Pneumonia Signs and Symptoms Pathophysiology Types of Pneumonia

Pneumonia Signs and Symptoms Pathophysiology Types of Pneumonia

clinicalHypertension with Diabetes, heart failure, MI, CHF and Hypertension with Pregnancy. Read more ... » presentation of childhood pneumonia often is dictated by the responsible pathogen, the particular host, and the severity of the pneumonia.

Inflammation of the lungs, usually due to infection with bacteria, viruses, or other pathogenic organisms. Clinically, the term “pneumonia” is used to indicate an infectious diseaseHypertension with Diabetes, heart failure, MI, CHF and Hypertension with Pregnancy. Read more ... »

Bacterial infection of lung parenchyma: Community-acquired pneumonia: AcuteHypertension with Diabetes, heart failure, MI, CHF and Hypertension with Pregnancy. Read more ... » infection of the pulmonary parenchyma in a patient who has acquired the infection in the community

Pneumonia means infection of the alveoli, dis­tal airways, and interstitium of the lung.

• As a result of infection there is :
• Increase in bulk of lungs
• Decreased sponginess of lungs
• Consolidation of lungs
• Air in alveoli replaced by WBC, RBC, Fibrin.

Risk Factorsfor Pneumonia

• CAP:
  • Alterations in the level of consciousness, smoking, hypoxemia, acidosis, toxic inhalations, pulmonary edemaPulmonary Edema Causes Diagnosis with Treatment. Read more ... », uremia, malnutrition, immunosuppression, mechanical obstructionIntestinal Obstruction Symptoms and Treatment of Intestinal Obstruction. Read more ... » of a bronchus, elderly, cystic fibrosis, bronchiectasis, chronicChronic Hepatitis Classification viral hepatitis Clinical features and Treatment. Read more ... » obstructive pulmonary disease (COPD), alcoholism, seizure disorder
  • HIVAIDS Acquired Immunodeficiency Syndrome Diagnosis Signs and Symptoms with Treatment. Read more ... » infection: 40-fold increase in risk
• Risk factors for HAP, VAP, HCAP:
  • Intubation: 6- to 21-fold increase in risk
  • If >70 years of age: COPD, depressed consciousness, aspiration, chest surgery, the presence of an intracranial pressureChronic Long-term Complications Of Diabetes Mellitus. Read more ... » monitor or nasogastric tube, H₂ blockers or antacid therapy, transport from the ICU for diagnostic or therapeutics procedures, previous antibiotic exposure (particularly to 3rd-generation cephalosporin), reintubation, hospitalization during fall or winter season, mechanical ventilation for acute respiratory distress syndromeAcute Respiratory Distress Syndrome (ARDS) Causes Clinical feature Treatment. Read more ... » (ARDSAcute Respiratory Distress Syndrome (ARDS) Causes Clinical feature Treatment. Read more ... »)

History Pneumonia

• Thick, yellow-green, bloody or rusty sputum
• Mental status changes: Anxiety, confusion, restlessness, obtundation, coma
• Abdominal pain, anorexia, diarrhea
• CoughInfluenza SARS and Whooping Cough Signs and Symptoms with Diagnosis and Treatment. Read more ... », feverHow to Manage Hay Fever at Home. Read more ... », dyspnea, chills
• Chest painApproach to Chest Pain Differential diagnosis of chest pain. Read more ... » (pleuritic or nonpleuritic)
• Atypical:
• Insidious onset of dry cough
• Extrapulmonary symptoms: Diarrhea, headacheHeadache. Read more ... », myalgias, sore throat

Symptoms of pneumonia

• Fever
• Chills
• Cough .
• Pleuritic chest pain
• Sputum production
• Body may be ,cold or hot. ,

Signs of pneumonia

• Fever
• Respiratory rate increased
• Dullness on percussionPalpation of Precordium and Percussion of the Heart. Read more ... » of lungs
• Bronchial breathing
• Aegophony
• Crackles and wheezes (crepts and ronchi) Pleural friction rub.

