- Bacterial Pneumonia
Overview
Etiology
Pathogenesis
Pathology
Clinical Symptoms
Diagnosis
Differential Diagnosis
Complications
Prognosis
Pneumonia is the second difference, lies in the etiology and management.
Etiology
Bacterial pneumonia, can be basically caused by all kinds of bacteria, but most are caused by streptococcus pneumonia (80%), staphylococcus aureus, haemophilus influenza, pneumonia klebsiela germs while others are very rare.
Pathogenesis
The bacteria enter the lungs through:
- Aspiration of secretions from the oropharyngeal
- Inhalation of fine granules sputum (droplet)
- Channels of blood from an outside source of pulmonary infection (haematogenous).
Pathology
Germ that enters the alveoli causes an inflammatory reaction that can spread through the process of Kohn and airways to the surrounding lung parenchyma.
These inflammatory cells to satisfy one segment of one lobe extends into the forming process of consolidation. This process causes lung tissue become dense and resembles a heart so called hepatization.
Particularly for infections caused by Staphylococcus aureus, where the infection process begins in the bronchioles and accompanied by focal necrosis and abscess formation, then spread to peribronchial will facilitate the emergence of pneumatokel. Germ staphylococcus aureus, in its distribution can also reach the lung tissue through the septic emboli.
Clinical Symptoms
Characterized by the presence of acute infection and pulmonary consolidation.
Usually there are circumstances that underlie the onset of acute infection, such as: advanced age,Chronic Obstructive Pulmonary Disease (COPD), diabetes, alcoholism, post-influenza etc..
Acute infection is characterized by:
Sudden high fever with chills. Body temperature can reach 40 degrees Celsius or more and accompanied by general symptoms such as malaise, weakness, weight and appetite loss.
Pulmonary inflammation characterized by:
Chest pain (pleuritic) in place processes, shortness of breath, cough with purulent sputum are sometimes mixed with blood.
Diagnosis
Diagnosis of a bacterial pneumonia based on:
1. History of disease, signs of acute infection that usually there are basically disease (see clinical symptoms).
2. Signs of lung consolidation, and the sick lung area found abnormalities in the form:
Inspection: left pulmonary respiratory movements, because the patient sought3. Laboratory:
withstand the movement of the sore area with your hands or a pillow.
Palpation: fremitus touched up. Palpable presence of pleural friction.
Percussion: the sound of overcast condition in accordance with the lobes or the appropriate boundary
with an area of the sore area.
Auscultation: breath sounds audible to the bronchial bronchovesikuler.
Sometimes the sound of extra breaths of crackles. Be accompanied
with positive bronchofoni and whispered voice.
Peripheral blood: leucositosis 15,000 - 40.000/ml.
Sputum: macroscopic, purulent blood mixed with or without microscopically, the painting looks gram positive cocci gram and / or gram-negative bacilli along with many types of Polimorfonukleus (PMN) leucocytes.
Chest X-ray photo: looks a gloom on one lobe and accompanied by a picture bronchogram air.
Differential Diagnosis
- Non-bacterial pneumonia
- Pulmonary tuberculosis, particularly tuberculosis pneumonia
- Non-infectious pneumonia
- Puffy Lung
- Pulmonary infarction.
Complications
- Coughing up blood
- Pleural effusion
- Empyema
- Lung Abscess
- Respiratory failure
- Acute Cor-pulmonale
- Septic Shock
Prognosis
- Community acquired pneumonia prognosis is good as long as not too late for treatment and receive adequate treatment.
- Hospital acquired pneumonia prognosis is worse, because bacteria are often resistant to various drugs (multi resistant).
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Pneumonia disease also affect cardiovascular system of the body that helps in transporting oxygen and removing carbon dioxide and many other function thus slowing down the body temperature and causing weakness.
Contagious Pneumonia