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PNEUMONIAPNEUMONIA
Prepared by
ASWATHI C K
3rd YEAR BAMS
What is pneumonia?
 Pneumonia
 Infection of the lungs.
 Alveoli fill with fluid and pus, making
breathing more difficul...
EPIDEMOLOGICAL DETERMINANTS
• AGENT FACTOR
Bacteria : Most common
Streptococcus pneumoniae
Streptococcus pyogenes
Legionel...
AGENT......
• There are more than 100 strains of
infectious agents identified, only a few are
responsible for the majority...
STREPTOCOCCUS PNEUMONIAE
• Gram-positive, alpha-hemolytic, facultative
anaerobic bacteria
• resides asymptomatically in th...
Reservoir
• Exclusively a human pathogen; no animal or
environmental reservoir
Carrier
• Carried in the nasopharynx of 40-...
HOST FACTOR
• Case fatality rates are higher in young
infants & malnourished children
• Rate more in children <5yrs & adul...
RISK FACTORS
Developing countries : overcrowded dwellings, poor
nutrition
low birth weight, intense indoor smoke pollution...
ENVIRONEMENT
• More common in winter & early spring
• Overcrowding
• Diminished host resistance
MODE OF TRANSMISSION
Direct transmission(person to person)
Normally by the airborne route(droplets)-
sneezing,coughing.......
 Most cases of pneumonia are spread
person-to-person by coughing out of
tiny droplets.
 Some pathogens can live in nose ...
PATHOGENESIS
• bacteria invade the spaces between cells
and between alveol
• macrophages and neutrophils attempt to
inacti...
TYPES OF PNEUMONIA
Pneumonia affects your lungs in two
Ways .
According to areas involved :
 Lobar pneumonia : affects a
...
LOBAR PNEUMONIA
BRONCHOPNEUMONIA
(Bronchitis and Pneumonia occur together)
CLINICAL MANIFESTATIONS
SIGNS AND SYMPTOMS
 High fever, Shaking Chills
 Shortness of breath (Dyspnoea)
 Increased breathing rate
 Chest pain w...
SIGNS AND SYMPTOMS
 Streptococcus pneumoniae: Rust-colored sputum
Pseudomonas, Haemophilus, and pneumococcal species:
May...
COMPLICATIONS
 Bacteria in the bloodstream (bacteremia)
 Lung abscess.
 Build up of fluid in the space between the lung...
DIAGNOSIS
• History taking and clinical assessment
• Physical examination
• X-ray findings of lobar consolidation
• Leukoc...
 PHYSICAL EXAMINATION
• Count the breath in one minute
• Look for chest indrawing
• Look & listen for stridor
• Look for ...
CONTROL
• Improving the primary medical care
services
• Developing better methods for early
detection,treatment & where po...
PREVENTION
• Better nutrition
• Reduction of smoke pollution
• Better MCH care
• Immunization
Measles vaccine
Hib vaccine
...
• Measles:
Dose : 0.5 ml age : 9th month
• Hib vaccine:
Dose : combined with DPT & polio myelitis
Age : 6,10,14th week
Boo...
PPV23(Pneumococcal Polysaccharide
Vaccine)
• protects against 23 types of pneumococcus
• Children under 2 yrs of age and ...
• Dose : 0.5ml(25microgrms of purified capsular
polysaccharide from each 23 serotypes)
• Site : intra-muscular ,deltoid or...
PCV(Pneumococcal conjugate vaccine)
• 2conjugate vaccines : PCV10 & PCV13
• 2 schedules 3 primary doses(3p+0)
2primarydos...
• 4-8 weeks or more b/w primary doses for
infants≥7 months
• 1 booster dose should be given between
9-15 months of age
• m...
TREATMENT
• COTRIMOXAZOLE
• IM injection of benzyl pencillin,ampicillin or
chloramphenicol
• very severe : provision of ox...
