UNIVERSIDAD NACIONAL MAYOR DE SAN MARCOS

(Universidad del Perú, DECANA DE AMÉRICA)

ASIGNATURA:

IACS II

TEMA:

PNEUMONIA

DOCENTE:

Laguna Chávez, Bryan Kevin

PARTICIPANTES:

Aro Palma, Alejandra Estefania

Ayarsa Chumbes, Luis Antonio

Cabrera Espinoza, Orlando Hector

Jaico Saavedra, Piero Emerson

Morales Espinoza, Nayeli Nicole

Rios Chavez, Melhany Antuaneth

AÑO:

2022

LIMA-PERÚ
1. Overview

Pneumonia is an infection that causes inflammation, irritation, and a buildup of

mucus in the air sacs of one or both lungs. These fill with air when a healthy

person breathes. When you have pneumonia, the alveoli fill with inflammatory

fluid.

Each lung has separate sections called lobes. Normally as you inhale, air

circulates freely through the trachea and then through large tubes called

bronchi. Through smaller tubes called bronchioles and finally into small sacs

called alveoli. Normally,

the airways and alveoli

are flexible and elastic.

When you breathe in,

each air sac inflates like

a small balloon, and

when you exhale, the

air sacs deflate. There

are small blood vessels

called capillaries, which

surround the alveoli. Oxygen from the air you breathe passes through the

capillaries. Carbon dioxide from the body then leaves the capillaries into the

alveoli so that the lungs can get rid of it when you exhale.

Pneumonia is an infection caused by germs such as bacteria, viruses, fungi,

or parasites. The airways capture most germs in the mucus that lines the

trachea, bronchi, and bronchioles. The cilia, hair-like projections that line the
 tubes, constantly push mucus and germs out of the airways where you can

cough them out. Sometimes the microbes pass past the mucus and cilia and

enter the alveoli (1). Normally, immune system cells attack these germs and

keep you from getting sick. However, if the immune system is weakened by

age, illness, or fatigue, the pneumonia-causing germs can overwhelm the

immune cells and begin to multiply. The bronchioles and alveoli become

inflamed and irritated as the immune system attacks the multiplying germs. As

a result, the alveoli fill with fluid, making it difficult for the body to get the

oxygen it needs (2).

2. Symptoms

Among the signs and symptoms of pneumonia we have:

➔ Fever, sweating, and chills with trembling.

➔ Coughing fits.

➔ Expulsion of phlegm.

➔ Difficulty breathing.

➔ Chest pain when breathing or coughing.

➔ General discomfort.

➔ Fatigue.

➔ Nausea, vomiting, or diarrhea.

➔ Disorientation or changes in mental perception (in adults 65 years or

older).

➔ Lower than normal body temperature (in adults over 65 and people

with a weak immune system).

 ➔ Newborns and babies may not show signs of having the infection. Or

they may vomit, have a fever and cough, seem restless or tired and

lack energy, or have trouble breathing and eating (3).

3. Causes:

Sometimes germs such as bacteria, viruses or fungi enter the lungs and

cause infections. When these germs enter the lungs, the immune system,

which is the body's natural defense against germs, goes into action. The

immune cells attack the germs and can cause inflammation of the air sacs, or

alveoli. The inflammation can cause the air sacs to fill with fluid and pus and

cause symptoms of pneumonia.

BACTERIA: Some bacteria cause pneumonia with different symptoms or with

other characteristics that are not those of usual pneumonia. Such an infection

is called atypical pneumonia. For example, Mycoplasma pneumoniae causes

a mild form of pneumonia that is often called "walking pneumonia". Legionella

pneumophila causes a severe type of pneumonia called Legionnaires' disease

external link . Bacterial pneumonia can develop on its own or after you have

had a cold or the flu.

VIRUSES: Viruses infect the lungs and airways and can cause pneumonia.

Influenza (influenza virus) and the common cold (rhinovirus) are the most

common causes of viral pneumonia in adults. Respiratory syncytial virus

(RSV) is the most common cause of viral pneumonia in young children.

FUNGI: Fungi such as Pneumocystis jirovecii can cause pneumonia,

especially in people with a weakened immune system(4).

4. Risk factors:

The risk of pneumonia may be higher due to age, environment, lifestyle habits

and other medical conditions.

AGE: Pneumonia can affect people of any age. However, there are two age

groups that have a higher risk of developing pneumonia and having more

severe pneumonia.

Environment or occupation: In the setting or occupation most people develop

pneumonia when they get an infection from another person in the community.

Lifestyle habits: Smoking cigarettes may prevent you from clearing mucus

from your airways.

Using drugs or alcohol can weaken the immune system. You are also more

likely to accidentally get saliva or vomit into your windpipe if you are sedated

or unconscious from an overdose(5).

Other medical conditions: In other medical conditions you may have an

increased risk of pneumonia if you have any of the following medical

conditions.

● Cerebral disorders.

● Conditions that weaken the immune system.

● Critical illnesses requiring hospitalization.

● Pulmonary diseases.
5. Complications

Complications of pneumonias are: parapneumonic pleural effusion, pulmonary

empyema, pneumothorax, bronchopleural fistula, lung abscess, necrotizing or

necrotizing pneumonia and pneumothorax.

These complications account for only 1% of but this percentage rises to

almost 40% in the to almost 40% if hospital admission is required, so that it

can be considered as a fundamentally hospital pathology. hospital pathology.

Pneumonia is usually the main cause of pleural effusion in children and,

approximately 20-40% of those admitted between 0.6-2% end in empyema(6).

6. Preventions

Pneumonia can be very serious and even life-threatening. That is why some

measures can be taken to try to prevent it.

➔ Vaccines, which can help prevent pneumonia caused by bacteria called

pneumococci (which are the most common type of bacteria that cause

pneumonia) or by the flu virus.

