Identifying The Most Common Types of Pneumonia

types of pneumonia

Hi guys, this is Mubeen we are talking about the respiratory pathology within that we are covering pneumonias this particular lecture we will introduce the pneumonia the definition the classification of pneumonia

and then various pathogens that are involved in causing pneumonias in various settings and

then we would discuss those one by one in our next lectures so let's start first of all the

definition of pneumonia pneumonia is broadly termed as anything any infection of the lungs

 is called pneumonia that is a broadest definition that we can go with now classification

understand one thing that for the classification what is important is not to remember the

classifications but what is important is that you as a doctor be able to treat the patient and for the treatment of pneumonia it is important that you can quickly empirically start the

treatment for that out of all of these classifications what is important is to understand what is

 the clinical setting what is the setting in which the patient became sick did the patient move

around in the community for example did he go to school or office and came back and became sick or was the patient admitted in a hospital and became sick over there or got pneumonia

over there does a patient work in military and got pneumonia there or is the patient an

alcoholic or immune compromised and so on these settings give you clues for the type of

pathogen faster than trying to understand the other classifications so keep this in mind you

have to see where the patient was you have to try to establish that to start the antibiotic

certain treatment quickly of course the culture and the right understanding of the right
pathogen is most important so let's start first of all clinical classification of pneumonia

clinically pneumonia can be classified into acute which of course means an immediate

infection which needs attention fulminant which is also sort of acute and is really dangerous

can progress and cause death I actually had a patient in hospital brought to me I was working

in the emergency room patient was brought in child and by the time they put the patient on my bed and by the time I reached the patient the child expired and he had pneumonia so

fulminant ammonia is very dangerous and then the chronic chronic pneumonia so these are

the clinical classification again does it tell you that what is the treatment and how to

approach the patient not really it just tells you that how urgent it is that you start working

with the patient histologically the pneumonia can be divided in were multiple types of pictures

 one type is where the alveoli so if I make let's make a respiratory system here and let's say

this is the alveoli so let's say these are the alveoli inside the alveoli one histological picture is

 that we have lots of fibrin ER so that is fibrous fibrin fibrin or purulent so lots of exudate is

present coifs is present if I bring a purulent consolidation of the lung alveoli is present
so al Villa al villas is filled with pus and fibrin and other inflammatory proteins and structures

and cells that is one then it is possible that alveoli are actually empty but the septum the

interstitium the parent Kaymer of the lung is inflamed normally it is the atypical pneumonia

this is very dangerous as well because you would not see patient having cuff and pus and

sputum and you might actually ignore it while the patient has lots of damage going on within the lungs interstitial so into a typical pneumonia what is more common here mostly it is

caused by the viruses and that means mononuclear cells will be very common presence in this

 one then the third type histologically is the chronic pneumonia where there is continuous

destruction of the lung tissue and there are big cavities and abscesses and granulomas that are present for example tuberculosis and other such things Aspergillus and candidiasis so

granuloma granuloma necrosis cavitation etc present in the chronic so histologically you

might see a pattern from here to here you might see pus you might see atypical pneumonia or interstitial inflammation or you might see in the chrony cases the granulomas then is

anatomic and radiographic classification what is that very commonly seen so here there are

two basic types of that one type is where more than one lobes of the lung are consolidated or

affected by pneumonia more than one lobe so that is called bronco braum for pulmonary

pneumonia on the other hand if only one lobe is involved if just one lobe is involved then it is

 of course called lobar pneumonia now does it help is it useful is this setting useful if I if I have

 a patient that comes to you and I tell you that hey this patient has lobar pneumonia versus
broke up on orede does that as a doctor help you the only one help this gives you is that lobar

 pneumonia 90% of the cases are biased Raptor caucus pneumonia that's it otherwise nothing

 much other than you being able to see look at the radiograph and say well I think this is a

lobar pneumonia or I think it is a broke open one in pneumonia alright so not much use other

than 90% of the lobar pneumonia being streptococcus pneumoniae clinical setting this is the

 most important classification or syndrome which you should be working with so I'm gonna go

and work here to represent various pathogens that are that cause pneumonia in various

settings and then we'll discuss them one by one so let's start there are seven settings these are called seven pneumonia syndromes first is community communities schools offices

workplaces running around in the bazaars and shopping malls and so on so these are all

community areas over there the most the pneumonia is there or caused by interacting with

others are divided into two types one are called typical and the other one are a typical typical

 pneumonias as we discussed over there here these are the mu copula or fabrina purulent

diseases with the consolidation of the alveoli and the lungs a typical are where the lung

interstitium is inflamed but the alveoli are mostly clear so here typical pneumonia is usually

caused by streptococcus pneumonia or pneumococcus him awfulest influenza remember this

 hi by him Oh him Oh Phyllis influenza in flames here and causes the upper respiratory tract

infections can cause pneumonia as well and then lower is the parainfluenza virus especially in the children then is the Legionella of course people who are gathered around in some

community event and there is water coolers or there is air mist in the on the vegetable racks in the shopping malls and so on so related to the moist areas and community gatherings

