Is a respiratory illness that causes inflammation of the lungs.

Can be casued by bacteria, virus and other cause agents

The area affected is the alveolar region of the lungs.

Also referred to as the parenchyma and often abnormal filling of fluid within the alveolar.

Pneumonia is a common illness among those who are chronically and terminally ill.

Vaccines are available for prevention.

The prognosis of the patiently largely depends on underlying conditions, current health situation, and possible or potential complications.

Bronchitis affects the bronchi and is a different diagnosis and different symptoms.

Alveoli – are sacs that fill with air and allow for respiration of oxygen

Symptoms:

   -    Cough
   -    Mucus production – with or without blood
   -    Difficulty breathing
   -    Shortness of breath
   -    Dyspnea
   -    Fever
   -    Chills
   -    Shaking
   -    Nausea
   -    Vomiting
   -    Chest pain
   -    Fatigue
   -    Decreased appetite
   -    Nasal congestion
   -    Headache

Complications:

   -    Hospitalization
   -    Breathing tubes
   -    Ventilator
   -    Respiratory failure
   -    Sepsis
   -    Shock
   -    Pleural effusion
   -    Empyema

Classifications of Pneumonia

1.)   Lobar pneumonia

     -    Only affects a single lobe
     -    May only be in a section of the lung

2.)   Multilobar pneumonia

     -    More than one lobe
     -    Is increasingly severe
     -    Increases complications

3.)   Interstitial pneumonia

     -    Inflammation and infections of the tissues between the alveoli.
     -    More often caused by Virus
     -    Can also be caused by “atypical bacteria”

4.)   Bronchial pneumonia

     -    Affects the lungs and tubes leading to the lungs
     -    Affects the bronchi and bronchioles

Causes:

Viral Pneumonia

-      Adenovirus
-      Influenza virus A & B
-      Respiratory syncytial virus (RSV)
-      Herpes Simplex virus
-      Parainfluenza virus   [children]
-      Cytomegalovirus
-      Varicella-zoster virus

Bacterial Pneumonia

Gram Positive

-      Streptococcus pneumoniae
-      Staphylococcus aureus

Atypical Pneumonia

-      Legionella pneumophila
-      Mycoplasma pneumoniae
-      Chlamydophila pneumoniae

Fungal Pneumonia

-      Histoplasma capsulatum     [Histoplasmosis]
-      Coccidioides immitis      [Coccidioidomycosis]
-      Blastomycosis
-      Cryptococcosis
-      Aspergillosis
-      Pneumocystis pneumonia – seen in immunocompromised and HIV patients
-      Sporotrichosis
-      Candidiasis

Parasite Pneumonia

-      Toxoplasma gondii
-      Ascariasis
-      Stringyloides
-      Hook worm

Pneumonia can be classified in two areas

1.)  Community-Acquired Pneumonia

2.)  Hospital-Acquired Pneumonia

Community-Acquired Pneumonia

   -    Acquired outside a hospital setting.
   -    X-ray is very important
   -    Blood sputum helpful

Hospital-Acquired Pneumonia

   -   Also called “nosocomial pneumonia”
   -   Acquired 72 hours or more after hospitalization
   -   Cause agents are often different
   -   On average – 5% of patients at hospitals will develop pneumonia
   -   Bacteria may be resistant such as:
                    .   MRSA
                    .   Pseudomonas
                    .   Serratia
                    .   Enterobacter
                    .   others

   -   May also be a result of a ventilator

Other types include:

1.)    Severe Acute Respiratory Syndrome
2.)    Chemical pneumonia
3.)    Aspiration pneumonia
4.)    Eosinophilic pneumonia
5.)    Dust pneumonia
6.)    Bronchiolitis obliterans organizing pneumonia  (BOOP)
7.)    Opportunistic pneumonia
8.)    Necrotizing pneumonia

Treatment:

Antibiotics for bacterial pneumonia

.        Amoxicillin  –  Strept treatment
.        Flucloxacillin  -  Staph treatment
.        Doxycycline  -  C. pneumoniae
.        Erythromycin  –  C. psittaci, Mycoplasma, Legionella treatment
.        Rifampicin  -  added for Legionella
.        Clarithromycin
.        Azithromycin
.        Fluoroquinolones

Hospital Acquired Pneumonia

Medicaion for viral pneumonia

.        Oseltamivir  -  is anantiviral drug

Antibiotics for bacterial pneumonia

.        Vancomycin
.        Ceftazidime  [Cefzim, Fortum]  -  antibiotic  -  Pseudomonas aeruginosa
.        Carbapenem  -  class of antibiotics
.        Beta Lactam –  class of antibiotics
.        Beta Lactamase Inhibitors- class of antibioitics

Antifungal for fungal pneumonia

Antifungal Medications

.         Fluconazole[Diflucan, Trican]
.         Itraconazole
.         Amphotericin B