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Bacterial Pneumonia

Bacterial Pneumonias


Presentation

Persistent cough, and cough with sputum is the most common symptom of bacterial pneumonia.

The color of the sputum can help determine the type of pathogen that has caused the infection, for example: rust-colored sputum is due to Streptococcus pneumonia, while if the infection is caused by Pseudomonas, Haemophilus, and pneumococcal species, the color of sputum is green. Infections due to anaerobic bacteria produce foul-smelling sputum.

Some of the other symptoms of bacterial pneumonia are yperthermia or hypothermia, tachypnea, tachycardia, central cyanosis, and mental impairment.

Physical findings in patient with bacterial pneumonia are significant breath sounds such as wheezes, crackles or rhonchi, reduction in the intensity of the sound, lymphadenopathy and deviation of the trachea [7].

Fever
  • Your doctor might also suggest medication for pain and fever. Other things you can do to help yourself get better: Get lots of rest. Drink plenty of fluids (they’ll loosen up the gunk in your lungs so you can cough it out).[webmd.com]
  • Older adults may also be less likely to have a fever. Symptoms in children Pneumonia can be particularly dangerous for infants, children, and toddlers. They may display similar symptoms to the ones above.[healthline.com]
  • Fever reducers : Doctors also suggest fever reducers in case of high fever. These include medications such as aspirin, ibuprofen and acetaminophen.[md-health.com]
  • Fever symptoms due to this bacterial lung infection may be as high as 105 degrees F, Cleveland Clinic health professionals warn. Patients who develop a high, persistent fever should seek medical care immediately.[livestrong.com]
Chills
  • This results in the fever, chills, and fatigue common in bacterial and fungal pneumonia. The neutrophils, bacteria, and fluid leaked from surrounding blood vessels fill the alveoli and result in impaired oxygen transportation.[en.wikipedia.org]
  • Besides difficulty breathing and coughing, bacterial pneumonia can cause other signs and symptoms, such as a fever, sweating, chills, and a loss of appetite.[study.com]
  • Common symptoms are: High fever up to 105 F Coughing out greenish, yellow, or bloody mucus Chills that make you shake Feeling like you can’t catch your breath, especially when you move around a lot Feeling very tired Low appetite Sharp or stabby chest[webmd.com]
  • Patients with bacterial pneumonia can develop shaking chills followed by a high fever. These bacterial pneumonia symptoms typically arise suddenly and may be accompanied by sweating or headache.[livestrong.com]
High Fever
  • Patients who experience unintended weight loss in conjunction with high fever, cough, breathing difficulties or stomach upset should seek further care from a medical professional.[livestrong.com]
  • Common symptoms are: High fever up to 105 F Coughing out greenish, yellow, or bloody mucus Chills that make you shake Feeling like you can’t catch your breath, especially when you move around a lot Feeling very tired Low appetite Sharp or stabby chest[webmd.com]
  • Main symptoms include coughing up mucus, shortness of breath and high fever. Diagnosis can be made from sputum and blood culture and X-ray image. Treatment is by antibiotics; if left untreated, bacterial pneumonia can be deadly.[ehealthstar.com]
  • Emergency symptoms Seek immediate medical attention if you are experiencing: blood in mucus trouble breathing high fever of 102.5 F of higher confusion rapid heartbeat skin with a bluish tone Bacteria pneumonia is caused by bacteria that works its way[healthline.com]
Weakness
  • Symptoms in children under 1 month of age include weakness or lethargy, poor feeding, fever, or grunting. Symptoms in older children are the same as adults. They mostly have cough and difficulty in breathing.[md-health.com]
  • But if your body’s defenses (immune system) become weak for some reason, the bacteria can go down into your lungs. When this happens, the air sacs in your lungs get infected and inflamed. They fill up with fluid, and that causes pneumonia.[webmd.com]
  • If symptoms are getting worse, you have other health issues, or your immune system is weak, you might have to go to the hospital for around the clock monitoring and treatment with fluids, oxygen, breathing support and IV medication.[healthpages.org]
  • 細菌性肺炎に合併する横紋筋融解症は比較的稀なため留意されることは少ないが, 高齢糖尿病患者では, 重篤な経過をとりうる点からも十分な認識が必要である A 78-year-old man with type 2 diabetes mellitus admitted for fever and muscular weakness had elevated serum creatine kinase (CK) and myoglobin.[ci.nii.ac.jp]
Rigor
  • The Clinical Trials Transformation Initiative (CTTI) seeks to advance antibacterial drug development (ABDD) by streamlining clinical trials to improve efficiency and feasibility while maintaining ethical rigor, patient safety, information value, and scientific[ncbi.nlm.nih.gov]
