Pneumonia

Pneumonia is common and, depending on the etiology and general health of the patient, can be treated with outpatient antibiotics or require admission to the ICU. Patients with asthma, COPD, diabetes, CHF, renal failure, asplenic state (splenectomy or sickle cell patients), chronic liver disease, predilection for aspiration, malnutrition, recent hospitalization (< 1 year), and age >65 are at particular risk. In winter, influenza pneumonia (potentially severe and complicated by staphylococcal infection) and respiratory syncytial virus should be considered in adults and children, respectively. A history of occupational exposure to animals may suggest unusual but potentially severe forms of pneumonia, such as hantavirus (rodent droppings), plague (rodents), tularemia (rabbits), Q fever, or psittacosis (pet birds). Foreign body aspiration is particularly prevalent in patients under age 3 and involves food in 61 %. Tuberculosis (and respiratory isolation) should be considered in patients at risk for this disease.

Causes

• The most common cause of pneumonia is Bacterial pneumonias. Mostly the pneumonia may cause by the bacterium such as Streptococcus pneumoniae.
• Respiratory viruses may also cause pneumonia in young children, peaking between the ages of 2 and 3. By school age, the bacterium Mycoplasma pneumoniae becomes more common.
• Hemophilus influenza is a bacterium that often causes pneumonia in people who suffering from chronic obstructive pulmonary disease (COPD) or alcoholism.

Symptoms

• Cough
• Sputum production
• Pleuritic chest pain
• Fever
• Dyspnea/shortness of breath (less frequent in the elderly)
• Altered mental status

Signs

• Fever
• Tachypnea
• Tachycardia
• Diaphoresis
• Crackles
• Egophony
• Dullness to percussion
• Pleural friction rub
• Wasting
• Cyanosis
• Altered mental status
• Hypotension
• Decreased urine output
• Abdominal signs in elderly and the very young

Treatment

• You can use the antibiotics for the treatment of pneumonia such as penicillin, amoxicillin and clavulanic acid, and macrolide antibiotics including erythromycin, azithromycin, and clarithromycins.
• For the treatment pneumonia that are caused by Hemophilus influenza, useful antibiotics in this case are the second and third generation cephalosporins, amoxicillin and clavulanic acid, fluoroquinolones, moxifloxacin-oral, gatifloxacin-oral, and sulfamethoxazole and trimethoprim.
• You can also be treated Pneumonia at home with antibiotics by mouth. Steps that you can take at home such as drink plenty of fluids to help loosen secretions and bring up phlegm, get lots of rest, control your fever with aspirin or acetaminophen. Aspirin must NOT be given to children.