Azerbaijan

Medical
University

 Name: Zakarya Kamal Al-Sattouf

 Group: 180B
 Subject: Pneumonia and COPD
 Date: 10/3/2021
What is pneumonia?
Pneumonia is defined as inflammation of the substance of the lungs. It is
usually caused by bacteria but can also be caused by viruses and fungi.
Clinically, it usually presents as an acute illness with cough, purulent
sputum, breathlessness and fever, together with physical signs or
radiological changes compatible with consolidation of the lung However, it
can present with more subtle symptoms, particularly in the elderly.
Who is at risk for pneumonia?
Anyone can get pneumonia. However, the following groups are at the
highest risk:
•Adults ages 65 and older
•Children younger than age 2
•People with certain medical conditions
•People that smoke
What causes pneumonia?
•Bacterial pneumonia. This type is caused by various
bacteria. The most common is Streptococcus
pneumoniae. It usually occurs when the body is
weakened in some way, such as by illness, poor nutrition,
old age, or impaired immunity, and the bacteria are able
to work their way into the lungs. Bacterial pneumonia
can affect all ages, but you are at greater risk if you abuse
alcohol, smoke cigarettes, are debilitated, have recently
had surgery, have a respiratory disease or viral infection,
or have a weakened immune system.

•Viral pneumonia. This type is caused by various

viruses, including the flu (influenza), and is responsible
for about one-third of all pneumonia cases. You may be
more likely to get bacterial pneumonia if you have viral
pneumonia.

•Mycoplasma pneumonia. This type has somewhat

different symptoms and physical signs and is referred to
as atypical pneumonia. It is caused by the
 Clinical features The clinical presentation varies according to the immune state of the patient and
the infecting agent.

• Cough: this may be dry or productive; hemoptysis can occur. In pneumococcal pneumonia,
sputum is characteristically rust- coloured

• Breathlessness: the alveoli become filled with pus and debris, impairing gas exchange. Coarse
crackles are often heard on auscultation, due to consolidation of the lung parenchyma. Bronchial
breath sounds may be heard over areas of consolidated lung.

• Fever: this can be as high as 39.5–40°C. If swinging fevers are present, this often indicates
empyema

• Chest pain: this is commonly pleuritic in nature and is due to inflammation of the pleura. A
pleural rub may be heard early on in the illness.

• Extrapulmonary features : these are more common in certain infections and are not universal.
Sometimes the presence of these symptoms gives a clinical clue as to the
Extrapulmonary features of community-acquired pneumonia

• Myalgia, arthralgia and malaise are common, particularly in infections

caused by Legionella and Mycoplasma
• Myocarditis and pericarditis are cardiac manifestations of infection, most
commonly in Mycoplasma pneumonia
• Headache is common in Legionella pneumonia. Meningoencephalitis and
other neurological abnormalities also occur but are much less common
• Abdominal pain, diarrhoea and vomiting are common. Hepatitis can be a
feature of Legionella pneumonia
• Labial herpes simplex reactivation is relatively common in pneumococcal
pneumonia
• Other skin rashes, such as erythema multiforme and erythema nodosum, are
found in Mycoplasma pneumonia. Stevens–Johnson syndrome (see pp. 1383–
1384) is a rare and potentially life-threatening complication of pneumonia
Clinical types of pneumonia
Pneumonia is classified according to a different principles:

1. One classification system divides pneumonia into

• Community-acquired pneumonia (CAP)
• Hospital-acquired pneumonia (HAP)
• Ventilator-associated pneumonia (VAP)
• Aspiration pneumonia
1. According to a course of disease two main types exist: acute and chronic
Pneumonia
2. Due to nosological factors Pneumonia may be: Primary and Secondary;
3. According to size of involved area of lung tissue there may be. acinous,
lobular, segmental, polysegmental, lobar and total Pneumonias
4. According to clinical and morphological appearances Pneumonias may be
subdivided into: Parenchymatous Pneumonias, which include Lobar
pneumonia and Bronchopneumonia; • Stromal Pneumonias - Interstitial
pneumonias
How is pneumonia diagnosed?
Diagnosis is usually made based on your recent health history (such as surgery, a cold, or
travel exposures) and the extent of the illness. Based on these factors, your healthcare
provider may diagnose pneumonia simply on a thorough history and physical exam. The
following tests may be used to confirm the diagnosis:

1. Chest x-ray
2. Blood test
3. Sputum culture
4. Bronchoscopy
5. Chest CT scan
6. Plural fluid culture
 Lobar pneumonia
On the chest x-ray there is an ill-defined area of increased
Chest X-ray showing lobar pneumonia. density in the right upper lobe without volume loss.
The right hilus is in a normal position
General management
a) Oxygen. Supplemental oxygen should be administered to maintain saturations between 94%and 98%
(provided the patient is not at risk of carbon dioxide retention, due to loss of hypoxic drive in
COPD). In patients with known COPD, oxygen saturations should be maintained between 88% and
92%, normally with controlled oxygen via fixed-percentage delivery mask
b) Intravenous fluids. These are required in hypotensive patients showing any evidence of volume
depletion.
c) Antibiotics. The first dose of antibiotic should be administered within 4 h of presentation in
hospital and treatment should not be delayed while investigations are awaited.
d) Parenteral antibiotics should be switched to oral once the temperature has settled for a period of 24â€
‰h, provided there is no contraindication to oral therapy.
e) If patients fail to respond to initial treatment, microbiological advice should be sought and
alternative diagnoses considered (e.g. Staph. aureus pneumonia, which requires addition of
flucloxacillin, and possibly cover for MRSA infection)
How Is Pneumonia Treated?
Most people can manage their symptoms such as fever and cough at home by following these steps:
•Control your fever with aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or
naproxen), or acetaminophen. DO NOT give aspirin to children.
•Drink plenty of fluids to help loosen secretions and bring up phlegm.
•Do not take cough medicines without first talking to your doctor. Coughing is one way your body works
to get rid of an infection. If your cough is preventing you from getting the rest you need, ask your doctor
about steps you can take to get relief.
•Drink warm beverages, take steamy baths and use a humidifier to help open your airways and ease your
breathing. Contact your doctor right away if your breathing gets worse instead of better over time.
•Stay away from smoke to let your lungs heal. This includes smoking, secondhand smoke and wood
smoke. Talk to your doctor if you are a smoker and are having trouble staying smoke free while you
recover. This would be a good time to think about quitting for good.
•Get lots of rest. You may need to stay in bed for a while. Get as much help as you can with meal
preparation and household chores until you are feeling stronger. It is important not to overdo daily
activities until you are fully recovered.
If your pneumonia is so severe that you are treated in the hospital, you may be given intravenous fluids
and antibiotics, as well as oxygen therapy, and possibly other breathing treatments.
Sources:
https://www.mayoclinic.org/tests-procedures/chemotherapy/about/pac-20385033
https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy/chemothe
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https://www.healthline.com/health/chemotherapy#side-effects
https://cfch.com.sg/chemotherapy-side-effects/
https://en.wikipedia.org/wiki/Chemotherapy