Bacteria Pneumonia

Respiratory (12%) Core Clinical Conditions

1A: Able to diagnose and manage

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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management

Definition

Bacterial pneumonia is a form of pneumonia that targets the airways and it is commonly caused by the bacteria: mycoplasma pneumoniae and streptococcus pneumoniae.

Aetiology

Mainly caused by the following organisms:

Streptococcus pneumoniae (most common).
Mycoplasma pneumoniae.
Legionella pneumophila.
Chlamydia pneumoniae.

Pathophysiology

Bacterial infiltration to the lower resp. tract.
Inflammatory response > trigger immune response.
Damage to the alveolar (caused by bacteria + immune response).
Accumulation of fluid in the lungs (consolidation).
Resolution (with appropriate treatment) or progression of disease if treatment failed or left untreated.

Risk factors

Smoking and environmental causes.
Weak immune system e.g. HIV/AIDS, cancer, receiving chemotherapy treatment.
Age: young and older individuals are more at risk.
Asthma/COPD, diabetes, heart disease and kidney disease.

Sign and symptoms

Productive cough.
Wheeze, SOB and fatigue.
Pleuritic chest pain.
O/E:dullness on percussion, crackles, hypoxia and tachycardia.

Diagnosis and investigations

CURB-65: used to check severity of pneumonia and if a patient needs to be admitted in the hospital: any presence of Confusion, Urea > 7, Resp rate > 30, Bp < 90 bpm and age over 65. If the patient scores more than 2 they will likely need to be admitted to the hospital.
Chest X-ray may display consolidation.
Blood test: full blood count (FBC), C-reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR), Full blood count (FBC) and UE to measure the urea.
Sputum culture.
Sepsis screening.
Arterial Blood Gas (ABG) Test.