Pneumonia
Name: KHOR WEI CHIAN
Batch: BTCM19C
Lecturer: Dr. Liew Zhi Hao
Lung anatomy
Lung anatomy
Definition
 Pneumonia defined as an acute infection of pulmonary parenchyma in
one or both lungs.
 Pneumonia causes inflammation in the alveoli.
 The alveoli are filled with fluid or pus, making it difficult to breath
Etiology
Bacterial
Viruses
 Streptococcus pneumoniae
 Adenovirus
 Haemophilus influenza
 Influenza A and B
 Staphylococcus aureus
 Parainfluenza
 Mycoplasma pneumoniae
 Respiratorysyncytial virus
 Chlamydia species
Fungi(Rare)
 Legionella species
 Coccidioidomycosis
 Histoplasmosis
 Blastomyosis
Pathophysiology
Infection to the lung(eg. bacteria, virus)
Inflammatory response initiated
Alveolar edema+ exudate formation
Alveoli and respiratory bronchioles fill with serous exudate, blood cells, fibrin,
bacteria
Consolidation of lung tissues
Factors that predispose to pneumonia
Classification
TYPE OF PNEUMONIA
1. Community-Acquired Pneumonia (CAP)
 Occurs in community & during < 48 hours of hospitalization.
 Is the most common type of pneumonia.
2. Hospital-Acquired Pneumonia (HAP)
 Pneumonia occurring 48 hours or more during a hospital stay for another
illness. Higher risk client on a mechanical ventilator eg. Ventilatorassociated pneumonia (VAP).
Classification
3. Health Care-associated Pneumonia (HCP)
 Pneumonia in other health care settings, such as nursing homes, dialysis
centers, and outpatient clinics.
4. Aspiration Pneumonia
 Due to inhale foreign body, food, drink, vomit, or saliva from your mouth
into lungs that occur in condition of poor gag reflex eg. Brain injury,
dysphagia, or excessive use of alcohol or drugs.
Classification
5. Atypical Pneumonia
 Is most commonly caused by mycoplasma. Legionnaires' disease or
chlamydia and usually appears in children and young adults.
6.Hypostatic pneumonia
 Results from the collection of fluid in the dorsal region of the lungs and
occurs especially in those(as the bedridden or elderly, etc).
Anatomical classification
 Bronchopneumonia affects the
lungs in patches around bronchi
 Lobar pneumonia is an infection
that only involves a single lobe
or section
 Interstitial pneumonia involves the
areas in between the alveoli
• Patchy areas
• Asymmetrical
• Peribronchial
cuffing
• Fluid localized to a
single lobe
• Unilateral
• Air bronchogram
• Ground glass
appearance
• Bilateral,
symmetrical
• Concentrated in
the perihilar
region
• Reticular
Symptoms
 Difficulty breathing
 Chest pain
 Productive Cough- pus or bloody sputum
 Nausea
 Vomit
 Diarrhea
 Fever and chills
 Confusion
 Headache
 Muscle pain
 Fatigue
Complications
SLAP HER
 Septicaemia 败血症
 Lung abscess
 Acute respiratory distress syndrome
 Pleural effusions
 Hypotension
 Empyema
 Respiratory failure / Renal failure
Diagnosis
 1. History- s/s of suggestive pneumonia
 2. Auscultation: Abnormal lung sound. (bubbling or crackling)
 3. Palpation: Increased tactile fremitus
 4. Percussion: Dullness on percussion
 3. Blood test- raised WBC
 4. Chest X Ray
 5. Sputum test
Bacterial Pneumonia: Streptococcus pneumoniae, Haemophilus influenza, etc.
Purulent (pus-like) sputum, which may be yellow or greenish in color.
Viral Pneumonia: Influenza A and B, etc.
Sputum may be less purulent compared to bacterial pneumonia.
 6. Pulse oximetry
 7. Bronchoscopy
may reveal inflamed and reddened airway walls
may show the presence of excessive mucus, pus, or fluid in the airways
 8. CT scan and pleural fluid culture
Treatment
 Antibiotics
 Analgesics
 Mucolytic drugs
 Antihistamines
 Oxygen therapy
TCM Treatment
 Syndrome Differentiation and Treatment: the practitioner will determine the
patient's diagnosis based on the patient's signs, symptoms, tongue and
pulse.
Common types of pneumonia include:
 Phlegm-heat congestion of the lungs (痰热壅肺)- 清金化痰汤加减 to clear
away heat and resolve phlegm
 Lung yin deficiency (肺阴虚证)- 养阴清肺汤加减 to nourish Yin and moisten
the lungs
 Wind-cold attacking the lungs (风寒袭肺)- 小青龙汤加减 to relieving exterior
cold
 Acupuncture therapy: regulate the body's qi and blood balance, enhance
immunity, and relieve inflammation by stimulating specific points.
References
 Hua-Huat Soo, Lee-Gong Lau, Peng-Hong Chew. Sarawak Handbook of
Medical Emergencies. C. E. Publishing First Edition; 1999.
 Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds.
Harrison's Principles of Internal Medicine, 18e. New York, NY: McGraw-Hill;
2012.
 World Health Organization. (2021, November 11). Pneumonia. Who.int;
World Health Organization: WHO. https://www.who.int/news-room/factsheets/detail/pneumonia
 Cunha, B. A. (2001). Pneumonia in the Elderly. Clinical Microbiology and
Infection, 7(11), 581–588. https://doi.org/10.1046/j.1198-743x.2001.00328.x
 Carden DL, Gibb KA. Pneumonia and lung abscess. Emerg Med Clin North
Am. 1983 Aug;1(2):345-70. PMID: 6394291.
Thank You!!!