X-RAYS
Viral pneumonia x-ray
X-RAYS
Lobar pneumonia x-ray (RUL)
X-RAYS
bronchopneumonia x-ray
X-RAYS
Staph pneumonia x-ray
Pneumonia
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Pneumonia

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PNEUMONIA in preventive aspect based on PARK'S TEXT BOOK OF PREVENTIVE & SOCIAL MEDICINE

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Pneumonia

  1. 1. PNEUMONIAPNEUMONIA Prepared by ASWATHI C K 3rd YEAR BAMS
  2. 2. What is pneumonia?  Pneumonia  Infection of the lungs.  Alveoli fill with fluid and pus, making breathing more difficult.  Pneumococcal pneumonia  Caused by bacteria called pneumococcus (Streptococcus pneumoniae).  Can also be caused by other bacteria, viruses, fungi, parasites.
  3. 3. EPIDEMOLOGICAL DETERMINANTS • AGENT FACTOR Bacteria : Most common Streptococcus pneumoniae Streptococcus pyogenes Legionella pneumophila Klebsiella pneumoniae Virus : Respiratory syncycial virus Influenza A,B Parainfluenza 1-3 Adenoviruses Other agents Clamydia type B Coxiella burntti Mycoplasma pneumoniae
  4. 4. AGENT...... • There are more than 100 strains of infectious agents identified, only a few are responsible for the majority of the cases • Mixed infections with both viruses and bacteria may occur in up to 45% of infections in children • agent may not be isolated in approximately half of cases despite careful testing
  5. 5. STREPTOCOCCUS PNEUMONIAE • Gram-positive, alpha-hemolytic, facultative anaerobic bacteria • resides asymptomatically in the nasopharynx of healthy carriers
  6. 6. Reservoir • Exclusively a human pathogen; no animal or environmental reservoir Carrier • Carried in the nasopharynx of 40-70% of humans without symptoms. Portal of entry • Respiratory tract Infecting body parts • respiratory tract, sinuses, and nasal cavity
  7. 7. HOST FACTOR • Case fatality rates are higher in young infants & malnourished children • Rate more in children <5yrs & adults older than 75yrs • In developing countries,rate is highest due to malnutrition & low birth weight • In developed countries RI are less fatal
  8. 8. RISK FACTORS Developing countries : overcrowded dwellings, poor nutrition low birth weight, intense indoor smoke pollution Developed countries : school going children to - household  People with some medical conditions are at higher risk for pneumonia, including: heart disease, lung disease, diabetes, etc.  Smoking also increases risk of developing pneumonia.
  9. 9. ENVIRONEMENT • More common in winter & early spring • Overcrowding • Diminished host resistance
  10. 10. MODE OF TRANSMISSION Direct transmission(person to person) Normally by the airborne route(droplets)- sneezing,coughing..... INCUBATION PERIOD 1-4 Weeks
  11. 11.  Most cases of pneumonia are spread person-to-person by coughing out of tiny droplets.  Some pathogens can live in nose and throat without causing disease.  But when inhaled into lungs, they can cause pneumonia.  While many people are exposed to pneumococcus, usually only those with underlying health issues develop pneumonia.
  12. 12. PATHOGENESIS • bacteria invade the spaces between cells and between alveol • macrophages and neutrophils attempt to inactivate • neutrophils cytokines activate immune system fever, chills, and fatigue • neutrophils, bacteria, and fluid from surrounding blood vessels fill the alveoli, resulting in the consolidation
  13. 13. TYPES OF PNEUMONIA Pneumonia affects your lungs in two Ways . According to areas involved :  Lobar pneumonia : affects a section (lobe) of a lung.  Bronchial pneumonia (Bronchopneumonia) : affects patches throughout both lungs.
