13 Pneumonia
Lobar
- involves one or more lobes of lungs, ultimately entire lung
- currant jelly sputum
- currant jelly stool different (intussusception)
- 2: lung becomes to look like the liver, red
- exudates give lung red color
- gray: everything is dying
- 4: return to normal, regen, little scarring
Bronchopneumonia
.
- splotches everywhere instead of 1 lobe
- staph aureus, H. influenza, pseudomonas, moraxella, legionella
Legionella
Interstitial Pneumonia
- streaky white lines in both lung fields
- more benign
- pts not as sick
- atypical because not strep pneumoniae
- RSV: most common atypical in infants
- CMV: atypical with post transplant immunosuppression
- Influenza: elderly
- Coxiella: Q fever
- PCP: HIV
Influenza
- nonspecific symptoms
- damage mucociliary escalator
Mycoplasma
CMV
- clearing around dark material
RSV
- wheezing: infect and narrow the bronchioles
- CHD: can have life threatening disease if infected with RSV
PCP
Other Causes
Age
- neonates: same bug that causes meningitis, come from mother and passed to baby
- clinically, don't isolate bug, treat based on symptoms
- VAP: get while on ventilator
- levo usually just given because can treat all kinds of pneumonia
Aspiration
- anaerobic bacteria normally present in oral cavity
Symptoms
- chest pain on inhalation from stretching of pleura
- lavage: liquid solution, collect cells in lungs
ARDS
- same problem as pulmonary edema in HF but leaky vasculature instead of hydrostatic pressure
- set low TV and higher RR to compensate: less injury to lungs
Lung Abscesses
- aspirate anaerobes and cause abscess
- walled off area on imaging with fluid at bottom (pus)
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