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Pneumonia
Pneumonia
Introduction:
Pneumonia is defined as inflammation in the air sacs of lungs, which are called alveoli.It is
characterized by consolidation which is a pathological process in which alveoli fill with fluid or pus,
making it difficult to breathe.
Pathophysiology:
The normal function of alveoli is to exchange O2 and CO2 between the blood and external environment.
Bacteria or viruses usually cause pneumonia when they are breathe into lungs. The invading organisms
provoke an overly excited immune response in lungs. Due to inflammation of parenchyma & small blood
capillaries in lungs become leaky which drains inflammatory fluids into the alveoli .This results in a less
functional area for O2 and CO2 exchange. The patient becomes relatively oxygen deprived, while
retaining dangerous level of carbon dioxide. The patient breathes faster and faster, in an effort to bring
in more oxygen and blow off more carbon dioxide. Mucus production is increased, and the leaky
capillaries may tinge the mucus with blood. Mucus plugs actually further decrease the efficiency of gas
exchange in the lung. The alveoli fill further with fluid and debris from the large number of white blood
cells being produced to fight the infection.
Clinical features:
Viral pneumonia may start with flu-like symptoms, such as wheezing. A high fever may occur
after 12–36 hours.
Bacterial pneumonia may cause a fever as high as 105°F along with profuse sweating, bluish lips
and nails, and confusion.
Difficulty in breath because the air sacs are filled with inflammatory mixture.
Cough reflex with purulent sputum which is the normal response of lungs to clear up the lungs
from mucus.
Chest Pain. pleural cavity normally contains lubricating fluid that allows the two layers to slide
over each other when the pleura becomes inflamed, the layers rub together causing chest pain.
Confusion,mostly in elderly patients they may cough whole night but not bring up the mucus.
Fever & Sweating i.e 39.5-40°c which is the sign of an infection in body.
Chills ( called rigors).
Etiology:
A large number of organisms causes pneumonia such as;
1. Bacteria: most pneumonias are caused by pneumococcus spp commonest cause overall
ie. Streptococcus pneumoniae, Staphylococcus pneumoniae, Chlamydial pneumoniae,
Legionella spp.
2. Viruses: i.e Rhinovirus,Influenza virus,Varicella zoster virus.
3. Fungi: Candida species, Aspergilus species, mucur species.
4. Parasites: rare cases ie protozoa , toxoplasma.
5. In some cases of pneumonia there is an unknown cause.
Types of pneumonia:
The major types of pneumonia are classified by the cause of the infection.
1.Types by germs example bacteria,viral,fungal pneumonia
2.Types by Location example community acquired pneumonia ,hospital acquired pneumonia.
3.Types by how they are acquired example aspiration pneumonia , VAP pneumonia