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Pneumonia (Risk factors (cigarette smoking, URTI, alcohol, corticosteroid…
Pneumonia
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Types
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Suppurative pneumonia, aspiration pneumonia, and pulmonary abscess (others)
CAP
Clinical features
Symptoms:
:red_flag: fever
:red_flag: cough, chest pain, or shortness of breath
:red_flag: cough with or without sputum production
:red_flag: Fatigue
Signs
:red_flag: Fever
:red_flag: Tachypnea / Tachycardia
:red_flag: Increased pulse rate
:red_flag: Cyanosis present?
Chest examination
Inspection
:check: decreased volume R upper zone
Palpation
:check: decreased chest expansion
Percussion
:check: dull zones
Auscultation
:check: decreased breath sounds
Investigation
FBC: marker of infection severity, suggest bacterial infection
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CXR:
:tada: Lobar pneumonia: patchy consolidation of affected lobes
:tada: Bronchopneumonia: patchy shadowing
:tada: complications: pnuemonic effusion, pulmonary abcess
Management
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Intravenous fluid: for patients with low oral intake, and dehydrated
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HAP
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Management
goals focusing on adequate oxygenation, appropriate fluid balance, and antibiotics.
Antibiotic is given according to C&S mainly covering for broad spectrum Gram-negative bacteria, MRSA (vancomycin), and antipseudomonal
Others
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Suppurative pneumonia (SP): characterised by destruction of lung parenchyma by inflammatory process, although microabscess formation is a characteristic feature of pulmonary abscess (PA) referring to the lesion in which a large localised collection of pus or cavity lined with inflammatory cells.
Occurs when an infection of the lung parenchyma causes lower respiratory symptoms, and a pulmonary infiltrate is detected on a chest radiograph