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Wednesday, June 29, 2011

What causes pneunonia?

Pneumonia is a disease where the normally sterile lungs become infested with a pathogen. It usually occurs because the normal immune defence mechanisms do not function properly. Inflammation occurs in the lung parynchema, particularly in the alveoli, causing fluid buildup in that region.

Bacterial pneumonia is the most common pneumonia, and it can usually be identified by crackles heard only over one particular lobe, such as only in the left lower lobe, or only in right lower lobe. Bacterial pneumonias are treatable with antibiotics.

Pneumonia can also be caused by a virus or fungus, with viral pneumonias being the most difficult to diagnose and treat. Viral pneumonias usually effect more than one lobe of the lung, and usually result in crackles in both bases or crackles throughout the lung fields mimicking pulmonary edema. Viral pneumonias tend to be more deadly than bacterial.

The following are factors that predispose a patient to bacterial pneumonia:

A. Airway Disease: Increased sputum production
  1. Chronic Bronchitis: Unable to bring up sputum due to loss of cilia
  2. Asthma: Increased sputum production
  3. Bronchiectasis: Sputum too thick to expectorate (Cystic Fibrosis)
  4. Obstructed bronchus due to tumor:
  5. Smoking history:
B. Poor cough:
  1. Neuromuscular disease: Weak respiratory muscles
  2. Emphysema: Loss of lung tissue
  3. Abdominal pain: Post operative patients don't want to take deep breath due to pain
  4. Drug overdose: Relaxed respiratory muscles
C. Reduced gag reflex and aspiration:
  1. Drug overdose:
  2. Alcohol abuse:
  3. Stroke:
  4. Neuromuscular disease:
D. Decreased immunity:
  1. Leukemia
  2. Chemotherapy:
  3. AIDS: They are highly susceptible to pneumocystis carinii pneumonia
  4. Organ transplant:
E. Chronic diseases
  1. Diabetes:
  2. Cirrhosis:
  3. Renal Failure:
  4. Heart Failure:
F. Procedures:
  1. Intubation: Bacteria pushed down by insertion
  2. Mechanical ventilation: Ventilator acquired pneumonia
  3. Use of humidifiers and aerosols: Creates breeding ground
  4. Lack of handwashing: #1 most preventable
  5. Lack of sterile technique:
  6. Contaminated equipment:

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