...INTRODUCTION Pneumonia is an inflammation of the lungs caused by an infection. It is also called Pneumonitis or Bronchopneumonia. Pneumonia can be a serious threat to our health. Although pneumonia is a special concern for older adults and those with chronic illnesses, it can also strike young, healthy people as well. It is a common illness that affects thousands of people each year in the Philippines, thus, it remains an important cause of morbidity and mortality in the country. There are many kinds of pneumonia that range in seriousness from mild to life-threatening. In infectious pneumonia, bacteria, viruses, fungi or other organisms attack your lungs, leading to inflammation that makes it hard to breathe. Pneumonia can affect one or both lungs. In the young and healthy, early treatment with antibiotics can cure bacterial pneumonia. The drugs used to fight pneumonia are determined by the germ causing the pneumonia and the judgment of the doctor. It’s best to do everything we can to prevent pneumonia, but if one do get sick, recognizing and treating the disease early offers the best chance for a full recovery. A case with a diagnosis of Pneumonia may catch one’s attention, though the disease is just like an ordinary cough and fever, it can lead to death especially when no intervention or care is done. Since the case is a toddler, an appropriate care has to be done to make the patient’s recovery faster. Treating patients with pneumonia is necessary to prevent its spread to...
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...Pneumonia Over the years, many people have found new research on Pneumonia. In Latin, “pnemon” means lungs, “-ia” is the pathological condition, and “-itis” means inflammation. Hippocrates was the first person, on record, to discover pneumonia. He lived during the years of 60BC – 370BC. The “Father or Medicine” was one of the names this Greek physician was considered as in history. Pneumonia descriptions was most accurately given from a Jewish philosopher and physician, who goes by the name Moses ben-Maimom. Even though they were the most accurate, doesn’t mean they are the most current. He lived from 1135AD – 1240AD. Edwin Klebs discovered that bacteria was the cause of pneumonia in 1875. He found this out while studying bacteria in airways of pneumonia patients who died. Klebs was a German-Swiss Pathologist. Bacterial genus Klebsiella is named after him. In 1882 and 1884, Carl Friedländer and Albert Fränkel found the two main causes of Pneumonia, which were Klebsiella pneumoniae and Streptococcus pneumoniae. Through Friedländer’s research, the Gram Stain was introduced and helps identify the two types of bacteria that cause pneumonia. Klebsiella pneumoniae is a respiratory pathogen that causes pneumonia. This bacteria is found most of the time in the gastrointestinal tract and the nasopharnyx. Another common place it is found is on hands of hospital workers. This bacteria is not only in humans, it is everywhere in the ecological environment. It has been correlated worldwide...
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...CASE STUDY: PNEUMONIA SUBJECTIVE: This is a 63 year old female with complain of cough for 1-week with yellowish sputum accompanied with fever and chills at home. She denies current chest pain during examination but claims of on and off chest pain episodes for about 5 days from the visit. She complains of having shortness of breath for 2 weeks. She went to ER 6 days ago with fever of 100.4 ḟ. She reports a Computed Tomographic Pulmonary Angiography (CTPA), which was negative for Pulmonary Embolism (PE) but found positive for Pneumonia. Patient reports to take antibiotic started during the ER visit but has not been taking the breathing treatment at home. The patient has no known drug allergy. Patient denies postnasal drip and sneezing and no hemoptysis. Patient denies any abdominal pan, nausea, vomiting, diarrhea, lower extremity swelling nor dysuria. He also denies smoking. Past Medical History is coronary artery disease with stent, hyperlipidemia, hypertension, diabetes mellitus, CKD, Stage 3 (GFR 30-59), anxiety disorder, stridor 2nd to history of intubation and tracheostomy, gastric rectal bleeding with chronic anemia, major Depression – recurrent, non-alcoholic cirrhosis, obesity (BMI-30-39.9), obstructive sleep apnea and venous stasis. OBJECTIVE: PHYSICAL ASSESSMENT Ht. 5’1, Wt. 175 lbs. BMI = 33.1 VS are BP 155/69, HR= 83-97, T 37.7, RR 32, SpO2 91-93% @ 2L O2 by nasal cannula General: She appears to be calm and breathing fairly, saturating well without oxygen but...
