Pneumonia

Pneumonia 

Pneumonia

Definition:

- Inflammation process of the lung parenchyma with a microbial agent. it's an acute illness characterized by a productive cough, pain and fever.

- The most common cause of death from infectious diseases.

- Classified according to the causative agent.

- Bacterial could be caused by radiation, ingestion of chemicals, and aspiration.

- Labour pneumonia: a substantial portion of one or more lobes is involved.

- Bronchopneumonia: pneumonia distributed in the patchy fashion. it originates in one, or more localized areas within the bronchi and extends to the surrounding parenchyma. it is more common than labour pneumonia.

Predisposing factors:

1- Conditions such as CA or COPD.

2- Decreased immunity.

3- Smoking: disrupts mucociliary, and macrophage activity.

4- Bed ridden patients.

5- Depressed cough reflex and aspiration of the foreign body.

6- Alcohol.

7- Unconscious pt. old pt. ( depressed cough reflex).

8- Other diseases (CHF, DM, COPD, influenza, cystic fibrosis).

Aetiology:

1- Viruses.

2- Rickessiea.

3- Bacteria – most commonly pneumonia ( diplococcus pneumonia ) is normally presented in the throat and Staphylococcus aureus.

4- Mycoplasma pneumonia.

Signs and symptoms:

1- Severe pain stabbing in the chest worsens by breathing and coughing.

2- Rapid increase in fever up to ( 39.5 – 40.5 ).

3- Shaking chills.

4- A Painful cough usually productive of rusty exudates sputum.

5- Increase resp. rate, shallow rapid breathing.

6- Orthopnea / dyspnea. cyanosis and restlessness.

7- If not treated delirium might occur.

Diagnostic tests:

1- History.

2- Physical examination.

3- Culture and sensitivity of sputum.

4- X-Ray studies.

5- CBC.

Treatment:

1- Antibiotics ( after Culture and sensitivity).

2- Supportive therapy:-

a- Bed rest.

b- Fluids.PO or I.V.

c- O2 therapy through a mask or nasal cannula.

d- Suctioning if needed.

e- Warm moist inhalation are helpful to decrease bacterial irritation.

3- Tracheostomy if the airway is obstructed by captious secretion.

4- Decrease fever by cold compresses and acetaminophen.

Complications:

1- Congestive heart failure.

2- Empyema ( collection of pus in the pleural space).

3- Pleurisy ( inflammation of pleura ).

4- Septicemia.

5- Atelectasis ( collapse of the lung tissue due to plugging of a bronchus by mucus).

6- Hypertension and shock.

7- Otitis media.

8- Sinusitis.

9- Bronchitis.



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