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
 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
o Streptococcus Pneumonia
o Haemohilus inflenzae
o 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 G-
protein 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.