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Bacterial Pneumonia

Bacterial Pneumonia. Sung Chul Hwang, M.D. Dept. of Pulmonary and Critical Care Medicine Ajou University School of Medicine. Epidemiology. 6th leading cause of death in U.S. Number one Among the infectious diseases 4 million patients annually in US Incidence 12/1,000/year

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Bacterial Pneumonia

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  1. Bacterial Pneumonia Sung Chul Hwang, M.D. Dept. of Pulmonary and Critical Care Medicine Ajou University School of Medicine

  2. Epidemiology • 6th leading cause of death in U.S. • Number one Among the infectious diseases • 4 million patients annually in US • Incidence 12/1,000/year • Mortality in OPD patients 1-5 %, but Inpatients 25%, ICU 50-60%

  3. Definition • Pneumonia is the inflammation of lower respiratory tracts including alveoli, interstitial tissues, and broncioles by the microorganisms, chemical irritations or by an immunological process

  4. Classifications & Terminology • Community Acquired Pneumonia Nosocomial Pneumonia Ventilator Associated Pneumionia • Mild, moderate, severe • Bacterial, viral, fungal, parasitic • Primary vs. Secondary • Immune compromised vs. Normal immunity • Lobar vs interstitial • Typical vs. Atypical

  5. Severe Community Acquired Pneumonia • Respiratory rate > 30/min • PaO2/FiO2 ratio < 250mmHg • Need for Mechanical Ventilation • Diffuse bilateral involvement or multiple lobes, incresing infiltration > 50% within 48 hours • B.P. < 90systolic or 60 mmHg diastolic • Need for vasopressors • Renal failure

  6. Mycoplasma Pneumonia

  7. Mycoplasma Pneumonia

  8. Mycoplasma Pneumonia

  9. Streptococcal Pneumonia

  10. Streptococcus pneumoniae Gram + Diplococci

  11. Streptococcal Pneumonia

  12. Streptococcal Pneumonia

  13. Staphylococcus aureus BAL Fluid

  14. Staphylococcal Pneumonia Pneumatocele

  15. Staphylococcal Pneumonia

  16. Staphylococcal Pneumonia

  17. Staphylococcal Pneumonia Osler’s Node

  18. Pseudomonas Pneumonia

  19. Pseudomonas Pneumonia

  20. Pseudomonas Pneumonia Ecthyma gangrenosum

  21. Immunofluorescent Ab Test RSV Antigen Detection

  22. Legionella Pneumonia

  23. Legionella Pneumonia Legionella pneumophila by Silver impregnation Stain

  24. Pneumonia in COPD

  25. CMV Inclusion in BAL

  26. Sputum Gram Stain

  27. Treatment of CAP <60yrs/OPD/no Comorbid conditions • Pathogens : S. pneumoniae, Mycoplasma& Chlamydia pneumoniae, H. indfluenzae, RSV, Legionella, S. aureus • Treatment : 2nd Generation Cephalosporin + Macrolide or Quinolone monotherapy

  28. Treatment of CAP >60yrs/OPD/with Comorbid conditions • Pathogens : S. pneumoniae, RSV, H. indfluenzae, Gram (-) rod, S. aureus, Morexella catarrhalis, Legionella spp. • Treatment : 2nd Generation Cephalosporin + TMX/SFX, or beta lactam/betalactam inhibitor + Macrolide

  29. Treatment of Severe CAP • Pathogens : S. pneumoniae, Legionella spp. Gram (-) rod, Mycoplasma,H. indfluenzae,S. aureus • Treatment : 3rd Generation Cephalosporin with anti-Pseudomonal activity or + other anti Pseudomonal agent (Imipenem/quinolone) + Macrolide

  30. Aspiration Pneumonia

  31. Aspiration Pneumonia

  32. Lipoid Pneumonia

  33. Lipoid Pneumonia

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