|Video: Pneumonia Overview|
Overview Types of pneumonia include lobar pneumonia (infection affects a whole lobe of a lung) and bronchopneumonia (affects the bronchioles through out a lung lobe). The infection is identified by the site of consolidation. Consolidation is where the lung tissue is filled with fluid (ie. water, blood, pus, microbes).
Classification by location acquired
- Community Acquired Pneumonia (CAP)
- Hospital Acquired Pneumonia (HAP) also known as Nosocomial Pneumonia
- Ventilator associated pneumonia
Classification by microorganism
- Typical bacterial pneumonia
- Atypical bacterial pneumonia
Classification by lung involvement
- Lobar pneumonia
- Pleural Pneumonia
Risk Factors for pneumonia include smoking, recent travel/antibiotics use, age and being immunocompromised.
Signs and Symptoms
|Cardinal symptoms: Cough (productive), Dyspnoea, Pleuritic chest pain, Fever.|
Examination findings include signs of consolidation on affect side and lobe
- Decreased chest expansion on affected side
- Dullness on percussion
- Bronchial breath sounds and whispering pectoriloquy +/- crackles/rales on site of consolidation
- +/- increase vocal fremitus and resonance
|S. pneumoniae||H. influenzae||S. aureus||M. pneumoniae||M. catarrhalis||Gram – Enterobacteriae||Klebsiella spp.||Legionalla spp.|
Management depends on where the pneumonia was acquired and what the causative agent is or might be. The standard is antibiotic therapy. However again, antibiotic therapy will depend on the most likely bacteria, patient co-morbidities, allergies and antibiotic resistance.
Assessment of severity
Some patients with mild illness, good social circumstances and no significant co-morbidities may be safely discharges with appropriate antibiotics, simple analgesia for pleuritic chest pain. Follow up with doctors.
For patients with a high severity score (CURB-65 or SMART-COP or PSI index) admission to hospital is advised.