Blog Blogger Investigation Nepal Pneumonia Sumit Dhakal Treatment


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
• Fever
• Tachypnoea ( rapid breathing)
• Cyanosis
• Hypotension ( Blood Pressure Low )
• Confusion
1)Bacterial• Streptococcus Pneumonia
2) Viruses
• Influenza
• Para Influenza
• Measles
Risk Factors• Smoking
• Alcoholism
• Asthma
• Liver Disease
Investigation(A)Chest X-ray
    • 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 microscopey

Figure credit : @wikipedia

Management [ Investigation + Treatment ]
•Oxygen Inhalation to maintain PaO2 > 8kpa
Antibiotic required currently recommended in uncomplicated and sever community acquired pneumonia.
•Amoxicillin 500mg X 8hours X orally
Instead of penicillin
•Clarithromycin 500mg X 12 hours X orally
•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 pneumoniaClarithromycin 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
•Lobar collapse due to retention of sputum
•Lung abscess
•Renal Failure
•Respiratory Failure


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