[11] Pneumonia Flashcards
What is pneumonia?
An infection of the lower respiratory tract and lung parenchyma
What does pneumonia lead to?
Consolidation
To cause pneumonia, what must an organism do?
Bypass the host’s normal non-immune and immune defence mechanisms
What are the non-immune mechanisms?
- Aerodynamic filtering of particles
- Cough reflex
- Mucociliary clearance
- Secreted substances including lysozymes, complement and defensins
What carries out the immune mediated response?
- Macrophages
- Neutrophils
- Lymphocytes
What percentage of CAP cases in children are caused by viruses?
14-35%
What causes variation in the causative organisms?
Age
What are the common causative bacteria of pneumonia in neonates?
- Group B strep
- E. Coli
- Klebsiella
- Staph aureus
What are the common causative bacteria of pneumonia in infants?
- Strep pneumoniae
- Chlamydia
What are the common causative bacteria of pneumonia in school age children?
- Strep pneumoniae
- Staph aureus
- Group A strep
- Bordetella pertussis
- Mycoplasma pneumoniae
What are the risk factors for pneumonia in children?
- Congenital lung cysts
- Chronic lung disease
- Immunodeficiency
- Cystic fibrosis
- Sickle cell disease
- Tracheostomy
What features may be present in the history?
- Recent URTI
- Pleuritic chest pain
- Temperature >38.5
- Shortness of breath
- Cough with sputum in children > 7
What features may be present on examination?
- Signs of respiratory distress
- Desaturation and cyanosis
- General ill health and lethargy
- Auscultation signs of lobar pneumonia
What are some signs of respiratory distress?
- Tachypnoea
- Grunting
- Intercostal recession
- Use of accessory muscles for breathing
What signs may be present on auscultation?
- Dullness to percussion
- Crackles
- Decreased breath sounds
- Tactile vocal Freitas
- Bronchial breathing