Pneumonia By Kamran Uosargodha

PNEUMONIA Presented to: Abdul Malik Presented by: Kamran Gulzar

Contents           

Introduction Causes Pathogens Community Acquired Pneumonia Streptococcus pneumoniae Transmission Pathogenesis Symptoms Diagnosis Treatment Prevention

Introduction 

Pneumonia is a inflammatory illness of the lung. Frequently, it is described as lung parenchyma/alveolar inflammation and abnormal alveolar filling with fluid ( consolidation and exudation).

Causes 

Pneumonia can result from a variety of causes, including infection with bacteria, viruses, fungi, or parasites, and chemical or physical injury to the lungs. Its cause may also be officially described as idiopathic—that is, unknown—when infectious causes have been excluded.

Pathogenes Bacterias         

Streptococcus Pneumoniae Haemohilus inflenzae Morxella catarrhalis Legionella pneumophila Mycoplasma pneumoniae Staphylococcus pneumoniae Pseudomonas Pneumoniae Pneumocystis carinii Pneumoniae Klebsiella Pneumoniae

Viral pneumonia

  

Influenza virus Adenovirus Cytomegalovirus

Community Acquired Pneumonia    o o o  

CAP is the third most common cause of death due to infectious disease. According to WHO 3-4 million pepole die each year. Most common community acquired respiratory pathogens are Streptococcus Pneumonia Haemohilus inflenzae Morxella catarrhalis Streptococcus Pneumonia causes up to 70% of cases of CAP Streptococcus Pneumonia is the major cause of CAP , meningitis, otitis media, and sinusitis.

Streptococcus pneumoniae 



Gram-positive, lancet-shaped cocci Usually, they are seen as pairs of cocci (diplococci), but they may also occur singly and in short chains. When cultured on blood agar, they are alpha hemolytic. Individual cells are between 0.5 and 1.25 micrometers in diameter. They do not form spores, and they are nonmotile. Like other streptococci, they lack catalase and ferment glucose to lactic acid. Unlike other streptococci, they do not display an M protein, they hydrolyze inulin, and their cell wall composition is characteristic both in terms of their peptidoglycan and their teichoic acid. Surface Proteins: Five penicillin binding proteins (PBPs), two neuraminidases, Twelve CBPs and an IgA protease.

Streptococcus pneumoniae scanning electron micrograph of a pair of diplococci.

Transmission 

Humans are the natural host of pneumococci: there is no animal reservoir. Resistance is high in healthy individuals, and disease is most often when predisposing factors are present.

Pathogenesis 

The most important virulence factor is the capsular polysaccharide. In immunocompromised patient, inflammatory response and septic shocks are produced due to the activation of complement system. Complement system is activated by lipoteichoic acid.



Colonization and Invasion Pneumococci adhere tightly to the nasopharyngeal epithelium by multiple mechanisms and for some people, however, progression into the lungs or middle ear occurs. During invasion, the interaction between the bacterial cell wall choline and the host PAF receptor Gprotein contributes to a state of altered vascular permeability. In the lung, this leads to arrival of an inflammatory exudates.







 

Factors that lower the resistance and predispose person to pneumococcal infection includes Alcohol or drug intoxification or other cerebral impairment that can depress the cough reflex and increase aspiration of secretion. Abnormality of respiratory tract., bronchial obstruction and respiratory tract injury cause by irritants. Abnormal circulatory dynamic Certain chronic diseases such as sickle cell anemia and nephrosis.

Symptoms  

 

 

Cough with greenish or yellow mucus; bloody sputum happens on occasion Fever with shaking chills Sharp or stabbing chest pain worsened by deep breathing or coughing Rapid, shallow breathing Shortness of breath

Diagnosis 

  

Patient's symptoms and physical examination Chest X-ray Blood tests sputum cultures

Treatment 



The primaroy foccus of empiric therapy is S.pneumoniae. recent studies showed pathogens causing CAP are 98% susceptible to cefuroxime. Patients with mild pneumonia who are otherwise healthy are usually 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), sparfloxacin (Zagam), or gemifloxacin (Factive), moxifloxacin (Avelox) High-dose amoxicillin or amoxicillin-clavulanate, plus a macrolide antibiotic (azithromycin, clarithromycin, or erythromycin). Vancomycin is the drug of choice.ss

Prevention 



 







Wash your hands frequently, especially after blowing your nose, going to the bathroom, diapering, and before eating or preparing foods. Don't smoke. Tobacco damages the lung's ability to ward off infection. Wear a mask when cleaning dusty or moldy areas. Vaccines can help prevent pneumonia in children, the elderly, and people with diabetes, asthma, emphysema, HIV, cancer, or other chronic conditions: Pneumococcal vaccine (Pneumovax, Prevnar) prevents Streptococcus pneumoniae. Flu vaccine prevents pneumonia and other problems caused by the influenza virus. It must be given yearly to protect against new viral strains. Hib vaccine prevents pneumonia in children from Haemophilus influenzae type b.