Hospital acquired pneumonia

Menu Close • • Type • • • • • • • • • • Theme • • • • • • • • • • • Sector • • • • • Location • • • • Condition • • • • • • • • • • • • • • • • • • • • • • • Career stage • • • • • Theme • • • • • • • • Condition • • • • • • • • • • • • • • • • • • • • • • • Career development • • • • • • • • By publication • • • • • • • Search Search • News • • Type • • • • • • • • • • Theme • • • • • • • • • • • Sector • • • • • Location • • • • Condition • • • • • • • • • • • • • • • • • • • • • • CPD & Learning • • Career stage • • • • • Theme • • • • • • • • Condition • • • • • • • • • • • • • • • • • • • • • • • Career development • • • • • • • Research • • By publication • • • • • PJ Jobs • • • Pneumonia is usually caused by bacterial or viral infection, resulting in inflammation of the lungs (see Figure 1). Pneumonias represent a major medical and economic problem because they are the most frequent causes of morbidity and mortality worldwide , particularly in certain patient groups, such as people who are immunocompromised, children and older adults . Pneumonia can be broadly defined as community-acquired (acquired outside hospital or healthcare facilities) and hospital-acquired (acquired after 48 hours of admission to hospital) . The former can be caused by viruses; atypical bacteria (bacteria that are neither Gram-negative nor Gram-positive), including Mycoplasma pneumoniae, Chlamydophila pneumoniae and Legionella pneumophila; and fungi. Hospital-acquired pneumonia (HAP), althoug...

Of more concern, the CDC notes that some “ Klebsiella bacteria have developed antimicrobial resistance” — meaning, antibiotics are not effective against certain strains. Patients who have a diagnosed Klebsiella infection should follow a strict hygiene regimen, including washing their hands frequently and avoiding touching their eyes or nose.

Contents • 1 Background • 1.1 Hospital-acquired pneumonia (HAP) • 1.2 Pseudomonas risk factors • 1.3 Causes of Pneumonia • 1.3.1 Bacteria • 1.3.2 Viral • 1.3.3 Fungal • 1.3.4 Parasitic • 1.4 Commonly Encountered Pathogens by Risk Factor • 2 Clinical Features • 3 Differential Diagnosis • 3.1 Acute dyspnea • 3.1.1 Emergent • 3.1.2 Non-Emergent • 4 IDSA Severe Pneumonia Criteria • 4.1 Minor criteria • 4.2 Major criteria • 5 Evaluation • 5.1 Chest X-Ray Mimics • 6 Management • 6.1 Outpatient • 6.1.1 Healthy [5] • 6.1.2 Unhealthy [6] • 6.2 Inpatient • 6.2.1 Community Acquired (Non-ICU) • 6.2.2 Hospital Acquired or Ventilator Associated Pneumonia • 6.2.3 Ventilator Associated Pneumnoia • 6.2.4 ICU, low risk of pseudomonas • 6.2.5 ICU, risk of pseudomonas • 7 Disposition • 7.1 Pneumonia severity index (Port Score) • 7.2 Disposition Pathway • 7.3 CURB-65 • 8 Prognosis • 9 See Also • 10 External Links • 11 References Background • Definition: infection of lung parenchyma • Empirically classified based upon location/risk factors Hospital-acquired pneumonia (HAP) • HCAP no longer entity in ISDA/American Thoracic Society guidelines • ISDA recommends only covering empirically for • Commonly accepted risk factors for resistant pathogens (e.g. MRSA, pseudomonas) historically include: • Hospitalized for 2 or more days within past 90 days • Nursing home/long-term care residents • Receiving home IV antibiotics • • Receiving chronic wound care • Receiving chemotherapy • Immunocompromised • • ...

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Pneumonia as seen on chest x-ray. A: Normal chest x-ray. B: Abnormal chest x-ray with shadowing from pneumonia in the right lung (left side of image). Hospital-acquired pneumonia ( HAP) or nosocomial pneumonia refers to any Hospital acquired pneumonia is the second most common Hospital acquired pneumonia typically lengthens a hospital stay by 1–2 weeks. Signs and symptoms [ ] New or progressive infiltrate on the chest X-ray with one of the following: • • Purulent sputum • In an elderly person, the first sign of hospital-acquired pneumonia may be mental changes or confusion. Other symptoms may include: • A cough with greenish or pus-like phlegm (sputum) • Fever and chills • General discomfort, uneasiness, or ill feeling (malaise) • Loss of appetite • Nausea and vomiting • Sharp chest pain that gets worse with deep breathing or coughing • Shortness of breath • Decreased blood pressure and fast heart rate Types [ ] • S. aureus (17.4%), • Ventilator-associated pneumonia [ ] See also: Ventilator-associated pneumonia ( VAP) is a sub-type of hospital-acquired pneumonia (HAP) which occurs in people who are receiving mechanical ventilation. VAP is not characterized by the causative agents; rather, as its name implies, definition of VAP is restricted to patients undergoing mechanical ventilation while in a hospital. A positive culture after intubation is indicative of ventilator-associated pneumonia and is diagnosed as such. In order to appropriately categorize the causative agent o...