GANIBAN, GIL RAPHAEL L.

ADOLESCENTS GROUP
CASE: Community-acquired pneumonia in adolescents

Community acquired pneumonia (CAP) is defined as pneumonia acquired outside of

the hospital setting. Extensive studies of CAP in adolescents that characterize the true
incidence of various etiologic pathogens are not available. However, Streptococcus
pneumoniae, Mycoplasma pneumoniae, and Chlamydia pneumoniae appear to be the most
frequently encountered pathogens. These organisms often cause CAP in adults as well; other
infections are noted as well, including Legionella. Atypical pneumonia refers to pneumonia
not presenting with the usual clinical picture of pneumococcal infection which includes high
fever, productive cough, chills, and other classic features. The term is frequently used in
adolescents with CAP. However, this classification may not help in individual patients, who
often show a high degree of variability in the clinical presentation of pneumonia, also it does
not always predict microbial cause. There is currently a trend away from the concept of
atypical pneumonia syndrome and more discussion of atypical pathogens as commonly
causes of CAP. This article reviews recent literature on CAP with special emphasis on its
diagnosis and management in adolescent patients.
Prompt and effective treatment of pneumonia is also essential in order to decrease any
complication from occurring. These complications include pleurisy, atelectasis, pleural
effusion lung abscesses, bacteraemias, septicaemias and also death. If the patient deteriorates
and goes into respiratory failure, they may also require ventilation (Farrell & Dempsey 2013;
Watson 2008).
Treatment decisions in children with pneumonia are dictated based on the likely
etiology of the infectious organism and the age and clinical status of the patient. Antibiotic
administration must be targeted to the likely organism, bearing in mind the age of the patient,
the history of exposure, the possibility of resistance which may vary, depending on local
resistance patterns, and other pertinent history.
An important aspect of pneumonia treatment is oxygen therapy and maintaining
adequate oxygen saturation levels. Adolescents’ oxygen saturation levels should be above
93% with the oxygen concentrations also varying depending on the patient, their
comorbidities and severity of the pneumonia. Humidified oxygen therapy can also be used in
order to assist the patient with expectoration (Watson 2008). Oxygen supplementation is one
way to help patients who cannot breathe adequately on their own. Management of oxygen
supplementation is divided into nasal cannula and mechanical ventilation.
After initiating therapy, the most important tasks are resolving the symptoms and
clearing the infiltrate. With successful therapy, symptoms resolve much sooner that the
infiltrate
It takes a certain amount of time to start to feel sick after getting exposed to a germ.
This length of time is called the incubation period, and it depends on many things, especially
which bug is causing the illness. Despite advances in antibiotic treatment and prevention,
pneumonia, an acute infection of the pulmonary parenchyma, continues to have a significant
impact on adolescent health. Mortality remains low, but pneumonia is associated with
significant morbidity at considerable cost to our health care system. The first section of this
article focuses on general principles of pneumonia in adolescents, including epidemiology,
pathogenesis, etiology, clinical manifestations, radiography, laboratory evaluation,
management, complications, and prevention. The final section covers individual pathogens
associated with pneumonia in adolescents, including recent updates in diagnosis,
management, and prevention of these agents (Schlaudecker and Frenck, 2010). Smoke can
make pneumonia worse, so keep your home smoke free. If your child is very ill, or is less
than one year old, he’ll probably need to go to hospital for special treatment. In hospital, your
child will have antibiotics through a drip intravenously if the pneumonia is bacterial. Some
children also need oxygen to ease their breathing. Your child might also get extra fluids
through a drip.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to
all appointments, and call your doctor or nurse call line if you are having problems. It's also a
good idea to know your test results and keep a list of the medicines you take. If your doctor
prescribed antibiotics, take them as directed. Do not stop taking the medicine just because
you are feeling better. You need to take the full course of antibiotics to avoid getting sick
again. Take your medicines exactly as prescribed. For example, your doctor may have given
you medicine that makes breathing easier. Call your doctor or nurse call line if you think you
are having a problem with your medicine. Get plenty of rest and sleep. You may feel weak
and tired for a while, but your energy level will improve with time. To prevent dehydration,
drink plenty of fluids, enough so that your urine is light yellow or clear like water. Choose
water and other caffeine-free clear liquids until you feel better. If you have kidney, heart, or
liver disease and have to limit fluids, talk with your doctor before you increase the amount of
fluids you drink. Use a vaporizer or humidifier to add moisture to your bedroom. Follow the
directions for cleaning the machine. Dry air makes coughing worse. Do not smoke or allow
others to smoke around you. Smoke will make your cough last longer. If you need help
quitting, talk to your doctor about stop-smoking programs and medicines. These can increase
your chances of quitting for good. Take an over-the-counter pain medicine, such as
acetaminophen, ibuprofen , or naproxen. Read and follow all instructions on the label. No one
younger than 20 should take aspirin. It has been linked to Reye syndrome, a serious illness.
Be careful when taking over-the-counter cold or flu medicines and Tylenol at the same time.
Many of these medicines have acetaminophen, which is Tylenol. Read the labels to make
sure that you are not taking more than the recommended dose. Too much acetaminophen can
be harmful. If you were given a spirometer to measure how well your lungs are working, use
it as instructed. This can help your doctor tell how your recovery is going. To prevent
pneumonia in the future, talk to your doctor about getting an influenza vaccine every year.