  • The Clinical Trials Transformation Initiative (CTTI) seeks to advance antibacterial drug development by streamlining HABP/VABP clinical trials to improve efficiency and feasibility while maintaining ethical rigor, patient safety, information value, and[ncbi.nlm.nih.gov]
  • Pneumonia Fever Rigors Cough Runny nose (either direct bacterial pneumonia or accompanied by primary viral pneumonia) Dyspnea – shortness of breath Chest pain Shaking chills Pneumococcal pneumonia can cause coughing up of blood, or hemoptysis, characteristically[en.wikipedia.org]
  • Nonspecific symptoms such as fever, rigors or shaking chills, and malaise are common.[emedicine.medscape.com]
  • Common symptoms and signs include cough, fever, chills, fatigue, dyspnea, rigors, sputum production, and pleuritic chest pain.[merckmanuals.com]
Cough
  • Drink plenty of fluids (they’ll loosen up the gunk in your lungs so you can cough it out). Use a humidifier or take a warm bath (more gunk-loosening). Don’t smoke. Stay home until your fever goes down and you aren’t coughing anything out.[webmd.com]
  • You can get CAP by breathing in respiratory droplets from coughs or sneezes, or by skin-to-skin contact.[healthline.com]
  • Cough medicines: These agents help in managing sore throat and other discomforts by reducing the continuous coughing. Basically, it does not eliminate the cough completely but helps in loosening and moving the fluid present in the lung spaces. 2.[md-health.com]
  • Cough Medicine Coughing helps your lungs get rid of the mucus and keeps it from spreading in your lungs. Your doctor may prescribe an expectorant loosen the mucus and make it easier to cough up. Cough into tissues.[healthpages.org]
Pleural Effusion
  • Thoracentesis: In patients with parapneumonic pleural effusion, the analysis of the fluid is beneficial in identifying between the simple and complicated effusions.[symptoma.com]
  • Pleural effusion. N Engl J Med. 2002 Jun 20. 346 (25):1971-7. [Medline]. Bafadhel M, Clark TW, Reid C, Medina MJ, Batham S, Barer MR, et al.[emedicine.medscape.com]
  • Complications Without treatment, pneumonia may develop into: organ failure, due to bacterial infection difficulty breathing pleural effusion, buildup of fluid in the lungs lung abscess, cavity in the lung Bacterial pneumonia itself is not contagious,[healthline.com]
  • effusion associated with Heartworm Infection or with Dilated Cardiomyopathy in Ferrets . ( B627 .14.w14) Malignant hyperthermia. ( B232 .6.w6) Treatment In Ferrets Oxygen should be given if breathing is difficult. ( B232 .6.w6, B602 .7.w7, B628 .11.w11[wildpro.twycrosszoo.org]
Dyspnea
  • MATERIALS AND METHODS: In this prospective observational study, we enrolled patients with ILD who had experienced recently progressive dyspnea and exhibited new infiltrations on chest radiographs.[ncbi.nlm.nih.gov]
  • Pneumonia Fever Rigors Cough Runny nose (either direct bacterial pneumonia or accompanied by primary viral pneumonia) Dyspnea – shortness of breath Chest pain Shaking chills Pneumococcal pneumonia can cause coughing up of blood, or hemoptysis, characteristically[en.wikipedia.org]
  • Symptoms and Signs Early symptoms can include sudden high fever or hypothermia (up to 105 F or 40.5 C or lower than 95 F or 35 C), shaking chills, difficulty breathing (dyspnea), coughing up yellow, green or rusty sputum (occasionally with blood in it[ehealthstar.com]
  • Patients will present with fever, dyspnea, tachycardia, tachypnea, cough /- sputum Presentation and risk factors depends on etiology S. Pneumoniae: Rust colored sputum, common in patients with splenectomy S.[smartypance.com]
  • Breathing may be painful because of accompanying pleuritis, but real dyspnea is rare. Auscultation almost always allows distinction from PCP. If something can be heard, then PCP is unlikely. Chest radiography secures the diagnosis.[hivbook.com]
Tachypnea
  • Treatment failure will be defined as persistence of fever after 2 days, or tachypnea or diminishing in respiratory rate less than 5 bpm. after 2 days, or signs of severe pneumonia or requiring or changing antibiotics at any time.[clinicaltrials.gov]
  • Some of the other symptoms of bacterial pneumonia are yperthermia or hypothermia, tachypnea, tachycardia, central cyanosis, and mental impairment.[symptoma.com]
  • […] participants with use of any antibiotic, at any time after diagnosis Secondary Outcome Measures : Treatment Failure in Each Group [ Time Frame: 1, 2, 5, 7 and 10 days from baseline ] Number of participants with persistence of fever after 2 days, or tachypnea[clinicaltrials.gov]
  • No examination features are specific for CAP, but the absence of fever, tachypnea, AND tachycardia makes CAP much less likely.[clinicaladvisor.com]
  • Signs: Increased breathing frequency (tachypnea) and heart rate (tachycardia) Paleness, excessive sweating , clammy skin Crackling sounds, decreased breathing sounds or wheezing detected by auscultation (listening of the lungs by the stethoscope).[ehealthstar.com]