➔ Pneumococcal vaccines are especially important for people at high risk for

pneumonia.

Other ways to prevent it is to take preventive measures such as

➔ Performing proper hand washing to kill the genes and avoid

transmission.

➔ Not smoking, as the tobacco in cigarettes prevents the lungs from

filtering germs properly and defending the body.

 ➔ Maintain a strong immune system through physical activity and a

healthy eating plan.

➔ Cover your mouth and nose to protect yourself from external agents(7).

7. Diagnosis

Your healthcare provider will

diagnose pneumonia based

on your medical history, a

physical exam, and test

results. Sometimes

pneumonia is hard to

diagnose because your

symptoms may be the same

as a cold or flu. You may not

realize that your condition is

more serious until it lasts longer than these other conditions.

Medical history and physical exam

Your provider will ask about your symptoms and when they began. They will

also ask whether you have any risk factors for pneumonia. You may also be

asked about:

● Exposure to sick people at home, school, or work or in a hospital

● Flu or pneumonia vaccinations

● Medicines you take

 ● Past and current medical conditions and whether any have gotten

worse recently

● Recent travel Exposure to birds and other animals

● Smoking

During your physical exam, your provider will check your temperature and

listen to your lungs with a stethoscope (8).

Diagnostic tests and procedures

If your provider thinks you have pneumonia, he or she may do one or more of

the following tests.

A chest X-ray looks for inflammation in your lungs. A chest X-ray is often

used to diagnose pneumonia.

Blood tests, such as a complete blood count (CBC) see whether your

immune system is fighting an infection.

Pulse oximetry measures how much oxygen is in your blood. Pneumonia

can keep your lungs from getting enough oxygen into your blood. To measure

the levels, a small sensor called a pulse oximeter is attached to your finger or

ear.

If you are in the hospital, have serious symptoms, are older, or have other

health problems, your provider may do other tests to diagnose pneumonia.

A blood gas test may be done if you are very sick. For this test, your provider

measures your blood oxygen levels using a blood sample from an artery,

usually in your wrist. This is called an arterial blood gas test.

 A sputum test, using a sample of sputum (spit) or mucus from your cough,

may be used to find out what germ is causing your pneumonia.

A blood culture test can identify the germ causing your pneumonia and also

show whether a bacterial infection has spread to your blood.

A polymerase chain reaction (PCR) test quickly checks your blood or

sputum sample to find the DNA of germs that cause pneumonia.

A bronchoscopy looks inside your airways. If your treatment is not working

well, this procedure may be needed. At the same time, your doctor may also

collect samples of your lung tissue and fluid from your lungs to help find the

cause of your pneumonia.

A chest computed tomography (CT) scan can show how much of your

lungs are affected by pneumonia. It can also show whether you have

complications such as lung abscesses or pleural disorders. A CT scan shows

more detail than a chest X-ray.

A pleural fluid culture can be taken using a procedure called thoracentesis,

which is when a doctor uses a needle to take a sample of fluid from the

pleural space between your lungs and chest wall. The fluid is then tested for

bacteria (9).

8. Treatment

The treatment depends on the type and severity of the disease, in addition, it

depends on age, the type of germ that causes it and the general state of
 health; for that reason, a series of options are recommended to treat

pneumonia(10), among them, the following stand out:

Antibiotics: Especially used to treat bacterial pneumonia, if symptoms do not

improve the medical may recommend a different antibiotic. Among the most

important are: penicillins, beta-lactams, quinolones and macrolides.

Cough medicines: These are used to relieve coughing so you can rest. They

can help you feel more comfortable if you are coughing a lot. These

medications include: Hycodan, Sudafed, among others.

Analgesics: You will probably need these to relieve fever and discomfort.

These include medications such as aspirin, ibuprofen, acetaminophen, among

others(11).

Oxygen therapy: This option is used if your blood oxygen level is low, if you

are short of breath at rest or when you are exerting yourself. Some people

receive oxygen only at night, others receive it when they are active.

Mechanical ventilation: This tool is used for patients with severe pneumonia.

Mechanical ventilation delivers oxygen to the lungs and the body, helps the

lungs get rid of carbon dioxide, facilitates breathing, among others(12).

9. Clinical Case

Motivation of consulting

We have a 47-year-old man who consults for cough and fever.

Symptoms

For the past 4 days, the patient has been referring to coughing with expulsion

of phlegm, general malaise and fever with chills. He self-medicated with

paracetamol without any improvement. He does not refer to chest pain.

Risk Factors

● He reports not being in contact with sick people at home, nor in a

hospital

● He does not take medication

● He is an active smoker, 1 packet daily

● He drinks every weekend

● He had a clinical criteria of chronic bronchitis

Chest X-ray

Exams Performed

Complete Blood Count: Leukocytes below 5000, which indicates the presence

of an infection in his body.

 PCR Test: 38.9, which also indicates the presence of a bacterial infection.

Diagnosis

Thanks to all the tests performed, we diagnosed this patient with atypical

pneumonia.

Treatment

Antibiotic treatment with ceftriaxone and azithromycin was administered. After

that, this patient should feel better(13).

10. Conclusions

● Pneumonia is an infection on the lungs that results in air sacs being

filled with liquid.

● The most vulnerable population of this disease are the two extremes

of life (the kids and the seniors).

● Clinical manifestations may be typical (fever, cough, purulent sputum,

tachypnea, pleuritic pain, and auscultatory abnormalities).

● A chest x-ray is the best test for the diagnosis of pneumonia next to the

clinic.

● Prevention through vaccination, avoidance of risk factors such as

smoking, and awareness of the disease will decrease the incidence of

pneumonia.
 11. References

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12. Annexes

Evidence of our meeting: