Pneumonia Flashcards
Pneumonia:
Pneumonia is an acute inflammatory disease of the distal part of the respiratory tract, whoch manifests usually with fever, cough, dyspnea and infiltrations on chest x ray
Etiology of pneumonia in newborns?
- bacterias are the most common etiologic factors
- group B streptococci
- enterobacteriae
- chlamydia trachomatis
- listeria monocytogenes
Etiology of pneumonia in 3w. - 3 m.?
- bacterias are the most common etiologic factors
- strep. Pneumoniae
- Chlamydia trachomatis
- Bordetella pertussis
- Staph. Aureus
- RSV
- Parainfluenza
Etiology of pneumonia in 4 m. - 4 y.?
- Viruses are the most common etiologic factors
- streptococcus pneumoniae the most common bacteria
- mycoplasma pneumoniae is not an unusual cause of pneumonias in this age group
Etiology of viral lower respiratory tract infections in children?
- RSV
- Parainfluenza 1, 2, 3
- Influenza A and B
- Adenovirus
- Rhinovirus
- Human metapneumovirus
- Coronavirus
- Human bocavirus
Etiology of pneumonia in >5 y.?
- bacterias are the most common etiologic factors
- strep. Pneumoniae
- mycoplasma pneumoniae
- chlamydophila pneumoniae
- heamophilus influenzae
- moraxella catarrhalis
What are the most common symptoms of pneumonia?
- Fever and difficulity breathing are the most common presenting symptoms of pneumonia.
- The absence of fever has a negative predictive value of up to 97%
What are generally the symproms of pneumonia?
- cough, lethargy, poor feeding and an ‘unwell’ child
- localized chest or abdominal pain os a feature of pleural irritation
Percussion and auscultation findings in pneumonia?
- dullness to percussion
- crackles
- bronchial breathing
- wheeze - more suggestive of viral and mycoplasma infection
What are the objective clinical signs of pneumonia?
- skin color
- retractions and use of accessory muscles
- the presence of conjuctivitis in infants less than 3 months old with prominent cough suggests chlamydia trafhomatis infection
not done slide 13
Extrapulmonary symptooms of m. Pneumoniae infection
WHO def. of Tachypnea in children <2 months of age?
More than 60 breaths/min in children <2 months of age
WHO def. of Tachypnea children aged 2-12 months?
More than 50 breaths/min in children aged 2-12 months
WHO def. of Tachypnea in children aged > 12 months?
More than 40 breaths/min in hcildren aged >12 months
WHO def. of Tachypnea in children aged >5 years
More than 30 breaths/min in children > 5 years
DIDN’T DO SLIDE 15
Indication for hospital admission
Investigation for pneumonia:
Acute phase reactants
- total leukocyte and neurrophil count
- CRP
- Procalcitonin
- Erythrocyte sedimentation rate
When do we investigate electrolites?
It should be done of the patient is severely ill or shows the evidence of dehydration
- inappropriate secretion of antidiuretic hormone - results hyponatremia and low plasma osmolality (less than 280 m.osm./l).
- treatment is with fluid restriction
Micrpbiological investigation - community:
There is no indication for microbiological investigation of the child with penumonia in the community
DIDNT DO SLIDE 19
Microbiological investigation in hospital
Follow up chest radiography should only be performed in case of:
(Radiologic investigation)
- lobar collapse
- round pneumonia
- continuing symptoms
Treatment of pneumonia?
- amoxicillin ( first choicen for oral antibiotics)
- macrolide (may be added at any age if there is no response to first-line therapy)
When is macrolide used in the treatment of pneumonia?
- macrolide (may be added at any age if there is no response to first-line therapy)
- macrolide antibiotics sjould be used if either mycoplasma or chlamydia pneumonia is suspected in very severe disease
What do we use to treat pneumonia associated woth influenza?
Co-amoxiclav is recomended
What doe we use to treat pneumonia in newborns?
Antibiotics
- ampicyllin iv (+/-) aminoglycosid iv
- III generation cephalosporin (+/-) aminoglycosid
What do we use to treat pneumonia in children 3 w. - 3 m.?
- Strep. Pneumoniae
- ampicyllin, amoxicillin
- C. Trachomatis or B. Pertussis
- erythromycin
What doe we use to treat pneumonia in children 4 m. - 4 y.?
Amoxicillin
- see slide 28
What doe we use to treat pneumonia in children > 5 y.?
- Amoxicillin
- Macrolides