  14. 14. LOBAR PNEUMONIA
  15. 15. BRONCHOPNEUMONIA (Bronchitis and Pneumonia occur together)
  16. 16. CLINICAL MANIFESTATIONS
  17. 17. SIGNS AND SYMPTOMS  High fever, Shaking Chills  Shortness of breath (Dyspnoea)  Increased breathing rate  Chest pain when you breathe deeply or cough  Dusky or purplish skin colour (cyanosis) from poorly oxygenated blood  Fatigue and muscle aches  Nausea, vomiting or diarrhoea  Cough, particularly cough productive of sputum
  18. 18. SIGNS AND SYMPTOMS  Streptococcus pneumoniae: Rust-colored sputum Pseudomonas, Haemophilus, and pneumococcal species: May produce green sputum Klebsiella species pneumonia: Red currant-jelly sputum Anaerobic infections: Often produce foul-smelling or bad- tasting sputum Newborns and infants may not show any sign of the infection. Or they may vomit, have a fever and cough, appear restless or tired and without energy, or have difficulty breathing and eating. Older people who have pneumonia sometimes have sudden changes in mental awareness.
  19. 19. COMPLICATIONS  Bacteria in the bloodstream (bacteremia)  Lung abscess.  Build up of fluid in the space between the lung and chest wall (pleural effusion).  Difficulty breathing.  Shock and respiratory failure  Septic arthritis  Endocarditis
  20. 20. DIAGNOSIS • History taking and clinical assessment • Physical examination • X-ray findings of lobar consolidation • Leukocytosis • Bacteriological confirmation Sputam-gram staining & culture Blood culture
  21. 21.  PHYSICAL EXAMINATION • Count the breath in one minute • Look for chest indrawing • Look & listen for stridor • Look for wheeze • See if the child is abnormally sleepy or difficult to wake • Feel for fever • check for severe malnutrition • Look for cyanosis
  22. 22. CONTROL • Improving the primary medical care services • Developing better methods for early detection,treatment & where possible prevention • Education of mother
  23. 23. PREVENTION • Better nutrition • Reduction of smoke pollution • Better MCH care • Immunization Measles vaccine Hib vaccine Pneumococcal pneumonia vaccine
  24. 24. • Measles: Dose : 0.5 ml age : 9th month • Hib vaccine: Dose : combined with DPT & polio myelitis Age : 6,10,14th week Booster dose:12-18 months • Pneumococcal pneumonia vaccine a.PPV23 b.PCV
  25. 25. PPV23(Pneumococcal Polysaccharide Vaccine) • protects against 23 types of pneumococcus • Children under 2 yrs of age and immuno -compromised individuals does not respond • Recommended for selected groups - who have undergone splenectomy/sickle cell disease, chronic disease of heart,lung,liver,.....DM, alcoholism,generalized malignancies,organ transplant,....
  26. 26. • Dose : 0.5ml(25microgrms of purified capsular polysaccharide from each 23 serotypes) • Site : intra-muscular ,deltoid or as subcutaneous dose Protective capsular type specific antibodies develope by the 3rd week following vaccination minor adverse effects such as transient redness & pain at the site of injection occur in 30-50% cases
  27. 27. PCV(Pneumococcal conjugate vaccine) • 2conjugate vaccines : PCV10 & PCV13 • 2 schedules 3 primary doses(3p+0) 2primarydoses+1booster (2p+1) • (3p+0) : from 6 weeks of age interval : 4-8 weeks given at 6,10,14 weeks or 2,4,6 months • (2p+1) : 2 primary doses;as early as 6 weeks of age in infant-interval-8weeks
  28. 28. • 4-8 weeks or more b/w primary doses for infants≥7 months • 1 booster dose should be given between 9-15 months of age • mild reactions like erythema and tenderness in 50% of cases • HIV +ve and preterm babies : 3p doses in 12 month of age + booster dose in 2nd yr of life
  29. 29. TREATMENT • COTRIMOXAZOLE • IM injection of benzyl pencillin,ampicillin or chloramphenicol • very severe : provision of oxygen therapy IM injection of chloramphenicol IM of Cloxacillin & Gentamycin
  30. 30. X-RAYS Viral pneumonia x-ray
  31. 31. X-RAYS Lobar pneumonia x-ray (RUL)
  32. 32. X-RAYS bronchopneumonia x-ray
  33. 33. X-RAYS Staph pneumonia x-ray

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