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...Modifiable Factors: PLEURAL EFFUSION SECONDARY TO COMMUNITY ACQUIRED PNEUMONIA Non Modifiable factors: Underlying diseases Pneumonia, COPD Cardiovascular disease Diabetes mellitus Genetic The immunocompromised or immunosuppressed patients with low neutrophil count Age: Very young and of 60-70 yrs old Lifestyle Gender More t in males than in females Environment Exposure to Pathogens: S. Pneumoniae, H. Influenza, Lagionella, P. Aureginosa, other gram (-) rods and viruses Exposure and inhalation of Secondhand smoke and other chemical pollutants Smoking and Alcohol abuse Inhalation of foreign materials Improper diet and malnutrition Decreased/Disruption of mucocilliary and macrophage activity Decreased immune response or immunosuppresion Bacterial invasion in lower respiratory tract Inflammatory response Lymphocytes produce cytokinse Immune Response Triggered Increase WBC Filling of WBC in alveoli Release of chemical mediators (bradykinins, histamins, etc) Release of T- cells, macrophages phagocytes and atntibodies Crackles Immune Response Triggered Vasodilation and increase capillary permeability Dyspnea Cough with purulent yellowish secretions Non- productive cough WBC takes effect to pathogens Purulent...
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...Infections are caused by an invasion of unwanted organisms that attack ones body. With that being said, pneumonia is an acute infection of the lung parenchyma (Anatomical Chart Company, 2010, p. 100). Pneumonia, like any other infection, has a pathophysiology that describes how the infection affects the body. It also has different causes, several signs and symptoms, a variety of different treatments, and even a long list of possible complications. Pneumonia is always handled with delicate attention, but for individuals who have normal, healthy lungs and a strong immune system the final outcome is almost always a good one. Serious attention needs to be focused on those who are at a greater risk such as the elderly, children, and the immunocomprimised (Anatomical Chart Company, 2010, p. 100). According to the Atlas of Pathophysiology, there are three different basic types of pneumonia: bacterial, viral, and aspiration. The primary cause of pneumonia is an inhalation or aspiration of a pathogen. The secondary cause is related to an existing infection or disease. Each of these are caused by different irritants that result in the same disruption of normal perfusion. The attacks on the lung lead to alveolar inflammation and edema that causes low ventilation and blood and fluid to be pushed into the capillaries. This leads to a stasis in the lung’s gas perfusion and creates a pressure that makes it harder for the individual to breath (Anatomical Chart Company, 2010, p. 100). The...
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...Pneumonia is a very common lung infection that is a collection of pus and other fluids in the lung air sacs. Pneumonia is caused by many kinds of microorganisms called germs. The most common type of getting pneumonia is bacteria. When an organism is identified it is usually the bacteria Streptococcus pneumonia. Pneumonia is a common illness affecting approximately 450 million people a year and occurring in all parts of the world. It is a major cause of death among all age groups, resulting in 1.4 million deaths in the U.S. in 2010. There were 56,832 deaths due to pneumonia and influenza in 2013, which combined were the eighth leading cause of death in the U.S. While the age‐adjusted death rate for pneumonia and influenza increased 9 percent from 2012 to 2013, it has decreased an average of 3.8 percent per year since 1999. Pneumonia is endogenous, exogenous, as well as nosocomial. Usual reservoirs for this pathogen are water, soil, agriculture plants, animals, and humans. The bacteria can be entered in the body by you touching or inhaling the bacteria in the air from somebody who already has pneumonia. In order for the bacteria to exit your body it ejected from the mouse and nose from your lungs. The means of transmission is when someone coughs or sneezes and when this happens...
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...Pneumonia is a bacterial and viral infection. Pneumonia is the inflammation in the lungs, and can affect one lung or both lungs. What the pneumonia actually does, is with your lung(s) with fluid and can sometimes even become filled with pus. In most cases, when having a respiratory virus, that can be the cause of viral pneumonia infection, but if you recently had a severe cold or flu, that could be the cause as well. Bacterial Pneumonia infection can be caused by a severe cold or flu also. An infection that inflames your air sacs is pneumonia. It can be in one or both of your lungs. Your lungs become filled with fluid and pus. Also, because your lung(s) become filled with that nasty “gunk”, that causes coughing with “spit up”, or phlegm. All...
