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PNEUMONIA

Learn about pneumonia, an inflammation of the lungs caused by various infections, including bacteria, viruses, and fungi. Discover the symptoms, diagnostic tests, and classification of pneumonia. Explore the different types, such as community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP), and understand the risk factors and treatment options. Find out about prevention methods, including vaccination and managing underlying illnesses.

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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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