CLASSIFICATION OF

PNEUMONIA
KoumailYassine
6th year Doz1
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●Pneumonia is an inflammation of the parenchyma of
the lung.

- Most cases of pneunomin are

caused by microorganism.
- non infectious causes include
aspiration of food or
gastric acid foreign bodies
hydrocarbons and lipoid.
substances hypersensitivity
reaction and drug or radiation
induced pneumonitis.
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• Classification .
1 : Anatomical classification.
A – lobar pneumonia .
The consolidalion involves all or part of lobe
B – Bronchopneumonia
the consolidation involves scattered lobules
C - Interstitial pneumonia .
As in viral pneumonia where inflammatory .
Infiltrate involve mainly interstitial tissue between alveli.
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2 : Etiological classfication.
the cause of pneumonia in patient is often difficult to
determine because direct culture of lung tissue
invasive and rarely performed.
- culture obtained from upper respiratory tract or
sputum genenally not accurately.
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-Fungal.
Histoplasma capsulatum ➔ Bird bat contact
Cryptococcus neoformans ➔ Bird contact.
Aspergillus species ➔ Immunosuppressed.
Mucomycosis Immunosuppressed
➔ Coccidioides immitis
Blastomyces dermatitides
Rickettsial-

Coxiella burnetii ➔ Goat sheep cattle exposure

Rickettsia rickettsiae
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• Mycobacterial

Nycobacterium Tuberculosis ➔ Developed countries

Nycobacterium avium-inteacellulare ➔
Immunosuppressed.
•Parasitic
Pneumocystis Carini ➔ Immunosuppressed.
Steroid. Eosinophilic ➔ Ascaris .
Loeffler syndrom
•Non infectious causes
-Aspiration Of food.
-Gastric acid.
-foreign body.
-Hydrocarbon ➔ Kerosen
-Lipoid substances
- Aspiration of amniotic fluid.
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Age group Frequent Pathogens
Neonate <1mo Group B straptococcus – E coli
streptococcus Pneumoniae – H influeza.
1-3 mo Rsv . Influenza viruses para fluenza
febrile Pneu viruses – adenovirus
S. pneumoniae . H . influenza
Afebrile
Pneu Chlamydia trachomatis Mycoplasma
3 – 12 mo R.S.V
hominisInfluenza viruses para fluenza viruses adenovirus
cytomegalovirus.
S. pneumoniae H . Influenza Chlamydia trachomatis Mycoplasma
pneumoniae Group A straptococcus

2 – 5 yr Influenza viruses para fluenza viruses adenovirus S. pneumoniae

H . Influenza Mycoplasma pneumoniae Chlamydia pneumoniae
Group A straptococcus S . Aureus.

5 – 18 yr Mycoplasma pneumoniae S. pneumoniae Chlamydia pneumoniae

H . Influenza Influenza viruses adenovirus
> 18 yr Mycoplasma pneumoniae S. pneumoniae Chlamydia pneumoniae
H . Influenza Influenza viruses adenovirus.
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• Hospitalization of children with pneumonia
Age < 6 month-
- Sickle cell anemia with acute chest syndrom.
.- Multiple lobe involvement
Immunocompromised-
. Toxic appearance -
Sever respiratory distress-
.Requirement for
supplemental oxygen -
Dehydration -
.Vomiting -
.No response to oral
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• Recurrent pneumonia

-Hereditary disorder
Cystic fibrosis
Sickle cell disease

-Disorders of immunity
Aids
Bruton agammaglobulemia
Selective IgG subclass deficiencies
Common variable immunodeficiency syndrom
Sever combined immunodeficiency syndrom
-Disorders of leukocytes
Chronic granulomatous disease
Hyperimmunoglobulin E
syndrome Leukocyte adhesion
defect
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- Disorders of cilia
Immotile cilia syndrom
Kartagener syndrom

-Anatomic disorder
Sequestration
Lobar emphysema
Esophageal reflux
Foreign body
Tracheo esophageal fistula ( H type )
Gastroesophageal reflux
Bronchietasis
Aspiration ( oro pharyngeal in
coordination )
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•Viral pneumonia
usually result from spread of infection along the air way. Accompanied by
direct injury of respiratory epithelium resulting in air way obstruction from
swelling abnormal secretion and cellular debris small calibar of air way in
young infant makes them particularly susceptible to sever infection.
Viral infection predispose to secondary bacterial infection by disturbing
normal host defense mechanism altering secretion and modifying bacterial
flora.
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•Bacterial infection
In bacterial infection pathologic process varies according
to the invading organism
M . Pneumoniae attaches to
the respiratory epithelium inhibit ciliary action and
Lead to cellular destruction and an inflammatory
response in the submucosa
as the infection progresses sloughed cellular debris inflammatory cell and mucus
Cause airway obstruction with spread of infection occuriang along the bronchial
Tree as in viral pneumoia.

- S . Pneumoniae
Produce local edema that aids in the proliferation of organism and their spread
Into adjacent portion of lung often resulting in the characteristic focal lobar
Involvement
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-Grop A . Streptococcus
pathology Includes necrosis of tracheobronchial mucosa formation
-of large
amount of exudate edema and local hemorrhage with extension into
the Interalveolar septa and involvement of lymphatic vessel and pleura.

-S – aureus pneumonia
produces Toxin and enzymes as hemolysin coagulase
and staphylo kinase -
It causes broncho pneumonia often unilateral characterized
by prensence of
Hemorrhagic necrosis and irregular areas of cavitation of
lung parenchyma
Resulting in pneumatoceles empyema or broncho
pulmonary fistula
X-RAYS

Viral pneumonia x-ray

X-RAYS

(Lobar pneumonia x-ray (RUL

X-RAYS

bronchopneumonia x-ray
X-RAYS

Staph pneumonia x-ray