It is an inflammation of lung parenchyma, usually caused by bacteria and characterized by cough, productive sputum and fever.
a) on the basis of site of involvement
- lobar pneumonia
- interstitial pneumonia
b) on the basis of etiology
- secondary pneumonia (aspiration pneumonia)
Precipitating factor are upper respiratory tract infection, cigarette smoking. Alcohol, bronchial obstruction, immunosuppression and IV drug abuse.
- streptococcus pneumonia
- staphylococcus aureus
- Haemophilus influenza
- klebsiella pneumonia
- mycoplasma pneumonia
- respiratory syncytial virus
- Para influenza virus
- rhino virus
Clinical features of the pneumonia vary with the immune state of the patient.
i) history of upper respiratory tract infections
ii) high grade fever
iii) headache, malaise, vomiting
iv) cheat pain
v) cough (productive)
vi) rusty sputum
i) patient look ill
ii) rapid pulse and shallow respiration
iii) chest movement less on affected side
iv) pleural rub and crepitation
v) signs of consolidation
vi) dull note on affected side
i) Blood cp shows increased ESR, W.B.C.
ii) sputum culture for sensitivity to isolate the organism
iii) X-Ray chest may show homogenous opacity localized to affected side.
iv) Blood culture and sensitivity on fever spike
Antimicrobial drug should be given according to the results of the culture and sensitivity which include
- Ampicilllin 500 mg Q.I.D
- Co-trimoxazole(septran DS ) 500 mg B.D
- Erythromycin 500 mg Q.I.D
If patient is seriously ill then above drug regime should administered I.V.
- Inj pathedine 50-100 mg IM
- Tab dolobid 1 bd
- Tab ponstan 2 T.D.S
- Codeine tincture if unproductive cough
- Expectorant (syp. Hydrylin) if productive cough.
- to encourage the cough out sputum
Complications of pneumonia
- Lung abscess
- Pleural effusion
- Pulmonary fibrosis
- Septic shock
- Septic arthritis