Definition

Inflammatory condition of the lung 

Classification

1. Primary vs secondary
2. Organism
   • Viral
   • Bacterial
   • Fungal
3. Anatomy
   • Lobar pneumonia: exudate forms directly in bronchioles/aveoli
     1. spills into adjacent segments via pores of Kohn
     2. Confined to a lobe
     3. Usually staph
     4. Phases: (1) Congestion - inflammatory exudate (2) Red hepatisation - Neutrophils and extravasated erythrocytes (3) Grey hepatisation - Fibrin meshwork and degenerating erythrocytes (4) Resolution - Macrophage release fibrinolytic enzymes
   • Bronchopneumonia: starts at bronchioles, extends to alveoli.  Common in extremes of age
   • Interstitial pneumonia: chronic alveolar inflammation
4. Aetiology
   • Hospital acquired: loss of barriers, instrumentation, impaired cough reflex, aspiration
     1. Early: - OP organisms - staph aureus, strep pneumoniae
     2. Late: Gram negative - pseudomonas, enterobacter, acinetobacter, morganella
   • Community acquired

Severity score : CURB

Normal respiratory defences

1. Cough reflex
2. Mucociliary function
3. Aleolar macrophages
4. Secretory IgA

Complications of Pneumonia

1. Pleuritis - pleural effusion
2. Empyema
3. Lung abscess
4. Generalised sepsis 

Prevention of pneumonia

1. Protection / isolation
2. Intermittent feeding
3. Controlled use of antibiotics
4. Regular suctioning / chest physio