Inflammation of the lung parenchyma is called pneumonia. Types:
*Lobar pneumonia *Bronchopneumonia In case of lobar pneumonia one or multiple
lobes of lungs are involved ! In case of broncho pneumonia, Only bronchus
of the lungs are involved! Now what are the factor predispose to pneumonia:
*Cigarette smoking *Old age *Upper respiratory tract infection
*Alcohol *HIV *Glucocorticoids therapy
*Recent influenza infection Organisms Responsible to pneumonia:
Bacteria: *Staphylococcus aureus
*Streptococcus pneumoniae *Micoplasma pneumoniae
*Legionella pneumophila *Clamydia pneumoniae
*Klebsiella pneumoniae *Haemophilus influenzae Viruses:
*Influenza, parainfluenza *Measles, Varicella
*Herpes simplex *Adenovirus , CMV Clinical Features:
(Symptomes) *Cough (Initially dry but later mucopurulent
*Fever (rigor, shivering, malaise) *Pleuritic chest pain
(Signs) On general examination: Patients is toxic,
ill looking, raised temperature, increased respiratory rate.
On Respiratory system examination: *On palpation: reduced chest expansion, increased
vocal fremitus. *On percussion: percussion node is dull.
*On auscultation: Bronchial Breath sound and inceased vocal resonance. Investigations:
Complete blood count: If bacterial neutrophilic leucocytosis, if
viral leukopenia. ESR And CRP: Raised.
Chest X ray: Radio opaque shadow with air bronchogram.
Sputum study: Microscopic and culture. Pulse oximetry: to see arterial oxygen saturation. Treatment:
#Uncomplicated community acquired pneumonia: amoxicillin 500mg 3 time daily orally.
#If patient is allergic to penicillin: Clarithromycin 500mg twice daily oraly
#If saphylococcusi is cultured or suspected: Flucloxacillin 1-2g 4 times daily i/v
plus, Clarithromycin 500mg twice daily i/v #Severe community acquired pneumonia:
Clarithromycin 500mg twice daily i/v plus,
Ceftriaxone 1-2 g daily i/v