Respiratory Distress
  • After the initial success of therapy and a symptom-free period, she developed pneumonia with septic shock and adult respiratory distress syndrome (ARDS).[ncbi.nlm.nih.gov]
  • Enhanced expression of IL-36γ was also observed in plasma and bronchoalveolar lavage fluid of patients with acute respiratory distress syndrome because of pneumonia.[ncbi.nlm.nih.gov]
  • Abstract Staphylococcus aureus is a common cause of nosocomial pneumonia frequently resulting in acute respiratory distress syndrome (ARDS).[ncbi.nlm.nih.gov]
Loss of Appetite
  • Loss of Appetite After Pneumonia: Causes, Home Remedies, Recovery Period, Effects What is Zoonotic Atypical Pneumonia, Know its Causes, Symptoms, Treatment, Types.[epainassist.com]
  • […] of appetite sweating Older adults will share all the symptoms with younger adults, but are much more likely to experience confusion and dizziness.[healthline.com]
  • Besides difficulty breathing and coughing, bacterial pneumonia can cause other signs and symptoms, such as a fever, sweating, chills, and a loss of appetite.[study.com]
  • […] of appetite If you start experiencing these symptoms, seek out medical attention right away to begin treatment early on and reduce your risk of complications.[belmarrahealth.com]
Abdominal Pain
  • These stomach upset symptoms can be accompanied by abdominal pain or discomfort and may contribute to a decreased appetite.[livestrong.com]
  • Patient may experience body pains, headache and abdominal pain. Shortness of breath Shaking chills.[epainassist.com]
  • Dry cough or coughing up mucus, which may be streaked with blood Fever or chills Shortness of breath, wheezing, or chest pain Feeling tired easily Fast heartbeat Headache, muscle pain, or abdominal pain or discomfort Trouble thinking clearly How is bacterial[drugs.com]
Chest Pain
  • You should also see your doctor if you have shortness of breath, chest pain , and confusion.[belmarrahealth.com]
  • If you have chest pain or confusion, you should seek emergency care.[emedicinehealth.com]
  • Symptoms of bacterial pneumonia include shortness of breath, pain when taking a breath and chest pain. Bacterial pneumonia, if left untreated, can lead to respiratory failure and death.[epainassist.com]
  • The primary outcome was early clinical response, defined as an improvement in at least two of four symptoms (cough, chest pain, sputum production, dyspnoea) with no worsening in any symptom at 72 h after the first dose of study drug, with a 10% non-inferiority[ncbi.nlm.nih.gov]
Tachycardia
  • Some of the other symptoms of bacterial pneumonia are yperthermia or hypothermia, tachypnea, tachycardia, central cyanosis, and mental impairment.[symptoma.com]
  • […] less common in older adults Body shakes and chills leading to teeth chattering Shortness of breath or breathlessness Chest pain is usually a result of extreme coughing and may cause difficulty in breathing as well Fast heartbeat , also referred to as tachycardia[md-health.com]
  • No examination features are specific for CAP, but the absence of fever, tachypnea, AND tachycardia makes CAP much less likely.[clinicaladvisor.com]
  • Signs: Increased breathing frequency (tachypnea) and heart rate (tachycardia) Paleness, excessive sweating , clammy skin Crackling sounds, decreased breathing sounds or wheezing detected by auscultation (listening of the lungs by the stethoscope).[ehealthstar.com]
  • Patients will present with fever, dyspnea, tachycardia, tachypnea, cough /- sputum Presentation and risk factors depends on etiology S. Pneumoniae: Rust colored sputum, common in patients with splenectomy S.[smartypance.com]
Cyanosis
  • Some of the other symptoms of bacterial pneumonia are yperthermia or hypothermia, tachypnea, tachycardia, central cyanosis, and mental impairment.[symptoma.com]
  • Dull sounds during percussion (tapping the chest by the fingers) Bluish discoloration around the mouth (cyanosis) and confusion (in severe pneumonia) White spots on the nails (white nail syndrome or leukonychia) References: [4,5,13,14,24] Causes The most[ehealthstar.com]
  • Description Clinical signs In Rabbits Poor exercise tolerance, increased respiratory rate - these may not be noticed in e.g. hutch-kept rabbits. ( B602 .17.w17) Anorexia and depression may occur in severe cases. ( B601 .7.w7, B614 .8.w8, J10 .36.w1) Dyspnoea, cyanosis[wildpro.twycrosszoo.org]
  • Some of the symptoms may include: rapid breathing breathing difficulties fever general malaise loss of appetite abdominal pain headache chest pain cough blue colouration of the skin around the mouth (cyanosis), caused by lack of oxygen.[betterhealth.vic.gov.au]
  • […] that usually worsens when taking a deep breath, known as pleuritic pain fast heartbeat fatigue and weakness nausea and vomiting diarrhea sweating headache muscle pain confusion or delirium, especially in older adults dusky or purplish skin color, or cyanosis[medicalnewstoday.com]
