Lobar pneumonia

Student name : amro azrak

Group number : 43
Faculty : medicine
 introduction
 DEFINITION •“inflammation and consolidation of lung tissue due to an infectious agent” 
 Lobar pneumonia is an infection that only involves a single lobe, or section, of a lung.
 Etiology : the disease is caused mostly by pneumococcus and staphylococci; in children of
breast-feeding age quite often the pathology is of viral-bacterial etiology.
 the basic way of infection into the lungs is through the respiratory system from top to
bottom. The disease often develops as the complication of AVIR {after infecting the upper
and middle respiratory ways, the infection spreads into the parenchyma tissues of the
lungs). In children of breast-feeding age, the infection of the lung tissues can spread from
intestines, through the lymphatic system, to the lungs. The tissue destruction usually occurs
unilaterally, more often the right side (remember the anatomic features of bronchial tubes).
 In the bronchopneumonic pattern, foci of inflammatory consolidation are
distributed in patches throughout one or several lobes, most frequently bilateral
and basal. confluence of these foci may occur in severe cases, producing the
appearance of a lobar consolidation. Pleural involvement is less common than in
lobar pneumonia. Histologically, the reaction consists of focal suppurative
exudate that fills the bronchi, bronchioles, and adjacent alveolar spaces.
 stages
 Stage 1: Congestion
During the congestion phase, the lungs become very heavy and congested due to infectious
fluid that has accumulated in the air sacs
 Stage 2: Red hepatization
Red blood cells and immune cells that enter the fluid-filled lungs to combat the infection give
the lungs a red appearance. Although the body is beginning to fight the infection during this
stage
 Stage 3: Gray hepatization
Red blood cells will disintegrate during this stage, giving the lungs a grayish color. However,
immune cells remain, and symptoms will likely persist.
 Stage 4: Resolution
During the resolution phase, seniors may begin to feel better as immune cells rid their body of
infection. However, they may develop a productive cough that helps to remove fluid from the
lungs
complication

 Acute respiratory distress syndrome (ARDS)

 Fluid around the lung (pleural effusion)
 Lung abscesses 0 Respiratory failure (which requires a
breathing machine or ventilator) 0
 Sepsis, which may lead to organ
 Predisposing features
Reduced host defenses against bacteria
 Reduced immune defenses (Corticosteroid treatment, diabetes, malignancy)
 Reduced cough reflux (Post operative)
 Disordered mucocilliary clearance (Anesthetic agents)
Aspiration of nasopharyngeal or gastric secretions
 Immobility or reduced conscious level
 Vomiting, Dysphagia,
 Nasogastric intubation
diagnosis

 complaints: cough (dry, moist), cold (nasal catarrh), hyperthermia

up to 37,5-39°C, low appetite, weakness.
 External appearances: dyspnea, the pallor of the skin, perioral
cyanosis.
 Objective examination
 palpation — at superficial and deep palpation, changes are not found; there can be changes of voice
trembling.
 percussion: Comparative percussion : intermediate percussion sound due to the decreased amount
of air in alveoli,
 topographic percussion lungs edges have normal characteristics, respiratory mobility of the lower
borders of the Lungs is decreased on the affected side.

 auscultation of the lungs :

Breath is weakened or exaggerated
Rales can be dry and (or} moist (small, medium and course bubbling) — bronchi during pneumonia, as
a rule, are also affected; the pathognomonic sign is crepitation in the affected area.
 Chest x-ray : is a necessary measure for confirming the diagnosis
of pneumonia: on the X-ray infiltration is shown as localized
shadows with indistinct contours on the affected site
 Laboratory analysis :
 Blood analysis :elevated ESR , CRP(c-reactive
protein increased), leukocytosis (high granulocytes) ,
neutrophilia
 Shift of leukocyte formula to the left
 Sputum : mucopurulent , glass like with yellow traces ,
odorless , thick
 Treatment and cure
Treatment Goals of therapy:

Eradication of the offending organism.

Selection of an appropriate antibiotic.

To minimize associated morbidit

General approach to treatment

  Adequacy of respiratory function

 Humidified oxygen for hypoxemia
 Bronchodilators (albuterol)
 Chest physiotherapy with postural drainage
 Adequate hydration if necessary
 Expectorants such as guaifenesin
 SUPPORTIVE TREATMENT
 RESPIRATORY SUPPORT
 FLUID AND ELECTROLYTE REPLACEMENT
 TOTAL PARENTERAL NUTRITION
 OTHERS
ANALGESICS
CORTICOSTEROIDS
NOTROPICS
 PREVENTION
 PNEUMOCOCCAL CAPSULAR POLYSACCHARIDE VACCINE
 INFLUENZA VACCINE
 FOR NOSOCOMIAL INFECTION –
SURVEILLANCE
EDUCATION & AWARENESS
HANDWASHING
GOOD DISINFECTION
CONTROLLED USE OF ANTIBIOTICS
Thank you 