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Pneumonia

Pneumonia. Zahra Raisi FY1. Plan of session. D efinition and classification E pidemiology C linical features A etiology M anagement (investigations and treatment) P rognosis and complications. D efinition: What is pneumonia?.

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Pneumonia

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  1. Pneumonia Zahra Raisi FY1

  2. Plan of session Definition and classification Epidemiology Clinical features Aetiology Management (investigations and treatment) Prognosis and complications

  3. Definition: What is pneumonia? “A 1. lower respiratory tract 2. infection, causing 3. fever and signs and symptoms in the chest with 4.radiological evidence of infection”

  4. Classification of pneumonia 1. Community acquired 2. Hospital acquired >48hours after hospital admission 3. Aspiration pneumonia Neuro e.g. Stroke, bulbar palsy. Alcohol 4. Pneumonia in the immunocompromised patient HIV/AIDS, organ transplant patients

  5. Epidemiolgy Who gets pneumonia? Elderly and children Is it common? Yes.

  6. Clinical features-symptoms Symptoms (infection—in the chest) Fever Unwell Confusion Short of breath Cough →productive of sputum → purulent ± haemoptysis Pleuritic chest pain

  7. Clinical features-signs Signs –of infection and consolidation Inspection Cyanosis Tachypnoea Tachycardia Hypotension Reduced oxygen saturation

  8. Clinical features-signs Palpation ↓expansion ↑vocal/tactile fremitus Percussion dull percussion note Auscultation Bronchial breathing Crepitations ↓air entry

  9. Aetiology Bacteria Fungi Viruses Community acquired-top three 1. Streptococcus pneumoniae (pneuomococcus) 2. Haemophilus influenzae 3. Mycoplasma pneumonia

  10. Management-Investigations

  11. Management-Investigations Blood tests Full blood count (FBC): ↑WCC C-reactive protein (CRP): ↑CRP Urea and electrolytes (U&Es): ↑urea ↑creatinine ↓Na Arterial blood gas (ABG): ↓O2 ↑lactate ↓pH Blood cultures

  12. Management-Investigations Sputum Culture and sensitivity Chest X-ray Consolidation Evidence of complications of pneumonia: cavitation, pleural effusion

  13. Management- treatment • Antibiotics • Analgesia • Hydration First assess severity –using CURB-65

  14. Management -treatment C-confusion U- urea >7mmol/l R-Respiratory rate>30/min B-systolic BP<90mmHg 65 –Age>65years 0-1 mild pneumonia, treatment in community with oral abx ≥3 severe pneumonia. Admit to hospital. IV abx IV fluids 2 moderate pneumonia – Admit. clinical judgement re: IV/PO abx

  15. Prognosis and complications Prognosis 10% in hospital mortality 30% if admitted to ITU

  16. Complications: Systemic complications Hypotension Sepsis Respiratory Failure

  17. Complications: Local complications Pleuraleffusion Pericarditis Empyema Myocarditis Pulmonaryabscess Atrial fibrillation

  18. Summary • Definition and classification • Epidemiology • Clinical features • Aetiology • Management (investigations and treatment) • Prognosis and complications

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