Hypotension
  • ) Multilobar infiltrates Confusion/disorientation Uremia (BUN 20 mg/dL or greater) Leukopenia (white blood cell [WBC] count less than 4000 cells/µL) Thrombocytopenia (platelet count less than 100,000/µL) Hypothermia (core temperature less than 36 C) Hypotension[emedicine.medscape.com]
  • An intensive care unit (ICU) admission is required for patients who Need mechanical ventilation Have hypotension (systolic blood pressure 90 mm Hg) that is unresponsive to volume resuscitation Other criteria that mandate consideration of ICU admission[merckmanuals.com]
Flushing
  • Signs and Symptoms Like many infections, pneumonia usually produces a fever, which in turn may cause sweating, chills, flushed skin, and general discomfort. The child also may lose her appetite and seem less energetic than normal.[healthychildren.org]
Myalgia
  • Pontiac fever has a viruslike presentation, with malaise, fever and/or chills, myalgias, and headache. This form of Legionella pneumonia usually subsides without sequelae.[emedicine.medscape.com]
  • Non-respiratory complaints will dominate in 10-30% of patients these include headache, fatigue, and myalgias.[clinicaladvisor.com]
Confusion
  • , especially among older persons loss of appetite sweating Older adults will share all the symptoms with younger adults, but are much more likely to experience confusion and dizziness.[healthline.com]
  • We have shown that bronchiectasis, recent hospitalization and severe pneumonia (confusion, blood urea level, respiratory rate, low blood pressure and 65 year old (CURB-65) score 3) were independent predictors of pneumonia caused by potentially drug-resistant[ncbi.nlm.nih.gov]
  • You should also see your doctor if you have shortness of breath, chest pain , and confusion.[belmarrahealth.com]
Headache
  • […] disorders, including diarrhoea (18 [4%] patients in the solithromycin group vs 28 [6%] patients in the moxifloxacin group), nausea (15 [4%] vs 17 [4%] patients) and vomiting (ten [2%] patients in each group); and nervous system disorders, including headache[ncbi.nlm.nih.gov]
  • These bacterial pneumonia symptoms typically arise suddenly and may be accompanied by sweating or headache. Fever symptoms due to this bacterial lung infection may be as high as 105 degrees F, Cleveland Clinic health professionals warn.[livestrong.com]
  • Patient may experience body pains, headache and abdominal pain. Shortness of breath Shaking chills.[epainassist.com]
  • […] green, or blood-tinged mucus stabbing chest pain that worsens when coughing or breathing sudden onset of chills severe enough to make you shake fever of 102-105 F or above (fever lower than 102 F in older persons) Other symptoms that may follow include: headache[healthline.com]
Meningism
  • Type b Haemophilus influenzae can cause pneumonia and bacterial meningitis. It can also cause otitis media and epiglottitis.[smartypance.com]
  • Morbidity rates from meningitis, however, are high.[emedicine.com]
  • Acute bacterial meningitis The vast majority of neonatal meningitis cases are caused by E coli and group B streptococcal infections (28.5% and 34.1% overall, respectively).[emedicine.com]
  • Patients, who develop complications of bacterial pneumonia, including sepsis, lung failure and meningitis, often die.[symptoma.com]
  • Complications Complications of bacterial pneumonia can include dilatation of bronchi (bronchiectasis), collection of pus in the lung tissue (abscess) or pleural space (empyema), blood infection (sepsis), meningitis, middle ear infection (otitis media)[ehealthstar.com]
Altered Mental Status
  • While the extrinsic factors include exposure to pulmonary irritants, causative agents and/or pulmonary injury, intrinsic factors are those related to the host, such as loss of the protective airway reflexes due to the altered mental status due to intoxication[symptoma.com]
  • Associated factors are as follows: Alcoholism Altered mental status Anatomic abnormalities, congenital or acquired Drug use Dysphagia Gastroesophageal reflux disease (GERD) Seizure disorder Additional host factors As always, a thorough interview and determination[emedicine.medscape.com]
  • In addition, elderly patients ( 65 years old) often do not have the classic features - over 40% will not have fever and nearly 50% will present with altered mental status.[clinicaladvisor.com]
  • mental status, poor fluid status) Ceftriaxone plus azithromycin, respiratory fluoroquinolones A chest X-ray showing a very prominent wedge-shape area of airspace consolidation in the right lung characteristic of bacterial pneumonia.[smartypance.com]
  • Various causes for this loss include altered mental status due to intoxication and other metabolic states and neurologic causes, such as stroke and endotracheal intubation.[emedicine.com]

