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Pneumonia

CNS Infections>

Mind Map branch: Pneumonia Pneumonia Classified by Etiology Agent Agent determines treatment Community Acquired pneumonia = Bacterial or Viral Bacterial Causes Alveoli to be filled with inflammatory exudate Consolidation or solidification of pulmonary tissue Predisposing conditions Age Chronic disease = DISH Congenital or Acquired immune Deficiency Decreased Splenic Function Morphology Pattern = Lobar & Lobular Pneumonia Most Important = Classification of Causative Agent and Extent of disease Lobar = Acute Infection w/Fibrinosuppurative Consolidation of entire lobe Stages Congestion Lung is Heavy, boggy and Red Vascular Engorgement Intraaveolar fluid with few Neutrophils Presence of numerous Bacteria Red Hepatization Massive amounts of Exudate with Red Cells, Fibrin, & Neutrophil Fill Alveolar Space Red, firm & Airless w/liver like consistency Gray Hepatization Red Cells Disintegrate Fibrinosuppurative exudate gives gray brown dry appearance Resolution Consolidated exudate digested by enzymes Produces granular, semifluid debris Resorbed, ingested by macrophages, coughed up or organized by fibroblasts Complications Abscess formation = Tissue destruction and necrosis Empyema = Spread of infection causing Fibrosuppurative exudate in pleura cavity Organization of exudate Bacteremic dissemination = to heart valves, pericardium, brain, kidneys, spleen and joints Major Symptoms Abrupt onset of High Fever Shaking Chills Cough production of mucopurulent sputum Agent Type Staphylococcus Aureus Cause of 2o Bacterial Pneumonia Children & Healthy Adults High Incidence of Complications Lung Empyema IV Drug Use (High Risk) Important cause of Nosocomial Pneumonia Streptococcus Pneumoniae (Aka Pneumococcus) Common Diagnose from Sputum Endogenous flora in 20% adults (false positive) Blood Culture (more specific) Penicillin Treatment Haemophilus Influenzae (G-) Pleomorphic Life Threatening acute lower respiratory tract infection & Meningitis Children Colonized in Pharynx Encapsulated = 5% Unecapsulated = 95% Pili on Surface Secretes factor that disorganizes ciliary beating Secretes protease degrades IgA High Mortality Rate Cause acute purulent Conjuctivitis Most common Bacterial cause of acute COPD Moraxella Catarrhalis Elderly 2nd most common Bacterial cause of acute COPD Pseudomonas Aeruginosa Most common cause of Nosocomial Infection Occurs in cystic Fibrosis Occurs in Neutropenic Patients Incases Vessels w/Consequent extrapulmonary spread Legionella Pneumophila Agent of Legionnaires disease Flourishes in artificial aquatic environment Water cooling tower Tubing system of domestic water supplies Transmitted by inhalation or aspiration Affects ppl with predisposing conditions Cardiac Disease Renal Disease Immunologic Diseas Hematologic Disease Organ Transplant Diagnosis by Legionella antigens in urine Diagnosis by positive fluorescent antibody test of Sputum Klebsiella Pneumoniae Frequent cause of (G-) Bacterial Pneumonia Affects debilitated and malnourished people Chronic Alcholoic Viral & Mycoplasmal (G- & need Sterols ie..Chol) Most Common Mycoplasma Pneumoniae Children and Young Adults Atypical Moderate Amt of Sputum No Physical finding of Consolidation Moderate Elevation of WBC Count Lack of Aveolar Exudate Other Viruses Influenza A & B Adenovirus RhinoVirus Rubeola Virus Varicella Virus Chlamydia Pneumoniae Coxiella Burnetti = Q Fever Causes (MAD) Malnutrition Alcholism Debilitating Illness DMG to respiratory Epithelium Predisposes to 2o Infection Morphology Patchy Pattern Involves Whole Uni-Bilateral Lobes Pleuritis Interstitial Nature of Inflammatory RxN Localized w/in Walls of Alveoli = Alveolar DMG Clinical Course Masquerade as Chest Cold Few Localizing Symptoms Cough Absent Low Mortality Rate Can Reach Epidemic Levels Major Manifestations Fever Headache Muscle Ache Pain in Legs 1 type of Pneumonia predisposes to another Hematogenous spread from one organ to another Chronic Patients acquire terminal pneumonia while hospitalized (null) Infection of lung parenchyma (many Causes) When defense mechanism impared Loss or suppression of cough reflex Injury to mucociliary apparatus Interference with phagocytic or bactericidal action of alveolar macrophages Pulmonary congestion and edema Accumulation of secretions Results when host resistance is low Chronic disease Immunological Deficiency Immunosuppressive agent treatment Luekopenia Virulent Infection

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Pulmonary Infection (Most frequent organ infection)

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