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Pneumonia WPS Office
Pneumonia WPS Office
Pathophysiology
The lung and tracheobronchial tree are usually sterile
below the level of the larynx, so an infecting agent must
reach this site via a breach in host defences. This may
be by micro-aspiration (which occurs
In around 45% of healthy individuals overnight),
haematogenous spread, direct spread from an adjacent
structure, inhalation, or activation of previously
dormant infection.
Aetiology
1. Streptococcus pneumoniae
2. Legionella pneumophilia
3. Staphylococcus aureus
4. Influenza
5. Mycoplasma pneumoniae
6. Chlamydophila pneumoniae
7. Coxiella burnetii (Q fever)
CAP: clinical features
• Fever
• Cough may or non ( Sputum)
• SOB
• Pleuritic chest pain
• Non-specific features in the elderly. May present ‘off
legs’ or with confusion, in the absence of fever.
Examination
Raised RR (may be the only sign in the elderly)
Tachycardia
Localizing signs on chest examination.
• Reduced chest expansion on the affected side,
• The signs consistent with consolidation (reduced air
entry, with bronchial breathing, reduced percussion
note, increased vocal resonance)
• crackles
A normal chest examination makes the diagnosis
unlikely.
Diagnosis of CAP
Symptoms and signs of an acute lower respiratory tract
infection
New focal chest signs
New radiographic shadowing, for which there is no
other explanation
At least one systemic feature (e.g. sweating, fevers,
aches, and pains)
No other explanation for the illness.