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| {{DiseaseDisorder infobox |
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| Name = Bacterial pneumonia |
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| ICD10 = {{ICD10|J|13||j|10}}-{{ICD10|J|16||j|10}} |
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| ICD9 = {{ICD9|481}}-{{ICD9|483}} |
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| DiseasesDB = |
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| {{Bacterial pneumonia}} | | {{Bacterial pneumonia}} |
| '''Editor(s)-in-Chief:''' [[C. Michael Gibson, M.S., M.D.]] [mailto:mgibson@perfuse.org] Phone:617-632-7753; [[Philip Marcus, M.D., M.P.H.]][mailto:pmarcus192@aol.com] | | '''For the main page on pneumonia, click [[Pneumonia|here]]''' |
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| ==Overview==
| | '''For the patient information on pneumonia, click [[Pneumonia (patient information)|here]]''' |
| '''Bacterial pneumonia''' is an [[infection]] of the [[lung]]s by [[bacteria]]. | |
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| ''[[Streptococcus pneumoniae]]'' ({{ICD10|J|13||j|10}}) is the most common [[bacteria]]l cause of pneumonia in all age groups except newborn infants. ''Streptococcus pneumoniae'' is a [[Gram-positive]] bacteria which often lives in the throat of people who do not have pneumonia. Another important Gram-positive cause of pneumonia is ''[[Staphylococcus aureus]]'' ({{ICD10|J|15|2|j|10}}). | | '''Editor(s)-in-Chief:''' [[C. Michael Gibson, M.S., M.D.]] [mailto:charlesmichaelgibson@gmail.com]; '''Associate Editor(s)-In-Chief:''' [[User:AroojNaz|Arooj Naz, M.B.B.S]] |
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| Gram-negative bacteria are seen less frequently; ''[[Haemophilus influenzae]]'' ({{ICD10|J|14||j|10}}), ''[[Klebsiella pneumoniae]]'' ({{ICD10|J|15|0|j|10}}), ''[[Escherichia coli]]'' ({{ICD10|J|15|5|j|10}}), ''[[Pseudomonas|Pseudomonas aeruginosa]]'' ({{ICD10|J|15|1|j|10}}) and ''[[Moraxella catarrhalis]]'' are the most common. These bacteria often live in the [[gastrointestinal tract|gut]] and enter the lungs when contents of the gut (such as vomit) are inhaled.
| | ==[[Bacterial pneumonia overview|Overview]]== |
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| The "atypical" bacteria are ''[[Coxiella burnetti]]'', ''[[Chlamydophila pneumoniae]]'' ({{ICD10|J|16|0|j|10}}), ''[[Mycoplasma pneumoniae]]'' ({{ICD10|J|15|7|j|10}}), and ''[[Legionella pneumophila]]''. They are "atypical" because they commonly affect teenagers and young adults, are less severe, and require different antibiotics than typical bacteria such as ''Streptococcus pneumoniae''.
| | ==[[Bacterial pneumonia historical perspective|Historical Perspective]]== |
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| ==Pathophysiology== | | ==[[Bacterial pneumonia pathophysiology|Pathophysiology]]== |
| Bacteria typically enter the lung with inhalation, though they can reach the lung through the bloodstream if other parts of the body are infected. Often, bacteria live in parts of the [[upper respiratory tract]] and are continually being inhaled into the alveoli. Once inside the alveoli, [[bacteria]] travel into the spaces between the cells and also between adjacent alveoli through connecting pores. This invasion triggers the [[immune system]] to respond by sending white blood cells responsible for attacking microorganisms ([[neutrophil]]s) to the lungs. The neutrophils [[phagocytosis|engulf]] and kill the offending organisms but also release cytokines which result in a general activation of the immune system. 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.
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| [[Image:Streptococcus pneumoniae.jpg|200px|thumb|The bacterium '''''[[Streptococcus pneumoniae]]''''', a common cause of pneumonia, photographed through an[[electron microscope]].]]