Workup

Severity Assessment: There are some tools to assess the severity of the bacterial pneumonia and the risk of death associated with it. They include:

  • PSI/PORT: Pneumonia severity index/Patient Outcomes Research Team score
  • CURB-65 system: Confusion, urea, respiratory rate, blood pressure, and age >65 years
  • APACHE: Acute physiology and chronic health evaluation

Laboratory tests: Some of the important laboratory tests to assess the severity of illness of the bacterial pneumonia are: Serum chemistry panel, determination of arterial blood gas (ABG) and venous blood gas, complete blood count (CBC) with differential, serum lactate and free cortisol value. 

Sputum evaluation: Before initiating the antibiotic therapy, the sputum is subjected to Gram stain and culture. In Gram staining, a single microbe must be identified, though mixed flora is observed in patients infected with anaerobic bacteria.

Imaging Studies: Chest radiography and chest ultrasonography are some of the imaging tests that can also be performed. 

Bronchoscopy: The bronchial specimen can be obtained with the help of fiberoptic bronchoscope. The bronchoalveolar lavage can be used to perform the fluid analysis and culture.

Thoracentesis: In patients with parapneumonic pleural effusion, the analysis of the fluid is beneficial in identifying between the simple and complicated effusions. 

Pathogen specific tests: Sputum, serum, serologic and urine tests are considered as pathogen specific tests [8].

Cavitary Lesion
  • Targeting blood cultures in patients with CAP who are most likely to have positive cultures can increase the yield.Thus guidelines recommend obtainingblood cultures in patients with 1) severe CAP (admitted to the ICU), 2)cavitary lesions on imaging, 3[clinicaladvisor.com]
Pulmonary Infiltrate
  • If a focal pulmonary infiltrate was noted, sputum samples were obtained for Gram's staining, acid-fast staining, and bacterial, fungal, and mycobacterial culture.[nejm.org]
Air Bronchogram
  • See: Imaging in Ferret Diagnosis and Treatment ( B602 .7.w7, B628 .11.w11, B631 .26.w26) Increased lung density may be seen, with e.g. air bronchograms or hilar oedema. ( B232 .6.w6) Bronchial patterns may suggest primary airway disease. ( B602 .7.w7)[wildpro.twycrosszoo.org]
Pleural Effusion
  • Thoracentesis: In patients with parapneumonic pleural effusion, the analysis of the fluid is beneficial in identifying between the simple and complicated effusions.[symptoma.com]
  • Pleural effusion. N Engl J Med. 2002 Jun 20. 346 (25):1971-7. [Medline]. Bafadhel M, Clark TW, Reid C, Medina MJ, Batham S, Barer MR, et al.[emedicine.medscape.com]
  • Complications Without treatment, pneumonia may develop into: organ failure, due to bacterial infection difficulty breathing pleural effusion, buildup of fluid in the lungs lung abscess, cavity in the lung Bacterial pneumonia itself is not contagious,[healthline.com]
  • effusion associated with Heartworm Infection or with Dilated Cardiomyopathy in Ferrets . ( B627 .14.w14) Malignant hyperthermia. ( B232 .6.w6) Treatment In Ferrets Oxygen should be given if breathing is difficult. ( B232 .6.w6, B602 .7.w7, B628 .11.w11[wildpro.twycrosszoo.org]

