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    Pneumonia I Pathophysiology and Clin Presentation

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    sunilsohanlalgurjar
    Pneumonia is an infection of the alveoli that can be caused by viruses or bacteria. It presents as either typical or atypical based on symptoms and causative pathogens. Typical pneumonia often features lobar consolidation on imaging, is caused by bacteria like S. pneumoniae that appear on smears, and responds to antibiotics. Atypical pneumonia has a more subacute onset and unclear causes, presenting with diffuse infiltrates. Complications include pleural effusions, empyema, abscesses, and fibrosis.

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    Pneumonia I Pathophysiology and Clin Presentation

    Uploaded by

    sunilsohanlalgurjar
    18 views10 pages
    Pneumonia is an infection of the alveoli that can be caused by viruses or bacteria. It presents as either typical or atypical based on symptoms and causative pathogens. Typical pneumonia often features lobar consolidation on imaging, is caused by bacteria like S. pneumoniae that appear on smears, and responds to antibiotics. Atypical pneumonia has a more subacute onset and unclear causes, presenting with diffuse infiltrates. Complications include pleural effusions, empyema, abscesses, and fibrosis.

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    Pneumonia is an infection of the alveoli that can be caused by viruses or bacteria. It presents as either typical or atypical based on symptoms and causative pathogens. Typical pneumonia often features lobar consolidation on imaging, is caused by bacteria like S. pneumoniae that appear on smears, and responds to antibiotics. Atypical pneumonia has a more subacute onset and unclear causes, presenting with diffuse infiltrates. Complications include pleural effusions, empyema, abscesses, and fibrosis.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    18 views10 pages

    Pneumonia I Pathophysiology and Clin Presentation

    Uploaded by

    sunilsohanlalgurjar
    Pneumonia is an infection of the alveoli that can be caused by viruses or bacteria. It presents as either typical or atypical based on symptoms and causative pathogens. Typical pneumonia often features lobar consolidation on imaging, is caused by bacteria like S. pneumoniae that appear on smears, and responds to antibiotics. Atypical pneumonia has a more subacute onset and unclear causes, presenting with diffuse infiltrates. Complications include pleural effusions, empyema, abscesses, and fibrosis.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 10

    Pneumonia

    Group :- 403 A
    Name sunil Gurjar

    1
    Lower respiratory and pleural disease
    Pneumonia -- infection of alveoli
    (viral or bacterial)
    vs. Pneumonitis -- immune-mediated
    inflammation of alveoli
    Empyema: purulent
    exudate in the pleural
    cavity
    Bronchitis -- inflammation of
    bronchi, may be immune-
    mediated, e.g. asthma,
    COPD, or infectious (usually
    viral but can be bacterial)
    Abscess: circumscribed
    collection of pus within
    the lung parenchyma
    Bronchiolitis: inflammation
    of bronchioles (often viral
    but can be bacterial)
    2
    PNEUMONIA:
    CLEARANCE vs. COLONIZATION
    Microbes constantly enter airways but
    many factors prevent colonization:
    • mucous entrapment
    • ciliary clearance
    • immune surveillance
    • intact epithelial barrier
    • secreted factors such as:
    ‒ secretory IgA
    ‒ surfactant proteins (SP-a, SP-d)
    ‒ defensins

    Disrupting or overwhelming these defense mechanisms can allow microbes to colonize the
    lungs, resulting in PNEUMONIA 3
    Eff ects and patt erns of microbial colonizati on:
    w h e re a n d h ow infl a m m ati o n a p p e a rs ca n b e info r m ati ve
    Alveolar Interstitial
    • In alveolar lumen • Mostly in alveolar wall
    • Purulent exudate of • Mononuclear WBCs
    RBCs and PMNs • Fibrinous exudate

    Lobar pneumonia
    • lobar distribution
    • “typical” CAP
    • S. pneumo, H. flu.

    Bronchopneumonia Atypical pneumonia


    • patchy distribution • diffuse infiltrate w/ perihilar concentration
    • aspiration, intubation, • Mycoplasma, Chlamydophila, Legionella
    bronchiectasis • Respiratory viruses, e.g. influenza
    • Staph, enterics,
    4
    Pseudomonas
    Community-Acquired Pneumonia
    • Infection of the pulmonary parenchyma acquired from
    exposure in the community
    • Classically divided into “typical” and “atypical” syndromes:
    I. “Typical” CAP:
    • presents with “typical” severe, acute infection
    • infectious agent (usually S. pneumo or H. flu) is culturable/ identifiable
    • responsive to cell-wall active antibiotics
    II. “Atypical” CAP:
    • presentation is usually sub-acute
    • causative pathogens are difficult to culture/identify by standard methods
    • not responsive to penicillins 5
    Typical CAP presentati on
    History
    • Previously healthy with sudden onset of fever and shortness of breath
    Physical signs and symptoms
    • fever
    • tachycardia
    • tachypnea
    • productive cough with purulent sputum and possible hemoptysis
    • pallor and cyanosis
    • localized:
    − dullness to percussion
    − decreased breath sounds
    − crackles , ronchi , egophony (“E” -to-”A” change)
    Investigations
    • CXR showing lobar consolidation
    • CBC showing leukocytosis w/ left shift
    • Sputum sample contains neutrophils, RBCs; Gram stain may be positive
    depending on organism 6
    Typical CAP presentati on
    History
    • Previously healthy with sudden onset of fever and shortness of breath
    Physical signs and symptoms
    • fever
    • tachycardia
    • tachypnea
    • productive cough with purulent sputum and possible hemoptysis
    • pallor and cyanosis
    • localized:
    − dullness to percussion
    − decreased breath sounds
    − crackles, ronchi, egophony (“E-to-A” change)
    Investigations
    • CXR showing lobar consolidation
    • CBC showing leukocytosis w/ left shift
    • Sputum sample contains neutrophils, RBCs; Gram stain may be positive
    depending on organism 7
    Atypical CAP Presentati on

    • 32 YO healthy patient – one week of low grade fever,


    sore throat, and intractable cough
    • Minimal sputum production
    • Able to continue to work
    • No sick contacts, recent travel, or evidence of
    altered immune system
    • PE reveals a mildly ill-appearing patient with diffuse
    wheezes on lung exam
    • Primary care physician prescribes empiric antibiotics for
    CAP with complete resolution
    • “Walking pneumonia” syndrome

    8
    Complicati ons of pneumonia

    Pleural effusion
    • inflammation leads to exudation of
    fluid into pleural space
    • can compromise lung function
    Empyema
    • purulent exudate in pleural space
    • necrosis/breakdown of visceral
    pleura and/or spread of infection into
    pleura
    Pleural adhesions, lung fibrosis
    9
    Complicati ons of pneumonia

    Abscess / cavitary lesion


    • circumscribed focus of liquefactive
    necrosis within lung tissue
    • associated with necrotizing Staph or
    Strep infections or Gram-neg rods
    (e.g. aspiration)

    10

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