Pneumonias

types, classification, feature , treatment

1. PNEUMONIAS By- kajal sansoya

2. Defination Pneumonia is define as inflammatory with exudate solidification of the parenchyma, generally acute.

3. CLASSIFICATION By site By etiology By mode

4. BY SITE Alveolar or air space pneumonia or lobar pneumonia- Most common type, the organism causes an inflammatory exudate that involves many contiguous alveoli. Bronchopneumonia Inflammation restricted to the conducting airways, especially terminal & respiratory bronchioles & the surrounding alveoli.

5. Intestinal pneumonia Inflammation is confined to intralveolar septa.

6. BY ETIOLOGY Primary pneumonias Caused by some specific pathogenic organism. There is no pre-existing abnormality of respiratory system. Aspiration/secondary pneumonias Characterized by the absence of any specific pathogenic organism in sputum & the presence of some pre-existing abnormalities of respiratory system.

7. Suppurative / necrosting pneumonia In some cases complete healing does lung disease not occur, features are destruction of lung disease/ tissue by inflammation, abscess formation & fibrosis & bronchiectasis .

8. BY MODE Community-acquired pneumonia Indicates pneumonia occurring in a person in a community. Define as an acute pulmonary infection in a patient who is not hospitalised or living in a long-term care facility 14 or more, before presentation & does not meet the criteria for health care associated pneumonia.

9. NASOCOMIAL/HOSPITAL-ACQUIRED PNEUMONIA Indication the development of pneumonia after more than 48 hur . Of hospitalization. Most of occur outside ICU. Higher risk in patient on mechanical- ventiliation .

10. Pneumonia in immunocompromised host. Seen immunocompromised patient like neutropenic , HIV, maligancies . Health care associated pneumonia (HCAP) I nfection occurring within 90 days of a 2 day or longer hospitalization, stay in nursing home or within 30 days receiving IV antibiotic therapy haemodyalysis .

11. Pathological stages in development of pneumonia Stage of congestion Stage of red hepatisation Stage of grey hepatisation Stage of resolution

12. Clinical features Systemic- fever, rigors, shivering, malaise, headache. Pulmonary- dry cough, later expectoration of muccopurrelent sputum, rust colour sputum, upper abdominal tenderness, pleuritic chest pain.

13. Examination - high RR tachycardia crepitation in involved area 1-3 bronchial breathing. Investigation - blood count urea & electrolyte ESR blood culture serology cold aggulutinis LFT.

14. Treatment chart of pneumonia Types of pneumonia Antibiotic treatment Uncomplicated pneumonia Erythromycin 500mg/ 6hur clarithromycin Moderately sick patients require hospitalization Ceftriaxone 2g once/ day.I.V Severe sick patients Ceftraiaxone 2g once/day I.V Underlying disease piperacillin + tazobactam / cefeime

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