Pneumonia and it’s Etiological Classification
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Hello friends, I’m back, so in this video we will be understanding what pneumonia and its classification.
So how do we define pneumonia?
Pneumonia is the inflammatory condition primarily affecting the small air sacs known as alveoli, these alveoli are then filled up with pus or fluid, making it difficult to breathe.
Now let us come to know the classification!
How do we classify pneumonia?
So, it can be broadly classified into etiological and morphological.
But in this video, we will give a quick revision of the etiological classification
Coming to the etiological classification it is again classified into infective and non-infective:
Now infective, that means this is caused due to the infection by virus that is the viral pneumonia.
It can be caused by bacteria or the bacterial pneumonia, fungus or the fungal pneumonia and last the parasitic or the parasitic pneumonia.
Now about the non-infective causes:
It can be due to certain toxins which can cause pneumonia, chemicals and in case of aspiration.
This is all about the etiological classification, in the next video we will learn about morphological classification. thank you!
Morphological Classification of Pneumonia
Hello friends in this video we will come to know about the morphological types of classification
so, what are the morphological types?
Lobar pneumonia
If the bronchus area is affected, then it is bronchopneumonia.
If the interstitial lining is affected, then it is interstitial pneumonia.
Now on the basis of duration it can be divided into three:
The first is acute, second chronic and the third sub-acute.
Acute means when it subsides within less than 3 weeks of duration.
In case Chronic it takes more than 8 weeks, or it takes a longer duration.
In case of sub-acute it takes a duration of 3 to 8 weeks.
Now on the basis of clinical classification
It can be primary or secondary,
Primary can be either infective or non-infective it basically means no underlying pathology
Whereas in secondary the patient is having pneumonia due to underlying pathology.
Then the second which is typical or atypical which again falls under clinical classification.
Typical pneumonia is basically caused by the most common microorganisms like streptococcus pneumoniae.
Where Atypical pneumonia is basically caused by microorganisms not too common to cause, the examples can be mycoplasma pneumoniae.
And then the last one that is community acquired pneumoniae or hospital acquired,
Community acquired is when the disease is present outside the hospital or in a particular area / community, whereas hospital acquired means the disease present in the health care community or the hospital.
So, this is all about pneumonia and its classification Thank you!
Community Acquired Pneumonia
Hello friends, in this video, we will learn about the community acquired pneumonia in a little bit more detail. So, what do we mean by community acquired pneumonia?
It is the pneumonia contacted by the person outside the healthcare system. We call it cap as well, is the most common type of pneumonia.
Now coming to the microbiology.
It is classified into bacterial and viral
Now bacterial is subdivided into typical and atypical. so typical pneumonia as we have discussed earlier in the previous video, it is caused by most common bacteria like streptococcus pneumoniae which is the most common cause.
Second is Hemophilus influenzae
Third is streptococcus Aureus
Most common cause of hospital acquired pneumonia is pseudomonas aeruginosa.
And Atypical bacteria which causes bacteria pneumonia are mycoplasma pneumoniae, legionella pneumophila and chlamydia pneumoniae.
Now let us come to the Second cause which is viral.
They include influenzae virus, adenovirus, Human metapneumovirus.
So, this is all about community acquired pneumonia, in the next video we will look into the symptoms of pneumonia, Thank you!
Symptoms of Pneumonia
Hello friends in this video we will learn about the symptoms of pneumonia,
What are the symptoms?
The symptoms are:
.High grade Fever
.Sweating
Productive cough which is very important , we can see productive cough with sputum in community acquired pneumonia.
.pleuritic chest pain
.Dyspnea
.pain in deep inspiration
.headache
Tachycardia
shortness of breath
Nausea
Vomiting
abdominal pain
Seizures caused by legionella.
This is all about the symptoms of pneumonia, in the next video we will learn about the stages of pneumonia, Thank you!
Stages of Typical Pneumonia (Part-1)
Hello friends, in this video we will learn about the stages of typical pneumonia.
So, it basically has four stages:
They’re congestion, red hepatization, grey hepatization and resolution, but in this video, we will be discussing about the first two stages that is the congestion and Red Hepatization. So
Basically, these are the steps happening in the lungs:
The first step is congestion:
So, congestion happens in the first 24 hours to 1-2 days.
Intra alveolar fluid is present.
There will be vascular enlargement, numerous bacteria with small number of neutrophils will be present.
The second stage which is red hepatization:
It is also known as consolidation; it is present during three to four days.
Alveolar exudate is present in high amount
With increase in WBC and RBC along with the increase in neutrophils and fibrin.
Due to the increase in fluids, it causes a heavy look of the lungs.
In the next video we will learn about the remaining two stages: third and fourth
Thank you!
Stages of Typical Pneumonia (Part-2)
Hello friends in this video we will learn about the remaining two stages that is grey hepatization and resolution
So, starting off with the grey hepatization:
It is present during 5 to 8 days.
