pneumonia part1
TRANSCRIPT
Definition
Syndrome caused by acute infection, usually bacterial
Clinical and radiological signs of consolidation
Pneumonitis – chemical , radiation
Classification
Anatomist Lobar, segmental, subsegmental,
Bronchopneumonia Empiricist’s
Community – acquired, Hospital-acquired, Aspiration, Immunocompromised host
Behaviorist’s Easy, Difficult
Pathogenesis
Predisposed by conditions that Reduces or suppresses cough Impair mucociliary activity Reduces phagocytic activity Impair immunoglobulin production
Factors that predispose to pneumonia Cigarette smoking Upper respiratory tract infections Alcohol Corticosteroid therapy Old age Recent influenza infection Pre-existing lung disease HIV Indoor air pollution
Investigations
Laboratory identification of infecting organisms Sputum Microscopy Sputum immunodetection Sputum culture Invasive methods for obtaining
respiratory secretions Blood culture
Investigations
Pneumococcal antigen detection Standard acute and convalescent
serological testing Newer microbiological technologies –
PCR Pleural fluid Chest radiography Arterial oxygen saturation and blood
gas analysis
Investigations
Other laboratory findings WBC counts Cold agglutinins – mycoplasma Biochemical abnormalities SIADH – hyponatremia Urine - serology
Differential diagnosis
Pulmonary infarction Pulmonary or pleural tuberculosis Pulmonary edema Pulmonary eosinophilia Malignancy: Bronchoalveolar cell
carcinoma Rare disorders – Bronchiolitis
obliterans organizing pneumonia (BOOP)