1
Q
Definition
A
• Acute infective disease of lungs, characterized by homologous consolidation of one or more lobes
2
Q
CAUSES
A
- Pneumococcus / Diplococcus pneumonia
- Streptococcus / staphylococcus – less frequently
Frequent in winter and spring.
3
Q
RISK FACTORS
A
- Vial respiratory infections ( influenza virus )
- COPD, chronic heart failure
- Immunosuppression
4
Q
CLINICAL FEATURES
A
Onset Begins suddenly with rigor and fever ( 39-40) Consolidation Inflammation progress Febrile symptoms and tachypnea continue Resolution Patient improves. No dyspnea Lung begins to function Fever decrease as crisis. Collapse occurs during crisis
5
Q
COMPLAINS
A
Onset • Pleuritic pain- worsen by deep breathing / cough • Dyspnea • Cough • Fever • Severe weakness • Fatigue • Headache Consolidation • Cough w/ sharp pain in affected side • Sputum – rusty red , mucous-purulent
6
Q
PHYSICAL EXAMINATION
A
Onset • State – severe • Cyanotic lips • Tachypnea • Dusky flushed face • Tactile fremitus increased • Herpetic lesions on lips, neck , ears. • Pleural friction rub • Forced position – lie on affected side Consolidation• Still severe • Diffuse cyanosis • Tachypnea ( 35- 40/min) • Tactile fremitus increased • Diminished repiratory excursion. • Pleural friction rub
7
Q
PERCUSSION
A
Onset
• Decreased resonance
Consolidation
• Dull – affected side
8
Q
AUSCULTATION
A
Onset • Decreased vesicular breath sound • Crackles. • Pleural rub Consolidation • Bronchial character • Pleural rub
9
Q
CVS
A
Onset • Accelerated pulse Consolidation • Pulse rate (120-140) • Arryhthmia • Low bp • Diminished heart sounds Other systems; Hepatitis Nephritis Meningitis Slight jaundice
10
Q
BLOOD TEST
A
- Neutrophil leukocytosis ( to20-30x10^9/l)
- Increased ESR
- Positive blood culture
- Hypoxemia – poor aeration
- Alkalosis – hyperventilation
11
Q
SPUTUM ANALYSIS
A
- Early – rusty red
- Later – mucous-prulent
- Blood, pus corpuscle
- Haematoidin crystals
- Gram stain – positive
12
Q
XRAY
A
- Pulmonary tissue infiltration
* Dense consolidation
13
Q
TREATMENT
A
• Antibiotic therapy ;
Anti-pneumococcal antibiotics
Beta-lactam antibiotics
• Supportive measures; Analgesia and antipyretics Chest physiotherapy Oxygen supplement Respiratory therapy – bronchodilators Intravenous fluids
14
Q
COMPLICATIONS
A
- Pleurisy
- Myocarditis
- Acute respiratory failure
- Collapse, shock
- death
