what is lobar pneumonia? its Symptoms, Etiology & Histology

what is pneumonia?

Pneumonia:- is an acute respiratory illness associated with recently developed radiological pulmonary consolidation(opacity) which may be segmental, foobar, or multilobar. It is secondary to infection with bacteria, viruses, or mycoplasma.

Anatomical Classification pneumonia?

• Lobar pneumonia (entire lobe is affected)
• Bronchopneumonia (patchy involvement affects bronchioles and adjacent alveoli)
• Interstitial pneumonia (affects interstitial tissue)

what is lobar pneumonia?

Lobar pneumonia:-It is a radiological and pathological term referring to homogeneous consolidation of one or more lung lobes, often with associated pleural inflammation.

Classification on the basis of how they are acquired

1. Community-acquired pneumonia

• Develops in community with little or no contact with the health care system
• Streptococcus pneumonia is the commonest cause.

2. Hospital-acquired/nosocomial pneumonia

• Pneumonia contracted by a patient in the hospital 48-72 hrs after admission
• VAP (ventilator-associated pneumonia)

3. Aspiration pneumonia

• Due to aspiration of food, vomitus, liquid, etc

Lobar pneumonia Etiology:-

Most common in adults:- Streptococcus pneumonia

Haemophilus influenza is more common in the elderly

Mycoplasma pneumonia is more common in young people

Viral infections are important causes of CAP in children.

Pneumonia evolves in Four stages:-

1. Stage of congestion (in 1″ 24 hrs)

Vascular engorgement, Intra alveolar fluid, and a small number of neutrophils are seen. Grossly the lung is heavy.

2. Stage of Red Hepatization (24-48 hrs)

Extravasation of RBCs, increase in neutrophil and fibrin: Due to fibrin deposition on the surface of the lobe, consistency resembles liver, so this is called hepatization.

3. Stage of Grey Hepatization (5-6 Days)

Heavy infiltration of neutrophils and disintegration of RBC. Lung tissues become grey.

4. Stage of Resolution (8-10 Days)

Clearance and repair mechanisms restore the normal architecture of the lung.

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WHO-recommended oral rehydration salts

Whitfield ointment uses

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malaria treatment & medication

Lobar pneumonia Symptoms:-

• High fever with chills.
• Shortness of breath.
• Increased breathing rate.
• A worsening cough that may produce discolored (rusty) or bloody sputum.
• Sharp chest pains

Sign:-

• Tachypnea, Chest indrawing
• Decreased air entry on auscultation
• Crackles
• Dullness on percussion

Complications:-

• Pleural effusion
• Empyema (pus in the pleural cavity)
• Pleurisy
• Atelectasis
• Septicaemia

Drugs for Lobar Pneumonia:-

Azithromycin:-

It is an antimicrobial agent which belongs to the macrolides group.

It is a semisynthetic derivative of erythromycin.

It inhibits protein synthesis by binding reversibly to the P site of 50 s ribosomal subunit of bacteria.lt inhibits translocation thereby inhibiting protein synthesis.

It is a weakly basic drug so antimicrobial activity is enhanced by alkaline Ph.

Food interferes with its absorption so it should be given either before the meal or 2 hours after the meal.

It shows a significant post-antibiotic effect.

Other antibiotics: Doxycycline

Macrolides:-

• Azithromycin
• Clarithromycin
• Erythromycin

Fluoroquinolones:-

• Levofloxacin
• Moxifloxacin
• Gemifloxacin

Cephalosporins:-

• Ceftriaxone
• Cefotaxime
• Cefuroxime
• Cefepime

Beta Lactam Antibiotics:-

• Amoxycillin
• Ampicillin
• Piperacillin

Beta Lactamase inhibitor:-

• Sulbactam
• Tazobactam