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Adult pneumonia, Pathophysiology
-pulmonary defence mechanisms…
Adult pneumonia
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Signs
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Pleuropneumonia
o Stand with elbows abducted, one leg further forward
o Pain on thorax palpation
o Tachycardia
Late
o Toxaemia > congested MM, tachycardia, fever
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Organisms
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Anaerobic bacteria
-Bacteroides spp., Clostridium spp.
-poor px
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Diagnosis
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US
o Look for bright white lines = pleura
o Ring down artefacts = suggest something at lung-pleural interface e.g. infiltrate
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Haematology & biochem
Acute = very nigh neutrophils, fibrinogen
Severe cases = electrolyte changes, azotaemia
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Tracheal aspirate
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Transtracheal = needle from outside through rings of trachea = good for culture as less contamination then from endoscope
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Treatment
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Antimicrobials
Initial broad spectrum e.g. penicillin, gentamicin, metronidazole
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Complication = pleural abscess
• Rib resection or intercostal incision
• Salvage – wont ever be elite athlete
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