Treatment

  • Antibiotics: The mainstay of the treatment of bacterial pneumonia is antibiotics. For managing infections by Streptococcus pneumoniae (most common cause of bacterial pneumonia), the first line of treatment is penicillin-G and amoxicillin. For penicillin-resistant form of this bacterium, sensitivity tests for identifying the appropriate antibiotics are conducted.
  • Supportive measures to manage bacterial infections are symptomatic treatment with analgesia, antipyretics, oxygen supplementation, intravenous fluids, respiratory therapy, suctioning and ventilation, use of intravenous fluids and chest physiotherapy. 
  • Proper hydration and nutrition also are important to manage the problems associated with bacterial pneumonia [9].

Prognosis

Most of the patients who suffer from bacterial pneumonia recuperate well with antibiotics. Patients, who develop complications of bacterial pneumonia, including sepsis, lung failure and meningitis, often die.

Though there is no possible method to predict the severity of the complications, patients with chronic medical conditions, or with low immunity is at a higher risk of complications.

Complications

Patients with pneumonia are often treated successfully with antibiotics, though some people may develop complications. Some of the complications of bacterial pneumonia are:

  • Bacteremia: In some patients, the bacteria can enter the bloodstream from the lungs parenchyma, thus spreading to the other organs, causing organ failure, a condition referred to as bacteremia.
  • Lung abscess: When pus forms in the cavity of the lungs, it is called an abscess. This condition can be successfully treated with antibiotics or by surgery
  • Pleural effusion: In this condition, fluid is accumulated around the lungs. In pneumonia, fluid is built up in the thin space between the linings of the lungs and the chest called pleura. If this fluid is infected, it must be drained with the help of a chest tube or surgery. 
  • Breathing problems: Patients with pneumonia often complain about difficulty in breathing enough oxygen. In severe cases, the patients are hospitalized and mechanical ventilator is used to assist breathing.

Etiology

The bacteria that cause community acquired pneumonia (CAP) in an outpatient setting are Klebsiella pneumonia, Streptococcus pneumoniae, and Haemophilus influenzae.

In non-intensive care unit, inpatient setting, the most common etiologies of CAP is Streptococcus pneumoniae, Klebsiella pneumonia, Haemophilus influenzae, Mycoplasma pneumoniae, and Legionella species. These infections are common in summer with the source of organisms arising from air conditioning systems.

In about 27% of the all the intubated patients, ventilator-associated pneumonia (VAP) develop, causing mortality as high as 30-60% [3] [4].

Epidemiology

Acute lower respiratory tract infections are one of the leading causes of death and hospitalization across the world. In fact, this type of infection is greater burden than HIV infection, cancer or malaria. Since the epidemiology of the disease varies significantly worldwide, the discussion of the international burden of the disease becomes difficult.

Pneumonia is prevalent in the winter, often resulting in impaired host defenses to bacterial superinfection. Race, gender and age also play a role in the pathogenesis of the bacterial pneumonia. For example, though the incidence of bacterial pneumonia is more in men than women, the number of deaths is higher among females. Advanced age increases the mortality from pneumonia. Compromised immune system and comorbidity often increase the chances of infection from bacteria [3] [4] [5] [6].

Sex distribution
Age distribution

Pathophysiology

The cause of bacterial pneumonia is both extrinsic and intrinsic. Several types of bacteria have been noted that can cause this type of pneumonia. While the extrinsic factors include exposure to pulmonary irritants, causative agents and/or pulmonary injury, intrinsic factors are those related to the host, such as loss of the protective airway reflexes due to the altered mental status due to intoxication or stroke.

