Pneumonia

Pneumonia - Inflammation of the lung parenchyma leading to pulmonary consolidation as the alveoli is filled with exudates.

Etiologic Agents:

• Streptococcus Pneumonia - causing pneumococcal pneumonia
• Hemophylus Influenzae - causing broncho pneumonia
• Diplococcus Pneumoniae
• Klebsella Pneumomiae
• Escherichia Pneumoniae
• Pseudomonas

High risk groups:

• Children below 5 years old
• Elderly

Predisposing factors:

• Smoking
• Air pollution
• Immunocompromised

           - AIDS
           > Pneumocystic carini pneumonia
           > Drug of choice Retrovir
           - Bronchogenic Cancer
           > Initial sign is non-productive cough
           > Chest X-ray confirms lung cancer

• Related to prolonged imobility (CVA clients), causing hypostatic pneumonia.
• Aspiration of fod causing aspiration pneumonia

Signs and Symptoms:

• Productive cough with greenish to rusty sputum
• Dyspnea with prolong expiratory grunt
• Fever, chills, anorexia, and general body malaise
• Weight loss
• Rales / crackles
• Bronchial wheezing
• Cyanosis
• Pleuritic friction rub
• chest pain
• Abdominal distention leading to paralytic ileus (absense of peristalsis)

Diagnostic procedure:

• Sputum Gram Staining and Culture Sensitivity - positive to cultured microoranisms
• Chest X-ray - reveals pulmonary consolidation
• ABG analysis - reveals decreased PO2 
• CBC - reveals increased WBC, erythrocyte sedimentation rate increased

Treatment:
If bacteria are causing the pneumonia, the doctor will try to cure the infection with antibiotics. It may be hard for your health care provider to know whether you have a viral or bacterial pneumonia, so you may receive antibiotics.

Patients with mild pneumonia who are otherwise healthy are sometimes treated with oral macrolide antibiotics (azithromycin, clarithromycin, or erythromycin).

Patients with other serious illnesses, such as heart disease, chronic obstructive pulmonary disease, or emphysema, kidney disease, or diabetes are often given one of the following:

• Fluoroquinolone (levofloxacin [Levaquin], gemifloxacin [Factive], or moxifloxacin [Avelox]) 
• High-dose amoxicillin or amoxicillin-clavulanate, plus a macrolide antibiotic (azithromycin, clarithromycin, or erythromycin)
• Cephalosporin antibiotics (for example, cefuroxime or cefpodoxime) plus a macrolide (azithromycin, clarithromycin, or erythromycin)

If the cause is a virus, typical antibiotics will NOT be effective. Sometimes, however, your doctor may use antiviral medication.

Home care:

• For fever - take aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or naproxen), or acetaminophen. DO NOT give aspirin to children.
• Do not take over the counter cough medicines without first talking to your doctor. Cough medicines may make it harder for your body to cough up the extra sputum.
• Drink plenty of fluids (water) to help loosen secretions and bring up phlegm.
• Get plenty of rest.