Pneumonia definition, cause, clinical feature, investigation, treatment

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Pneumonia definition, cause, clinical feature, investigation, treatment

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Pneumonia:
Inflammation of the lung parenchyma is called pneumonia.

Types:
*Lobar pneumonia
*Bronchopneumonia

In case of lobar pneumonia one or multiple lobes of lungs are involved !
In case of broncho pneumonia, Only bronchus of the lungs are involved!

Now what are the factor predispose to pneumonia:
*Cigarette smoking     *Old age
*Upper respiratory tract infection
*Alcohol      *HIV
*Glucocorticoids therapy
*Recent influenza infection

Organisms Responsible to pneumonia:
Bacteria:
*Staphylococcus aureus
*Streptococcus pneumoniae
*Micoplasma pneumoniae
*Legionella pneumophila
*Clamydia pneumoniae
*Klebsiella pneumoniae
*Haemophilus influenzae

Viruses:
*Influenza, parainfluenza
*Measles, Varicella
*Herpes simplex
*Adenovirus , CMV

Clinical Features:
(Symptomes)
*Cough (Initially dry but later mucopurulent sputum)
*Haemoptysis
*Fever (rigor, shivering, malaise)
*Pleuritic chest pain
(Signs)
On general examination: Patients is toxic, ill looking, raised temperature, increased respiratory rate.
On Respiratory system examination:
*On palpation: reduced chest expansion, increased vocal fremitus.
*On percussion: percussion node is dull.
*On auscultation: Bronchial Breath sound and inceased vocal resonance.


Investigations:
Complete blood count:
If bacterial neutrophilic leucocytosis, if viral leukopenia.
ESR And CRP: Raised.
Chest X ray: Radio opaque shadow with air bronchogram.
Sputum study: Microscopic and culture.
Pulse oximetry: to see arterial oxygen saturation.



Treatment:
#Uncomplicated community acquired pneumonia:
amoxicillin 500mg 3 time daily orally.
#If patient is allergic to penicillin:
Clarithromycin 500mg twice daily oraly
#If saphylococcusi is cultured or suspected:
Flucloxacillin 1-2g 4 times daily i/v
plus,
Clarithromycin 500mg twice daily i/v

#Severe community acquired pneumonia:
Clarithromycin 500mg twice daily i/v
plus,
Ceftriaxone 1-2 g daily i/v

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