Pneumonia refers to infection & inflammation of the lung tissue / parenchyma.
Pneumonia is an infection
that inflames the air sacs in one or both lungs. The air sacs may fill with
fluid or pus (purulent material), causing cough with phlegm or pus, fever,
chills, and difficulty breathing.
A variety of organisms,
including bacteria, viruses and fungi, can cause pneumonia.
Pneumonia can range in seriousness from mild to
life-threatening.
It is most serious for
infants and young children, people older than age 65, and people with health
problems or weakened immune systems.
Symptoms
The signs and symptoms of
pneumonia vary from mild to severe, depending on factors such as the type of
germ causing the infection, and your age and overall health.
Mild signs and symptoms often
are similar to those of a cold or flu, but they last longer.
Signs and symptoms of pneumonia may include:
Chest pain when you breathe
or cough
Confusion or changes in
mental awareness (in adults age 65 and older)
Cough, which may produce
phlegm
Fatigue
Fever, sweating and shaking
chills
Lower than normal body
temperature (in adults older than age 65 and people with weak immune systems)
Nausea, vomiting or diarrhea
Shortness of breath
Products & Services
Clinical features of
pneumonia
Fever
Cough
Shortness of breath
Malaise
Breathlessness
Confusion
Fever : is usually high grade upto 38.5 C
Breathlessness is a characteristic feature of pneumonia.
It indicates a ventilation perfusion mis match as seen in
pneumonic consolidation.
Cough :
Does the patient have a cough?
If yes,is it dry , productive or purulent?
Does the patient normally have a cough and produce sputum?
In a patient with Normal lungs, a dry cough is suggestive of
pneumonia of any sort.
A purulent cough is suggestive of an underlying bacterial
infection.
A brownish red / rusty colored cough is suggestive of
pneumococcal infection.
Chest pain could be due to soreness from coughing or it may
be pleuritic due to which is more common in bacterial than non-bacterial
infection.
When did the illness
start ?
Bacterial pneumonias have a small prodrome as compared to non-bacterial
infections
Eg Mycoplasma will have a longer prodromal phase.
Presence of confusion indicates the pneumonia is severe.
But note that classic symptoms and signs of pneumonia are
less likely in the elderly and hence confusion may be the main presenting
symptoms and only diagnostic clue.
Are there any other likely Diagnosis ?
Other common causes
of acute presentation with breathlessness include :
Pulmonary oedema
Pulmonary embolism
Are there any clinical features that suggest these as
possible cause ?
Patients with atypical pneumonias may have GI symptoms.
Relevant Past Medical
history
A detailed Past Medical history is required
But particular emphasis should be on the following ;
Ask if the patient has a previous history of
COPD / Chronic Obstructive Pulmonary Disease
Bronchiectasis or a long standing lung problem
Smoking history
Alcohol History
Alcoholism can lead to recurrent Aspiration Pneumonias as
well as pneumococcal and Gram negative and atypical infections.
Also determine if the patient has suffered from Alcohol
withdrawal if admitted to the hospital.
Pets : are there any parrots or budgies at home of patient ?
Is the patient immunosuppressed ?
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