Armando Hasudungan
Biology and Medicine videos

Pneumonia

Pneumonia

Summary of Pneumonia Pneumonia involves symptoms and sign of lower respiratory tract infections usually associated with chest x-ray abnormalities (consolidation). The majority of  causes is bacterial (80%). Finding on examination may show signs of consolation. Risk factors include smoking, young and old age and having an underlying respiratory disease. Treatment is antibiotic therapy.

 

Video: Pneumonia Overview

 

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).

types

Classification

Classification by location acquired

Classification by microorganism

  • Viral
  • Bacterial
    • Typical bacterial pneumonia
    • Atypical bacterial pneumonia
  • Fungal
  • Parasite

Classification by lung involvement

  • Lobar pneumonia
  • Broncho-pneumonia
  • Pleural Pneumonia

Risk Factors

RF

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.

Sands


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

PEx

Causative agent

  S. pneumoniae H. influenzae S. aureus M. pneumoniae M. catarrhalis Gram – Enterobacteriae Klebsiella spp. Legionalla spp.
Community-acquired Pneumonia
Hospital-acquired Pneumonia
Health-care Pneumonia

Investigations

ix

Management

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.

References

Best Practice
UpToDate
Toronto Essential Notes
Fishman’s Pulmonary Diseases and Disorders, 5e
Murray and Nadels Textbook of Respiratory Medicine – 2-Volume Set, 6e