PLASMA UNIVERSITY

Faculty of Nurse
Semester VII
Course Name
PATHOPHYSIOLOGY II

Lecturer : Dr: Ahmed Dheere Amc

MBBS , PLASMA UNIVERSITY
pneumonia
• Pneumonia is an acute respiratory infection of
the lunges. Is caused by bacteria, viruses, and
fungi.
• Most common cases pneumonia are caused
by bacteria, usually streptococcus pneumonia
(pneumococcal disease) but viral pneumonia
is more common in children.
• The lunges are made up of separate lobes.
• Three in the right lung and two in the left lung.
Pneumonia may affect only one lobe or may
be widespread in the children.
• Anyone can develop pneumonia but some
groups are at greater risk.
 High Risk for pneumonia
• Children
• People who have had heart disease
• People who have had diabetes
• Stroke people
• Ciggrate Smoking
• Malnutrition
• Alcoholism
• People aged 65 years or older
 Causes of pneumonia
Bacteria, Viruses, Fungi, protozoa.
Pneumonia can develop when a person breathes
In small droplets that contain pneumonia-
causing organisms.
It can also occur when bacteria or viruses that
are normally present in the mouth, nose, and
throat enter the lunges.
 Types Of Pneumonia
A. Community-acquired pneumonia(CAP) is the
respiratory infection of the lung that
develops outside of the hospital or health
care environment. It is more common than
hospital-acquired pneumonia.
• CAP is most common in winter and affects
about 4 million people a year in the U.S.
B. Hospital-acquired pneumonia(HAP) is
acquired when an individual is already
hospitalized for another condition. HAP is
generally more serious because it develops
in ill patients already hospitalized or under
medical care for another condition.
• Being on a ventilator for respiratory support
increases the risk of acquiring HAP.
• Health care-associated pneumonia is acquired
from other health care settings, like kidney
dialysis centers, outpatient clinics.
C. Lobar pneumonia :causes an inflammation of
one lobe of a lung and typically involves all
the airspaces in a single lobe.
• Most types of bacterial pneumonia are not
highly contagious. Even though it is possible to
spread bacteria from one person to another,
• Pneumonia typically occurs in people with risk
factors or weakened immune defenses when
bacteria that are normally present in the nose
or throat invade the lung tissue.
• Any kind of bacterial or viral pneumonia has
the potential to be contagious, but
mycoplasma pneumoniae and mycobacterium
tuberculosis(the cause of tuberculosis) are
two types of bacterial pneumonia that are
highly contagious.
• Breathing in infected droplets that come from
patients who are coughing or sneezing can
spread the disease to others.
 Sign and Symptoms
• Viral pneumonia tends to develop slowly over
a number of days, whereas bacterial
pneumonia usually develops quickly, often
over a day.
• Most people who develop pneumonia initially
have viral infection such as a cold or flu.
• If pneumonia develops, symptoms commonly
include:
• Fever , Chills , Shortness of breath
• Rapid breathing
• A worsening cough that may produce
yellow/green or blood mucus(phlegm).
• Chest pain when breathing or coughing- caused
by inflammation of the membrane that lines
the lungs.
 Pathophysiology
• Bacteria enter the lungs (from the throat or
nose, airborne droplets, or blood)
• Bacteria may invade the spaces between cells
and between alveoli.
• The macrophages and neutrophils inactivate
the bacteria. The neutrophils also release
cytokines.
 Cont.…
• This cause general activation of the immune
system. Leading to the fever, chills, and fatigue
• The neutrophils, and bacteria, and fluid fill the
alveoli. Resulting in the consolidation seen on
chest x-ray.
 4: Stages of pneumonia
Consolidation:
 occurs in the first 24 hours.
• Cellular exudates containing neutrophils,
lymphocytes and fibrin replaces the alveolar
walls become congested
• The infection spreads to hilum and pleura fairly
rapidly.
• Pleurisy occurs
• Marked by coughing and deep breathing
Red Hepatization.
• Occurs in the 2-3 days after consolidation
• At this point, the lungs became hyperaemic
• Alveolar capillaries are engorged with blood
• Fibrinous exudates fill the alveoli
• This stages is characterized by the presence of
many erythrocytes, neutrophils, fibrin within
the lveoli.
Grey Hepatization :
• Occurs in the 2-3 days after red hepatization
• This is an avascular stage
• The lung appears grey-brown to yellow
because disintegration of red cell, and
hemosiderin, the pressure of the exudates in
alveoli causes compression of the capillaries
• Leukocytes migrate into the congested alveoli.
Resolution:
• final stages of pneumonia(complete recovery)
the exudate in alveoli is digested by enzymatic
activity, and cleared by macrophages or by
cough mechanism.
 Investigations

• Full blood count : very high white blood cells

• Sputum culture
• Chest x-ray: shows consolidation
 Management

• The most important aspects of management

are oxygenation, fluid balance and antibiotic
therapy, in severe or prolonged illness,
nutritional support may required.
• Antibiotic treatment for pneumonia.
• Amoxicillin 500mg 3 times daily orally
• Clarithromycin 500mg twice daily orally or
erythromycin 500mg 4 times daily orally
• Ceftriaxone 1-2 g daily iv
 complications
• Pleural effusion
• Empyema
• Pneumothorax
• Prevention of pneumonia
• Current smokers should be stop
• Influenza and pneumococcal vaccination
should be considered in selected patients
 Cont.….
• Encouraging immunization against measles,
pertussis, H. influenzae type b are particularly
important in children .
Thanks For Listening
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