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Pneumonia (Symptoms (Malaise, Rigors, Fever, Anorexia, Dyspnoea, Cough,…
Pneumonia
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Investigations
Blood tests: WBC count is a marker of severity, CRP, blood cultures
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Chest X-ray: lobar or multilobar infiltrates, pleural effusion,
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Severity
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Score 2 = admission, 3+ indicates mortality + ITU
Vaccine
Chronic heart, liver, renal or lung conditions
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Contraindications: pregnancy, lactation, fever
Pathophysiology
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A pro inflammatory response occurs which attracts neutrophils, recruited to kill the bacteria
However in some infections, the macrophages ability to kill becomes overwhelmed
Results in dead bacteria + dead neutrophils + tissue fluid + inflammatory proteins = inflammatory exudate/pus in alveoli
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Aetiology
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Aspiration
Stroke, myasthenia, bulbar palsies, decreased consciousness, poor dental hygiene, oesophageal disease
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Community Acquired (CAP)
The rest of cases are caused by staph.aureus, legionella spp, chlamydia and moraxella catarrhalis
Rare causes: gram -ve bacilli, anaerobes
Most common is strep. pneumoniae, then H.influenzae + mycoplasma pneumonia
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Treatment
Severe CAP
If there is s.aureus, add flucloxacillin IV
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