pneumonia Flashcards
define pneumonia
Pneumonia is an inflammation of the parenchyma of the lungs
ETIOLOGIES
infectious and non infectious
bacterial and viral
o Aspiration of food or gastric acid,
o Foreign bodies,
o Hydrocarbons, and lipoid substances,
o Hypersensitivity reactions, and
o Drug- or radiation-induced pneumonitis.
Viral pathogens are a prominent cause of lower respiratory tract infections (age)
in infants and children <5 yr of age,
viruses and comminon bacterias
influenza virus and respiratory syncytial
virus are the major pathogens, especially in children <3 yr of age.
o S. pneumoniae, H. influenzae, and S. aureus
PATTERNS OF PNEUMONIA
based on anatomy
- Lobar pneumonia: involvement of a single lobe or segment of a lobe; this is
the classic pattern of S. pneumoniae pneumonia - Bronchopneumonia: primary involvement of airways and surrounding
interstitium; this pattern is sometimes seen in Streptococcus pyogenes and
Staphylococcus aureus pneumonia. - Necrotizing pneumonia: - associated with aspiration pneumonia and
pneumonia resulting from S. pneumoniae and S. aureus. - Caseating granuloma (as in tuberculosis pneumonia).
- Interstitial and peribronchiolar with secondary parenchymal infiltration: this
pattern typically occurs when a severe viral pneumonia is complicated by
bacterial pneumonia.
diagnosis is ………….. with ……………. features
clinical
fast bretahing cough and chest pain
investigation
cbc crp
chest xr
pleural fluid analysis
pleural fluid analysis if there is ……… to differentiate …………..
if there is effusion and to differentiate transudate exudate and empyma
complications of pneumonia
local and systemic complications
local
o Pleural effusion,
o Empyema and
o Lung abscess
o Pneumatoceles.
o Septic emboli in pulmonary veins
* Systemic complications
septicemia
meningitis
septic arthritis
endocarditis
pericarditis
peritonitis
managment principle
supportive care
treat complications
antibiotics
ADMISSION CRITERIA
6
- Age <6 mo
- Sickle cell anemia with acute
chest syndrome - Multiple lobe involvement
- Immunocompromised state
- Toxic appearance
- Severe respiratory distress
- Requirement for supplemental
oxygen - Dehydration
- Vomiting
- No response to appropriate oral
antibiotic therapy - Noncompliant parents
who classification of pneumonia
no pneumonia
pneumonia
severe pneumonia
severe pneumonia or severity features
o2 sat < 90%
resp distress- nasal flaring grunting retraction fast breathing
central cyanosis
loss of consciousness
recurrent pneumonia
> 2 episodes per year
3 episodes ever but radiological clearing in between
causes of recurrent pneumonia
disorders of immunity aids immunodefficiency
disorders of cilia Kartengers , immotile cilia syndrome
disorders of anatomy fistula , fba, GERD