Pneumonia Physical Exam

• Pulse oximetry to evaluate oxygenation
• Tachypnea, tachy/bradycardiaSINUS Bradycardia Bradyarrhythmia Symptoms Causes Diagnosis with Treatment. Read more ... », cyanosis
• Decreased breath sounds, rales, friction rub
• Consolidation: Egophony, increased fremitus, pectoriloquy, dullness to percussion
• Abdominal tenderness or pain
• VAP is suspected when a patient receiving mechanical ventilation develops a new or progressive infiltrate with fever, leukocytosis, or purulent tracheobronchial secretions; increased respiratory rate, increased minute ventilation, decreased tidal volume, decreased oxygenation, or a need for more ventilator support or inspired oxygen

Chest X-ray of pneumonia

• One or more opaque patches in lung fields.
• Pneumonia may be Community-acquired - Serious, less serious.
• Hospital acquired - Patient on ventilator, Patient not on ventilator.

Routes of Infection for pneumonia

• Aspiration
• Droplet infection
• Hematogenous spread
• Direct spread of Infection.
• In healthy persons Streptococcus pneumoniae and Hemophilus influenzae are normally present in oropharynx.
• These can cause pneumonia during stress, surgery, low immune status.
• Aspiration pneumonia can occur post-operatively, during seizures in patients of strokes, in unconscious patients.
• Hematogenous spread occurs in
• Endocarditis
• IV catheter
• Infective conditions
• UTI.
• Common organism in such cases is Staphylococcus aureus.
• E.coli infection occurs from urinary tract.
• Aerosol infection is by M. tuberculosisLeprosy Hansen's Disease types Causes of leprosy sign and Symptoms With Treatment. Read more ... », fungi, histo­lasma, legionella, Coxiella burneti, InfluenzaInfluenza SARS and Whooping Cough Signs and Symptoms with Diagnosis and Treatment. Read more ... » A and’ B.

Pathophysiology of pneumonia

• Vital capacity, lung compliance, functional residual capacity, total lung capacity are decreased.
• There is hypoxaemia. The pathological picture of lung shows:
• Lobar pneumonia
• Route of infection: Gross aspiration, microaspiration, aerosolization, hematogenous and direct spread
• Bronchopneumonia: Patchy consolidation involving one or several lobes
• Interstitial pneumonia: Interstitium, including alveolar walls and the connective tissue
• Vital capacity, lung compliance, functional residual capacity, and total lung capacity are below normal in patients with pneumonia. V/Q mismatch and intrapulmonary shunting are responsible for the hypoxemia.

Lobar pneumonia:

• Entire lobe involvement

Miliary pneumonia:

• Diffusely distributed 2- to 3-mm lesions (bloodstream spread)
• Bronchopneumonia
• Interstitial pneumonia
• Miliary pneumonia.
• Lobar Pneumonia
• One entire lug lobe is involved.
• There is homogenous opacity of one whole lobe seen on X-ray.

First stage:

• Congestion in first 24 hours.
• Bacteria, edema fluid and neutrophils invade the lung.

Second stage :

• It is red hepatiz.ation (so-called because the lungs resemble the colour and consistency of liver).

Third stage:

• is gray hepatization due to fibrino-purulent exu­dates and hemosiderin.
• This occurs by the 6^th day.

Fourth stage or Final stage:

• is resolution,when pulmonary architecture is restored.
• There may be pleural adhesions also.

Bronchopneumonia

• Is a patchy consolidation involving one or several lobes, usually lower and posterior portions because of aspiration of oropharyngeal contents by gravity.

Interstitial pneumonia

• Involves the interstitial, alveolar walls, and connec­tive tissue around the bronchovascular tree. Lesions are patchy or diffuse.

Miliary pneumonia

• There are 2 – 3 mm size lesions due to spread of ~acteria to lungs via blood stream.
• CausesHypertension with Diabetes, heart failure, MI, CHF and Hypertension with Pregnancy. Read more ... » of Miliary pneumonia are:
• Tuberculosis
• Histoplamosis
• Coccidioidomycosis
• Herpes
• Cytomegalovirus.
• Sometimes the patient is severely immuno­compromized.

COMPLICATIONS OF PNEUMONIA

• Necrotizing pneumonia
• Lung abscess
• Lung infarction
• Cavitation
• Empyema
• Broncho-pleural fistula
• Interstitial emphysemaChronic Obstructive Pulmonary Disease (COPD) Clinical features Symptoms Diagnosis. Read more ... »
• PneumothoraxPneumothorax Symptoms Causes Diagnosis Treatment with emergency. Read more ... »
• ARDS
• Lung fibrosis
• Pleural adhesions.