Legionella moxa cellar is another that is very common and especially in the COPD patients

patients with the chronic obstructive pulmonary disease it is very common occurrence layer it

causes acute exacerbation in the patients with the co pd's staph aureus another thing in the

community acquired is the alcoholics can develop Klebsiella pneumoniae more commonly and

 the Klebsiella pneumoniae how do you figure that out your steps or the patient when when he comes in he would have currant jelly red currant jelly like butum so very thick jelly like

sputum and the reason for that is that Klebsiella produces a lot of Vizard capsular you know

secretions which look like jelly so red currant jelly is the the verbage is the words that will be

used in your question now a typical pneumonias that is the interstitial pneumonias are mostly

by the viruses but of course other pathogens bacteria also involves mycoplasma is involved
chlamydia are involved rocks a lab but Nettie or the Q fever pathogen bacteria is in on the

virus's side respiratory syncytial virus in children parainfluenza in children influenza A and B

in adults specially in the in the older age and then add no virus in the military folks of the

 people who are working in the military military barrack somehow have prevalence of Edna

 virus so a typical mostly viruses and some bacteria as well now let's say the person got

admitted in a hospital so now we are at a nosocomial situation inside the hospital nosocomial pneumonias most of these are gram-negative rods and Klebsiella is very common equalised

common Pseudomonas is common and of course I'm sure that you have heard about staph

aureus from which the MRSA methyl ethyl saline resistant staph aureus is very common as

well important thing here is alcoholics once again inside the hospitals or other folks who are

bedridden and maybe have a stroke and are unconscious they might espy rate their

oropharyngeal secretions that would have oral flora so oral flora would also cause pneumonia

in the people who are aspirating that may be alcoholics they are spirit more often than others and secondly people who are bedridden because of strokes so in them bhakti right by rotella

use the bacterium staff streptococcus pneumoniae streptococcus staphylococcus aureus and

Pseudomonas are kind of the pathogens Candida is also involved as well if we go for the

hospitals ventilators are the most dangerous things patients on the ventilators have the

highest propensity to develop pneumonias because of he knows a Kamiel setting another

group of patients that develop pneumonia is very commonly are a splenic patients so patients

who have developed damage to the spleen may be sickle-cell disease which has caused spleen damage we'll discuss these very very much in detail later on one by one I just want to

introduce what are the pathogens so a splenic patients or patients who spleen have been

removed over patients whose spleen has become damaged and non-functional all of those

cases a splenic patients would have capsular pathogens will be more prevalent in them and
because spleen has the largest mass of macrophages and the macrophages present here filter

out the blood from the capsular pathogens and so when the spleen is not present those

capsular pathogens just run around and cause pneumonias and other infections for example

Klebsiella is very common in these patients streptococcus pneumoniae is very common and so they get repeated pneumonia and such infections so that is its planning patients if we

continue here chronic pneumonia pneumonias so chronic nocardia actinomycetes and micro

bacterium tuberculosis these are the pathogens that can cause chronic pneumonias which will

then means that they can cause neck necrosis of the lung tissue cavitation of the lung tissue

and granuloma formations for example with the micro bacterium then specifically necrotizing

pathogens that can cause necrosis Klebsiella is very very important streptococcus pyogenes is

 very important pneumonia is very important and staph aureus is very important so these can again cause necrosis and then cavitation and finally the seventh syndrome is the

immunocompromised patients that may be patients with HIV that may be patients who you have kept immunocompromised because of the therapy or or such other situations so

immunocompromised patients have common pneumonias with with the fungi so if you see

here cytomegalovirus Pneumocystis gr / c Mycobacterium avium candidiasis and aspergillosis

is common pneumonia types that affect immunocompromised patients so here is a patient
whose cd4 cell is running away so he's immunocompromised so these are this seven

pneumonia type and why are they clinically important well if you know this letting the

syndrome then you can very quickly when and very reasonably figure out or suspect what kind of pathogen may be involved and you can immediately start treatment till you get further

workup done and figure out what is the exact pathogen involved who thank you very much. next Top Powerful And [Easy Steps] To STOP and Cure Fever

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