Pneumonia

Pneumonia Chest X-ray

Chest X-ray

Pneumonia is an inflammatory condition of the lung affecting primarily the small air sacs known as alveoli. Typically symptoms include some combination of a productive or a dry cough, chest pain, fever, and trouble breathing.

Cause of Pneumonia:

  • Bacteria
  • Viruses
  • Less commonly by fungi and parasites

Bacteria:

These includes:

  • Streptococcus pneumoniae
    • In nearly 50% of cases
  • Haemophilus influenzae
    • In nearly 20% of cases
  • Chlamydophila pneumoniae
    • In nearly 13% of cases
  • Mycoplasma pneumoniae
    • In nearly 3% of cases

Viruses:

  • Rhinoviruses
  • Coronaviruses
  • Influenza virus
  • Respiratory syncytial virus (RSV)
  • Adenovirus
  • Parainfluenza
  • Herpes simplex virus (rarely)
  • Cytomegalovirus (Only after an organ transplant)

Fungi:

  • Due to AIDS
  • Immunosuppressive drugs
  • Histoplasma capsulatum
  • Blastomyces
  • Cryptococcus neoformans
  • Pneumocystis jiroveci
  • Coccidioides immitis
  • Histoplasmosis

Parasites:

  • Toxoplasma gondii
  • Strongyloides stercoralis
  • Ascaris lumbricoides
  • Plasmodium malariae

Diagnosis:

Physical exam:

Physical examination may sometimes reveal:

  • Low blood pressure
  • High heart rate
  • Low oxygen saturation

Imaging:

Chest X-ray

Management / Treatment:

Bacterial:

Antibiotics:

  • Amoxicillin
  • Doxycycline
  • Clarithromycin

Hospital-Acquired Pneumonia:

  • Cephalosporins
  • Carbapenems
  • Fluoroquinolones
  • Aminoglycosides
  • Vancomycin

Viral:

Neuraminidase inhibitors,

Prevention:

Vaccination

  • Influenza vaccines are modestly effective
  • Vaccination against Haemophilus influenzae and Streptococcus pneumoniae

Medications:

  • Amantadine
  • Rimantadine
  • Zanamivir
  • Oseltamivir

Others:

  • Smoking cessation
  • Reducing indoor air pollution
  • Hand hygiene
  • Coughing into one’s sleeve
  • Wearing surgical masks

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