Now here the RBC starts to break down which leads to the change in color.
Now there is an increase in levels of fibrin and neutrophils. The level of fibrin is the highest in this stage.
Now coming to the last stage which is the resolution.
It occurs after 8 days.
Macrophages and various enzymes clean up the exudates in this stage.
So, this pathophysiology is caused by typical microbes, and we all know the most common is streptococcus pneumonia. As this effects a large part of the lung.
This is also the pathophysiology of lobar pneumonia.
So, this is all about the stages, Thank you!
Physical Examination
Hi friends I am back with another video , so In this video we will look into the physical examination of pneumonia :
.The patient will be having Tachypnea, that is checking whether the breathing is fast or slow
.crackles or pleural fiction rub that is we can listen to crackle like sound when we will try to listen to the lungs using sthethoscope .
. due to the present of exudates we can see flat percussion .
So, this is all about physical examination, in the next video we will be learning about diagnosis of pneumonia. thank you!
Diagnosis of Pneumonia
Hi friends let us come to know about the diagnosis of pneumonia in this video. So, how diagnosis can be done in case of pneumonia?
Both physical and clinical examinations are important here: Chest x-rays should be done to find the correct diagnosis.
It is required to rule out other lung conditions.
So, in case of lobar pneumonia, we can see only a particular lobe is affected, whereas in case of bronchopneumonia it is scattered. But in both the cases they’re present bilaterally. So, by doing CT we can find or differentiate.
Sputum culture via bronchoscopy is also important for the diagnosis of pneumonia.
Urine antigen test is important in case of pneumonia caused by S. pneumoniae and legionella pneumophilia.
So, this is all about diagnosis, in the next video we will learn about the treatment. Thank you!
Treatment of Community Acquired Pneumonia
Hello friends, I am back with another video, today we will be discussing about the last part of the community acquired pneumonia which is the treatment.
So, let’s get into the video,
Now if the patient is basically healthy and he had no antibiotics in the past three months:
The drug of choice here would be macrolide, which is clarithromycin 500 mg
and Azithromycin, 500 mg.
Or Doxycycline 100 mg.
And if the patient has used antibiotics in the past three months:
The drugs to be given here is Respiratory fluroquinolones, specifically moxifloxacin 400 mg
Gemifloxacin and levofloxacin.
Or we can give Beta lactam which is the combination of amoxiclav and macrolide.
Now in case of non-ICU patients we will start the treatment with Respiratory fluroquinolones like Moxifloxacin or levofloxacin.
Then we can give B lactam and macrolide as we have already read earlier.
Now if pseudomonas is suspected,
Beta lactam with macrolide plus meropenem is given.
Now moving on to the ICU patients.
B lactam with azithromycin is given or Fluroquinolones can be given.
If Streptococcus aureus is suspected
We can give B lactam with macrolides plus linezolid.
This is all about treatment, see you in the next video Thank you!
Hospital Acquired Pneumonia and its Types
Hello friends in this video we will be discussing about hospital acquired pneumonia and its types.
So, what do we mean by HAP?
It is also known as nosocomial pneumonia,
contracted by a patient inside the hospital of At least 48 to 72 hours after being admitted.
It is caused by bacteria basically.
So, hospital acquired pneumonia is further divided into two types:
The first type is ventilator associated pneumonia.
It occurs on people who are on mechanical ventilation.
And clinical symptoms are either absent or difficult to diagnose because patients are often sedated.
The microorganisms which can cause are pseudomonas aeruginosa, klebsiella pneumoniae and Acinetobacter.
So, this is all about the first type
In the next video we will be learning about the health care associated pneumonia, which is the second type.
Thank you!
Healthcare Associated Pneumonia
Hello friends in this video we will be discussing about the Healthcare associated pneumonia, that is the second type of HAP in a little bit more details.
Now it occurs in the patients who have frequent contact with the health care environment.
Basically, hospital workers or patients with frequent visits to the hospitals are at higher risk.
Who what are the causative organisms?
The first one is streptococcus aureus.
Second pseudomonas aeruginosa
And streptococcus pneumoniae
Last H influenzae
Also, the most important thing, most of the Hospital acquired pneumonia are due to the micro aspiration of the upper airway’s secretions through aspirations into the lower respiratory tract.
So, in the next videos we will be learning about how to treat HAP, Thank you!
Treatment of Hospital Acquired Pneumonia
Hello friends in this video we will be learning how to treat HAP?
So, let’s start with the video.
If the causative agent is pseudomonas, then the drug which is preferred is piperacillin tazobactam or meropenem can be given with amikacin.
Now if the causative agent is MRSA that is methicillin resistant streptococcus aureus, then we can add linezolid.
Now if the causative agents are pseudomonas or pneumococcus
Then we can give penicillin tazobactam or levofloxacin.
This is all about the treatment, Thank you!
