoccocus or klebsiella pneumoniae)
2. multilobar pneumonia
3. interstitial pneumonia(viruses or atypical bacteria)
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Radiological
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Microbiological
Combined clinical classification:
1. ACUTE(less than three weeks duration)
- classic bacterial bronchopneumonia
- atypical(interstitial pneumonitis)
- aspiration pneumonia syndromes
2. CHRONIC
- non-infectious
- mycobacterial
Streptococcus pneumoniae
- fungal
- bacterial infections caused by airway obstruction
Community-acquired pneumonia (CAP)
- in a person who has not recently been hospitalized!
- most common type of pneumonia
- home care, oral antibiotics
Most common cause of CAP  H. influenzae
Streptococcus pneumoniae  most common cause of CAP worldwide
viruses
atypical bacteria
Fourth most common cause of death in UK and sixth in US
Hospital-acquired pneumonia (nosocomial)
- acquired during or after hospitalization for another illness or
procedure, 72h latency time after admission
- 5% patients develop HAP
- more deadly
Microorganisms (more resistant):
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MRSA (methicillin-resistant Staphylococcus aureus)
Pseudomonas
Enterobacter
Serratia
Risk factors :
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mechanical ventilation
decreased amounts of stomach acid
immune disturbances
heart and lung diseases
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Severe acute respiratory syndrome (SARS)
Bronchiolitis obliterans organizing pneumonia (BOOP)
Eosinophilic pneumonia
Aspiration pneumonia
Dust pneumonia
SARS
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oral antibiotics, rest, lots of fluid!
home care  no hospitalization needed
people with other medical problems and elderly  hospitalization if
pneumonia persists
Bacterial pneumonia  treated with antibiotics:
- amoxicillin
- fluoroquinolones
- cephalosporins
- aminoglycosides
Viral pneumonia  influenza A  rimantadine , amantadine
Bacterial pn.  resolves within 2 to 4 weeks
- 1/20 people with pneumococcal pneumonia die
- half of the people who develop MRSA on ventilator die
Viral pn.  lasts longer than bacterial
Mycoplasmal pn.  4 to 6 weeks to resolve
- low mortality
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Vaccination  H. influenzae and S. pneumoniae in the 1st year
- repeat after 5-10 years
Abtibiotics  Group B Streptococcus and Chlamydia trachomatis
positive pregnant women
Treating underlying illnesses (e.g. AIDS) can decrease the risk of
pneumonia
Smoking  cigarette smoke interferes with many of the body's
natural defenses against pneumonia
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