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PNEUMONIA

PNEUMONIA. Nikola Bla ž evi ć Mentor: A. Ž mega č Horvat. inflammation of the lungs caused by infection many different causes: bacteria, viruses, fungi, idiopathic damages ALVEOLI > exudate (fluid) > consolidates > lack of oxygen. NORMAL ALVEOLI 

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PNEUMONIA

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  1. PNEUMONIA Nikola Blažević Mentor: A. Žmegač Horvat

  2. inflammation of the lungs caused by infection many different causes: bacteria, viruses, fungi, idiopathic damages ALVEOLI > exudate (fluid) > consolidates > lack of oxygen

  3. NORMAL ALVEOLI  PNEUMONIA 

  4. DIAGNOSIS Symptoms (dyspnea, cough) Physical examination X-ray (not always reliable) Blood test (high white cell count > inflammation) Sputum cultures CT (most reliable)

  5. 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%

  6. Classification Early classification schemes: Anatomical: 1. lobar pneumonia(streptoccocus or klebsiella pneumoniae) 2. multilobar pneumonia 3. interstitial pneumonia(viruses or atypical bacteria) Radiological Microbiological Combined clinical classification: 1. ACUTE(less than three weeks duration) - classic bacterial bronchopneumonia - atypical(interstitial pneumonitis) - aspiration pneumonia syndromes 2. CHRONIC - non-infectious - mycobacterialStreptococcuspneumoniae - fungal - bacterial infections caused by airway obstruction

  7. 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 Streptococcuspneumoniae  most common cause of CAP worldwide viruses atypical bacteria Fourth most common cause of death in UKand 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

  8. Microorganisms (more resistant): • MRSA (methicillin-resistant Staphylococcus aureus) • Pseudomonas • Enterobacter • Serratia Risk factors : • mechanical ventilation • decreased amounts of stomach acid • immune disturbances • heart and lung diseases

  9. Other types of pneumonia • Severe acute respiratory syndrome (SARS) • Bronchiolitis obliterans organizing pneumonia (BOOP) • Eosinophilic pneumonia • Aspiration pneumonia • Dust pneumonia SARS

  10. Treatment • 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

  11. Prognosis and mortality Bacterial pn.  resolveswithin 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

  12. Prevention • 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  cigarettesmoke interferes with many of the body's natural defenses against pneumonia

  13. References • http://en.wikipedia.org/wiki/Main_Page • Med. English seminars

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