PNEUMONIA Flashcards
What is Pneumonia
Infection & inflammation of lungs
Causes of Pneumonia
1) BACTERIA
Streptococcus pneumoniae
Staphylococcus aureus
Mycoplasma
Hemophilus influenza
Chlamydia
Pseudonymonas pneumonia
Legionella
Klebsiella
Anaerobic bacterias
2) VIRUS
Parainfluenza virus
Influenza virus
Cytomegalovirus
Varicella Zoster
3) FUNGI
Pneumocystic pneumonia
Candida Albicans
Histoplasmosis
Cocciodes
4) PHYSICAL FACTORS
Allergens
Radiation
Chemicals
Drugs
Types of Pneumonia according to environment
Community acquired pneumonia
Hospital acquired pneumonia
Ventilator acquired pneumonia
Healthcare associated pneumonia
Types of Pneumonia according to Anatomy
Lobar/ Alveolar Pneumonia
Lobular/ Bronchopneumonia
Interstitial Pneumonia
Types of Pneumonia according to etiology
Bacterial Pneumonia
Viral Pneumonia
Fungal Pneumonia
Radiation Pneumonia
Chemical Pneumonia
Classifications of Pneumonia
According to environment acquired
According to anatomic position
According to etiology
According to clinical manifestations
Differential diagnosis of Pneumonia
Pulmonary Tuberculosis
Pulmonary Thromboembolism
Noninfectious pulmonary infiltration
Lung cancer
Lung abscess
ICU admissions criteria for Community Acquired Pneumonia (CAP)
*Mechanical Ventilation
*Septic Shock
- Respiratory rate>30/min
- Bp<90/60mmHg
- PaO2/FiO2 ratio<250
- Blood urea nitrogen (BUN)>7.0mM or 19.1mg/dl
- multilobar disease
- Confusion
What is the severity assessment for pneumonia
(CURB-65)
CURB-65 = 0-1 STAY HOME
CURB 65 = 2-3 HOSPITALIZATION/ OUTPATIENT FOLLOW UP
CURB-65 >3 HOSPITALIZATION/ ICU
What is CURB-65
- CONFUSION<8 on abbreviated mental test score
- UREA >7mmol/l
- RESPIRATORY RATE >30/min
- BP<90/60mmHg
- 65yrs or more
What is CAP
- Community Acquired Pneumonia
Only in patients outside hospital or hospitalized<48hrs
Usually streptococcus pneumoniae
Responds to antibiotics
Symptoms: fever, rales, elevated WBC, cough with/without sputum & dyspnea with/ without chest pain
What is HAP
Hospital acquired pneumonia
Obtained when hospitalized>48hrs
Usually staphylococcus aureus
Can be drug resistant
Symptoms: purulent cough, fever, leukocytosis & progressive parenchymal infiltration on x-ray
Streptococcus pneumonia
- common in CAP
- Gram positive
- responds to antibiotics
- Penicillin or 3rd gen cephalosporins/ vancomycin
Staphylococcus aureus pneumonia
Common in HAP
Gram positive & coagulase positive
usually drug resistant
Semisynthetic penicillin/ cephalosporins with aminoglycosides
MRSA - VANCOMYCIN
Types of pneumonia according to clinical manifestations
Typical
Atypical