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...Healthcare Associated Pneumonia vs Non Healthcare Associated Pneumonia Many germs can cause pneumonia. The most common are bacteria and viruses in the air we breathe. The human body usually prevents these germs from infecting your lungs, but sometimes these germs can overpower the person’s immune system, even if the person’s health is generally good. Pneumonia is classified according to the types of germs that cause it and where you got the infection (Staff, 2015). Pneumonia can be acquired in both health care facilities as well as in community environments. Preventative measures, outbreak detection, management and education, and statistics are all vital components to help healthcare providers as well as everyday citizens be aware and...
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...Pneumonia Case Study August 27th, 2014 Mrs. Yolanda Bone South University Pneumonia Case Study A major cause of morbidity and mortality is Pneumonia. Pneumonia is a lung infection caused by bacteria, fungi or viruses (Center for Disease Control, 2014).The infection is classified into two categories; community-acquired pneumonia (CAP) or health care-associated pneumonia (HCAP). The classification is determined by the environment in which the infection develops (CDC, 2014). HCAP develops during or following a stay in a healthcare facility. In contrast, patients who are diagnosed with CAP have had no contact within a health care setting prior to presenting with the infection (Driver, 2012). Pneumonia may be present as a mild illness but has the potential to be life-threatening. Despite advances in research, pneumonia remains a common illness contributing to the death of young children in developing countries and the elderly population of developed countries throughout the world (Ruuskanen, et al., 2011). In 2010, approximately 50,000 people in the U.S. died after developing the infection (CDC, 2014). From a global perspective, 450 million cases of pneumonia are recorded annually and roughly 4 million of those diagnosed will die from this illness (Ruuskanen, et al., 2011). CAP is the eighth-leading cause of death within the U.S. and is the leading cause of death from infection in the developed world (Brown, et al., 2012). While anyone is susceptible to contracting...
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...I. Introduction This is a case of a 74 year old woman who was diagnosed with Community Acquired Pneumonia. Pneumonia is an inflammation or infection of the lungs most commonly caused by a bacteria or virus. Pneumonia can also be caused by inhaling vomit or other foreign substances. In all cases, the lungs' air sacs fill with pus , mucous, and other liquids and cannot function properly. This means oxygen cannot reach the blood and the cells of the body. Most pneumonias are caused by bacterial infections.The most common infectious cause of pneumonia in the United States is the bacteria Streptococcus pneumoniae. Bacterial pneumonia can attack anyone. The most common cause of bacterial pneumonia in adults is a bacteria called Streptococcus pneumoniae or Pneumococcus. Pneumococcal pneumonia occurs only in the lobar form. An increasing number of viruses are being identified as the cause of respiratory infection. Half of all pneumonias are believed to be of viral origin. Most viral pneumonias are patchy and the body usually fights them off without help from medications or other treatments. Pneumococcus can affect more than the lungs. The bacteria can also cause serious infections of the covering of the brain (meningitis), the bloodstream, and other parts of the body. Community-acquired pneumonia develops in people with limited or no contact with medical institutions or settings. The most commonly identified pathogens areStreptococcus pneumoniae, Haemophilus influenzae, and...
