Pneumonia

Initial Date Of Blog Posted : 2017/11/08

Pneumonia is acute inflammation of pulmonary parenchyma (parts of lungs involved in gas transfer)

Classification Of Pneumonia

• Community acquired pneumonia is in community

• Health care : nursing home, dialysis center, chemotherapy

• Hospital :- Hospital acquired pneumonia is acquired in hospital. If 48-72 hours Pneumonia patient is admission in hospital then it’s acquired in hospital

• Post operative pneumonia

• Aspiration Pneumonia

• Bronchopneumonia ( inflammation of lungs, arising in the brochi


Clinical Features Symptoms :

Fever
• Malaise (physical disorders)
• Anorexia (eating disorders)
• Headache

Signs :

• Fever
• Tachypnoea ( rapid breathing)
• Cyanosis
• Hypotension ( Blood Pressure Low )
• Confusion


Causes :

Bacterial
• Streptococcus Pneumonia

Viruses
• Influenza
• Para Influenza
• Measles

Risk Factors
• Smoking
• Alcoholism
• Asthma
• Liver Disease

Investigation

(A) Chest X-ray

Finding :-
    • Consolidation
    • Pleural Effusion ( Water on the lungs)
    • Lobar or multi Lobar infiltration


(B) Blood Test

•Full blood count
•Urea, electrolyte, creatine
•Liver Function Tests
•C-reactive protein
•Blood culture and sensitivity

(C)Sputum :-

For microscopy

Figure credit : www.wikipedia.org @wikipedia

Management [ Investigation + Treatment ] :

Oxygen Inhalation to maintain PaO2 > 8kpaAntibiotic required currently recommended in uncomplicated and sever community acquired pneumonia.

Uncomplicated

• Amoxicillin 500mg X 8hours X orally
Instead of penicillin
• Clarithromycin 500mg X 12 hours X orally
   OR
• Erythromycin 500mg X 6 hours X orally
If Staphylococcus is culture or suspected
• Flucloxacillin 1-2gm 6-hourly iv. Plus
• Clarithromycin 500mg 6 hourly orally

If  Mycoplasma is suspected

• Clarithromycin 500 mg 12 hourly orally or iv. Plus
• Rifampicin 600 mg 12 hourly iv in sever cases
Sever community acquired pneumonia •Clarithromycin 500 mg X 12 hourly iv or
• Erythromycin 500 mg X 6 hourly iv plus
• Co-amoxiclav 1.2gm X 8 hourly iv plus or
• Cefuroxime 1.5gm X 8 hourly iv or
• Amoxicillin 1gm 6- hourly plus
• Flucloxacillin 2gm 6 hourly iv
Streptococcus pneumoniae:Inj. Benzyl penicillin 1-2gm 6 hourlyComplications Of Pneumonia
• Para Pneumonia Effusion
• Empyema
• Lobar collapse due to retention of sputum
• Pneumothorax
• Lung abscess
• Renal Failure
• Respiratory Failure

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