Bacteria find their way to the parenchyma of the lungs, causing bacterial pneumonia. Impaired immune response, dysfunctioning of the defense mechanisms and poor dentition are some of the predisposing factors of the disease.

This pulmonary infection causes acute inflammation of the parenchyma, causing the neutrophils to migrate to the air spaces, ready to respond to the situation. These neutrophils kill the microbes and also form a chromatin mesh-work to entrap and kill the extracellular bacteria [6].

Prevention

Bacterial pneumonia can be prevented by following the under said measures:

  • Getting vaccinated: Seasonal flu-shots and pneumonia vaccine
  • Quit smoking
  • Maintaining proper hygiene
  • Exercise regularly [10].

Summary

The inflammation of the parenchyma of the lung is defined as pneumonia. This inflammation is caused by infection by the bacteria or virus. Sometimes, inhalation of chemicals, or trauma and infection of the chest wall can also contribute to the pneumonia. When the etiology of the pneumonia is a bacterium, it is called bacterial pneumonia [1] [2] [3].

Patient Information

Definition

Bacterial pneumonia is the infection and inflammation of the pleura of the lungs caused by the bacteria such as Streptococcus pneumoniae, Pseudomonas, Haemophilus, and pneumococcal species. 

Cause

Both the external and the internal factors of the host are responsible for the infected associated with bacterial pneumonia. Pathogens cause the infection and a weakened immune system allows for the easier passage of these microbes to the host body causing infection.

Symptoms

The most common symptom of bacterial pneumonia is persistent cough which precipitates into production of sputum. Other symptoms are fever, altered heart rate, significant breath sounds and difficulty in breathing. Patients with bacterial pneumonia have reported mental instability.

Diagnosis

Severity of the bacterial pneumonia can be determined by severity scores such as APACHE, and PSI/PORT. There are some laboratory tests that may be performed such as blood tests to identify the serum chemistry panel, complete blood count (CBC) with differential and urine tests. Sputum of the patient is also evaluated to assess the type of bacteria. Imaging studies such as chest radiography or chest ultrasonography are also suggested. Patients may be advised to get bronchoscopy and thoracentesis done. 

Treatment

Antibiotics are the mainstay in the treatment of bacterial pneumonia with good prognosis.

References

Article

  1. Anand N, Kollef MH. The alphabet soup of pneumonia: CAP, HAP, HCAP, NHAP, and VAP. Semin Respir Crit Care Med. Feb 2009;30(1):3-9. 
  2. El Solh AA. Nursing home-acquired pneumonia. Semin Respir Crit Care Med. Feb 2009;30(1):16-25.
  3. Kuti JL, Shore E, Palter M, Nicolau DP. Tackling empirical antibiotic therapy for ventilator-associated pneumonia in your ICU: guidance for implementing the guidelines. Semin Respir Crit Care Med. Feb 2009;30(1):102-15. 
  4. Rello J, Ollendorf DA, Oster G, Vera-Llonch M, Bellm L, Redman R, et al. Epidemiology and outcomes of ventilator-associated pneumonia in a large US database. Chest. Dec 2002;122(6):2115-21.
  5. Mufson MA, Stanek RJ. Bacteremic pneumococcal pneumonia in one American City: a 20-year longitudinal study, 1978-1997. Am J Med. Jul 26 1999;107(1A):34S-43S.
  6. Mizgerd JP. Acute lower respiratory tract infection. N Engl J Med. Feb 14 2008;358(7):716-27
  7. Dennis DT, Inglesby TV, Henderson DA, Bartlett JG, Ascher MS, Eitzen E, et al. Tularemia as a biological weapon: medical and public health management. JAMA. Jun 6 2001;285(21):2763-73.
  8. Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. Mar 1 2007;44 Suppl 2:S27-72
  9. Phua J, See KC, Chan YH, Widjaja LS, Aung NW, Ngerng WJ, et al. Validation and clinical implications of the IDSA/ATS minor criteria for severe community-acquired pneumonia. Thorax. Jul 2009;64(7):598-603.
  10. Centers for Disease Control and Prevention. Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine for Adults with Immunocompromising Conditions: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. Oct 12 2012;61:816-9

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Last updated: 2019-07-11 21:14