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...Ventilator Associated Pneumonia and Guidelines VAP: Definition • Pneumonia in patients receiving invasive mechanical ventilation for at least 48 hours • Early VAP: < 4 days in the ICU • Late VAP: > 4 days in the ICU VAP: Incidence US National Nosocomial Infection Surveillance Type of ICU Mean VAP Rate (Cases/1000 vent days) Trauma 15.1 Neurosurgical Surgical Burn Cardiothoracic 12.9 9.9 9.6 7.9 Data from January 2002 – June 2003 Reported as VAP rates/1000 vent days VAP: Burden of Illness • Incidence 10-20% of patients receiving mechanical ventilation > 48 hours • Increased ICU Mortality (2-4 times) • Increased ICU LOS (5-7 days) • Increased hospital costs (>$10,000 US in additional costs) Safdar et al, Crit Care Med, 2005; 33: 2184 VAP: Healthcare Cost Burden of Illness Canada (per year) (10.6 cases/1000 Vent days) Excess Vent days Excess Deaths1 16,000 days (55 ICU beds) 216 Excess Cost2 $46,000,000 1Based on attributable mortality of 5.8% cost cost methodology 2Ontario Clinical Criteria for Suspicion of VAP • New or persistent infiltrate on CXR without another cause • Plus any 2 of the following: • • • • Purulent endotracheal secretions Increasing oxygen requirements Core temperature > 38.0o C WBC < 3.5 or > 11.0 Adapted from N Engl J Med 2006;355:2619-30. Host Risk Factors for VAP • Underlying pulmonary disease (e.g. COPD) • • • • • Sepsis ARDS ...
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...This patient may have a type of atypical pneumonia, often called “Walking Pneumonia”. This infectious lung disease is also bacterial and is a milder form of community-acquired pneumonia. According to the physical examination, mild fever, difficulty breathing and moderate rales over the right lower lung are common symptoms for this type of infection. Also, his chest x-ray shows patchy alveolar infiltrates; when fluid builds up in the alveoli of your lungs and is also another indicator. Since the patient is said to have “Walking Pneumonia”, the causative organism of this mild lung infection is a bacterium species called Mycoplasma Pneumoniae . This bacterium is under the Mycoplasma genus. Mycoplasma is also a class of mollicutes, a bacterial...
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...…………………………..……………………………7 Power analysis …………………………………..…………….……………………………8 Instrumentation ...............................................................................................................…...8 Data collection ……………………………………..………….……………………………8 Statistics and data analysis …………………………………………………………….…...9 Expected results …………………………………………………………………………………..9 References cited………………………………………………………………………………….10 Appendix A………………………………………………………………………………………13 Appendix B………………………………………………………………………………………14 Appendix C………………………………………………………………………………………15 Appendix D………………………………………………………………………………………16 Ventilator associated pneumonia and chlorhexidine use in the traumatic brain injured patient Ventilator associated pneumonia (VAP), is defined as, a nosocomial pneumonia that develops more than 48 hours following endotrachial intubation and mechanical ventilation, and is a common and serious intensive care unit (ICU) complication. VAP causes noteworthy morbidity, mortality, amplified hospital costs, and increased utilization of healthcare resources, prolonged time for ventilator support, as well as lengthened ICU and hospital stay (Caruso, 2009). Antibiotics (ATBs) have traditionally been used to treat VAP, but the occurrence of resistance...
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...Hospital Acquired Infections (HAI) are a concerning complication during hospital stays. In 2011, it was estimated that out of 722,000 calculated HAI’s, 157,500 were caused by Pneumonia (CDC.gov, 2015). Ventilator Associated Pneumonia (VAP), a sub-category of Pneumonia, is a worldwide, challenging complication in the Intensive Care Unit (ICU) setting of many hospitals. VAP often leads to not only increased mortality rates, but also an increase in comorbidity, and healthcare costs in the affected population. It has been estimated that VAP As of 2013, Ventilator Associated Pneumonia has been renamed under the umbrella term Ventilator Associated Events (VAE), making it difficult to find statistics that specifically represent VAP incidences and...
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...Ventilator-Associated Pneumonia In general, Healthcare acquired infections are caused by a viral, bacterial, or fungal pathogen that is not present at the time of admission to a hospital or other healthcare setting. These infections can result in an extended stay for patients, mortality, and increased healthcare costs. They can also occur in pediatric and adult patients of either sex, but are more common in critically ill patients. Healthcare acquired infections are a huge concern in the medical field, because they can be associated with medical equipment and involve any system of the body. The most common HAI’s are pneumonia, bloodstream, and urinary tract infections (Custodio, 2015). Ventilator-associated pneumonia or VAP is pneumonia that occurs longer than forty-eight hours after a patient has been intubated and receiving mechanical ventilation. This illness is the second most common hospital acquired infection in critically ill patients. Around eighty-six percent of healthcare acquired pneumonias are due to mechanical ventilation. Every year in the United...
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