Pneumonia

Question 1

Definition

Answer 1

Inflammation of the lungs
Lung infection that affect the alveoli producing intraalveolar exudation caused by a pathogen

Question 2

Etiology/ Causes

Answer 2

Virus (Influenza, Sars cov)
Bacteria (mycobacteria pneumoniae, streptococcus pneumoniae)
Protozoa
Fungi (Histoplasmosis)
Parasitical

Question 3

Pathogenesis

Answer 3

colonization of the upper respiratory tract by
pathogenic flora and violation of its elimination, the infection
can penetrate down the respiratory tract.

If the body’s immune mechanisms do not manage
with elimination, the infection will penetrate into the lung
tissue and inflammation will develop.

Microaspiration of the oropharynx secretion with
colonizing microorganisms contained in it (Streptococcus
pneumoniae, Haemophilus influenzae, gram-negative
bacteria & anaerobes).
 Decrease in local defense mechanisms - cough reflex,
mucociliary clearance, antibacterial activity of alveolar
macrophages and secretory immunoglobulins.
 Aspiration of a massive volume of bacteria in violation
of neurogenic mechanisms of protection of the upper
respiratory tract (stroke, convulsions) or if a concomitant
disease of the internal organs predisposes to repeated
vomiting.
- Inhalation
- hematogenous dissemination of extrapulmonary focus
of infection (e.g in the case of infectious endocarditis of
the right heart— Staphylococcus aureus)
 the direct spread of infection from adjacent foci of
infection (e.g. intrahepatic or subphrenic abscess)

Question 4

Symptoms

Answer 4

• Fever;
• Cough;
• Sputum discharge;
• Chest pain;
• Dyspnea

Question 5

Diagnosis

Answer 5

Acute onset of fever
Cough, sputum
Shortening of percussion tones
Local signs during auscultation
Blood analysis: Leukocytosis, leukopenia
X-ray: infiltration in the lungs
PCR (pathogen)
Bacteriology exam (sputum)

Leukopenia below Зх109/L or above
leukocytosis 25х109/L

Question 6

Scale

Answer 6

CURB65
Consciousness
Urea level 7mol
RR >30
BP <90/60
Age 65

0 - outpatient
1-2 - hospital
3-5 ICU dept

Question 7

Treatment

Answer 7

0) treatment regimen
* 1) Etiotropic therapy
* 2) detoxification
* 3) anti-inflammatory
* 4) mucokinetics
* 5) exercise therapy, physiotherapy (optional)

non severe, no concomitant - amoxicillin or macrolide (azithromycin)
no severe + concomitant - amoxicillin + clavulanate
hospital -amoxicillin, protected penicillin, cephalosphorins (3 generation) CETRIAFXONE

Question 8

Complications

Answer 8

Pneumothorax, Abscesses, pleural effusion, atelectasis