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| Bacteria often travel from the lung into the blood stream and can result in serious illness such as [[septic shock]], in which there is low blood pressure leading to damage in multiple parts of the body including the [[brain]], [[kidney]], and [[heart]]. They can also travel to the area between the lungs and the chest wall, called the [[pleural cavity]].
| | ==[[Bacterial pneumonia causes|Causes]]== |
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| ==Treatment== | | ==[[Bacterial pneumonia differential diagnosis|Differentiating Bacterial pneumonia from other Diseases]]== |
| [[Antibiotic]]s are the treatment of choice for bacterial pneumonia. The antibiotic choice depends on the nature of the pneumonia, the microorganisms most commonly causing pneumonia in the geographical region, and the immune status and underlying health of the individual. In the [[United Kingdom]], [[amoxicillin]] is used as first-line therapy in the vast majority of patients who acquire pneumonia in the community, sometimes with added [[clarithromycin]]. In North America, where the "atypical" forms of community-acquired pneumonia are becoming more common, [[clarithromycin]], [[azithromycin]], or [[fluoroquinolones]] as single therapy, have displaced the amoxicillin as first-line therapy. | | |
| Local patterns of antibiotic-resistance should always be considered when initiating pharmacotherapy. In hospitalized individuals or those with immune deficiencies, local guidelines determine the selection of antibiotics. These antibiotics are typically given through an [[intravenous]] line.
| | ==[[Bacterial pneumonia epidemiology and demographics|Epidemiology and Demographics]]== |
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| ===Treatment of gram-positive organisms=== | | ==[[Bacterial pneumonia risk factors|Risk Factors]]== |
| *Streptococcus pneumoniae - amoxicillin (or erythromycin in patients allergic to penicillin); cefuroxime and erythromycin in severe cases.
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| *Staphylococcus aureus - flucloxacillin (to counteract the organism's β-lactamase)
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| ===Treatment of gram-negative organisms=== | | ==[[Bacterial pneumonia natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| *Haemophilus influenzae
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| *Klebsiella pneumoniae
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| *Escherichia coli
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| *Pseudomonas aeruginosa
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| *Moraxella catarrhalis
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| ===Treatment of atypical organisms=== | | ==Diagnosis== |
| Most atypical causes of pneumonia require treatment for 14-21 days.
| | [[Bacterial pneumonia history and symptoms|History and Symptoms]] | [[Bacterial pneumonia physical examination|Physical Examination]] | [[Bacterial pneumonia laboratory findings|Laboratory Findings]] | [[Bacterial pneumonia chest x ray|Chest X Ray]] | [[Bacterial pneumonia CT|CT]] | [[Bacterial pneumonia other imaging findings|Other Imaging Findings]] | [[Bacterial pneumonia other diagnostic studies|Other Diagnostic Studies]] |
| *Chlamydophila pneumoniae - doxycycline
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| *[[Chlamydophila psittaci]] - erythromycin
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| *Mycoplasma pneumoniae - erythromycin
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| *Coxiella burnetti - erythromycin
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| *Legionella pneumophila - erythromycin, with [[rifampicin]] sometimes added.
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| People who have difficulty breathing due to pneumonia may require extra [[oxygen]]. An extremely sick individual may require [[artificial ventilation]] and [[intensive care medicine|intensive care]] as life-saving measures while his or her immune system fights off the infectious cause with the help of antibiotics and other drugs.
| | ==Treatment== |
| | [[Bacterial pneumonia medical therapy|Medical Therapy]] | [[Bacterial pneumonia primary prevention|Primary Prevention]] | [[Bacterial pneumonia secondary prevention|Secondary Prevention]] | [[Bacterial pneumonia cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Bacterial pneumonia future or investigational therapies|Future or Investigational Therapies]] |
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| ==References== | | ==Case Studies== |
| {{reflist|2}}
| | [[Bacterial pneumonia case study one|Case #1]] |
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| [[Category:Diseaase]] | | [[Category:Disease]] |
| [[Category:Pulmonology]] | | [[Category:Pulmonology]] |
| [[Category:Bacterial diseases]] | | [[Category:Bacterial diseases]] |
| [[Category:Pneumonia|Pneumonia]] | | [[Category:Pneumonia]] |
| [[Category:Emergency medicine]] | | [[Category:Emergency medicine]] |
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| {{WH}} | | {{WH}} |
| {{WS}} | | {{WS}} |