Internal Diseases – Part 1 (Rheumatology, Pulmonology, Phthisiatrics, Cardiology, Haematology) · MU Plovdiv
1. Pneumonias – pathogenesis , classification, clinical features, differential diagnosis
Inside: 25 sections · 3 labelled pictures · 8 tables · 29 flashcards · 23 min
Topic 6 of 68 in the MU Plovdiv syllabus for Internal Diseases – Part 1 (Rheumatology, Pulmonology, Phthisiatrics, Cardiology, Haematology) (Medicine, Year 4). The free AceMed note covers it in 20 sections, about 2,799 words (23 min of reading), with 29 flashcards.
In this note
- Essay 1- Pneumonias- Pathogenesis, Classification, Clinical features. Differential diagnosis
- Definition
- Classification
- Risk factors
- Pathogenesis
- Symptoms
- Physical examination
- How to differentiate between pneumonia and other respiratory tract infections
- Diagnosis
- Scoring
- DD
- Treatment
- Complications
- Etiology
- Clinical presentation
- Assessment of severity
- Treatment (overview — details in "Treatment of pneumonias")
- Prevention
- Hospital-acquired (nosocomial) pneumonia
- Pneumonia in immunocompromised patients
Definition
- Pneumonia is an infection of the lungs caused by bacteria, viruses, fungi and other microorganisms
- At least 2 of the following symptoms should be present:
- Fever
- Chills
- Cough with or without sputum production
- Chronic cough with change of sputum colour
- Pleural pain
- Breathlessness
- Signs of lung infiltrate on auscultation
- New infiltrate on CXR
Classification
Anatomical
- Lobar pneumonia
- Consolidation involves all or part of lobe
- Bronchopneumonia
- Consolidation involves scattered lobules
- Develops after bronchitis
- Interstitial pneumonia
- Infiltrate involves mainly interstitial tissue between alveoli
Etiological
- Bacterial:
- Typical- M.tuberculosis, Streptococcus, Staphylococcus, H.influenzae, K.pneumoniae
- Gram negative pneumonias are more common in the elderly
- Atypical- legionella, chlamydia, mycoplasma (they multiply intracellularly)
- Viral- SARS-CoV-2, RSV, adenovirus, infleunza viruses
- Fungal- Histoplasma, aspergillus, mucomycosis, blastomyces, candida
Mechanism of acquisition
- Community acquired pneumonia
- Hospital acquired pneumonia
- Aspiration pneumonia
- Health-care associated pneumonia
Risk factors
- Age over 65
- Recent antibiotics
- Immunocompromised patients
- Chronic respiratory illness (COPD or asthma)
- Diabetes mellitus
- Alcohol abusers
- Chronic liver and kidney disease
- Cancer
- Smokers
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