Hospital-acquired pneumonia: Difference between revisions

Pneumonia Main Page
	Hospital-acquired pneumonia Microchapters
Home
Patient Information
Overview
Historical Perspective
Pathophysiology
Causes
Differentiating Hospital-Acquired Pneumonia from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
Diagnostic Algorithm
History and Symptoms
Physical Examination
Laboratory Findings
Chest X Ray
CT
Other Imaging Findings
Treatment
Medical Therapy
Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Hospital-acquired pneumonia On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Hospital-acquired pneumonia All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Hospital-acquired pneumonia
CDC onHospital-acquired pneumonia
Hospital-acquired pneumonia in the news
Blogs on Hospital-acquired pneumonia
Directions to Hospitals Treating Hospital-acquired pneumonia
Risk calculators and risk factors for Hospital-acquired pneumonia

VisualWikitext

Latest revision as of 18:02, 18 September 2017

For the main page on pneumonia, click here.

For community-acquired pneumonia, click here.

For patient information, click here.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.D. [2]; Alejandro Lemor, M.D. [3]

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Hospital-Acquired Pneumonia from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

Treatment

Medical Therapy | Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Template:WH Template:WS

@@ Line 1: / Line 1: @@
+__NOTOC__
+'''For the main page on pneumonia, click [[pneumonia|here]].'''
+'''For community-acquired pneumonia, click [[community-acquired pneumonia|here]].'''
+'''For patient information, click [[Hospital-acquired pneumonia (patient information)|here]].'''
 {{Hospital-acquired pneumonia}}
-{{CMG}}
+{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.D.]] [mailto:psingh13579@gmail.com]; {{AL}}
 ==[[Hospital-acquired pneumonia overview|Overview]]==
 ==[[Hospital-acquired pneumonia historical perspective|Historical Perspective]]==
 ==[[Hospital-acquired pneumonia pathophysiology|Pathophysiology]]==
 ==[[Hospital-acquired pneumonia causes|Causes]]==
-==[[Hospital-acquired pneumonia differential diagnosis|Differentiating Hospital-acquired pneumonia from other Diseases]]==
+==[[Hospital-acquired pneumonia differential diagnosis|Differentiating Hospital-Acquired Pneumonia from other Diseases]]==
 ==[[Hospital-acquired pneumonia epidemiology and demographics|Epidemiology and Demographics]]==
 ==[[Hospital-acquired pneumonia risk factors|Risk Factors]]==
 ==[[Hospital-acquired pneumonia natural history, complications, and prognosis|Natural History, Complications and Prognosis]]==
-==Diagnosis==
-==[[Hospital-acquired pneumonia diagnostic criteria|Diagnostic criteria]]==
-==[[Hospital-acquired pneumonia history and symptoms|History and Symptoms]]==
-==[[Hospital-acquired pneumonia physical examination|Physical Examination]]==
-==[[Hospital-acquired pneumonia laboratory tests|Laboratory Findings]]==
-==[[Hospital-acquired pneumonia chest x ray|Chest X Ray]]==
-==[[Hospital-acquired pneumonia CT|CT]]==
-==Treatment==
-==[[Hospital-acquired pneumonia medical therapy|Medical Therapy]]==
-==[[Hospital-acquired pneumonia prevention|Prevention]]==
-==Etiology==
-The majority of cases related to various gram-negative bacilli(52%) and [[S. aureus]] (19%). Others are [[Haemophilus]] spp. (5%). In the ICU results were S. aureus(17.4%), [[P. aeruginosa]] (17.4%), [[Klebsiella pneumoniae]] and [[Enterobacter]] spp. (18.1%), and [[Haemophilus influenzae]] (4.9%).<ref name="Mandell"/> Viruses -[[influenza]] and [[respiratory syncytial virus]] and, in the immunocompromised host, [[cytomegalovirus]]- cause 10-20% of infections.<ref name="Oxford"/>
-==Risk factors==
-Among the factors contributing to contracting HAP are [[mechanical ventilation]] ([[ventilator-associated pneumonia]]), old age, decreased filtration of inspired air, intrinsic respiratory, neurologic, or other disease states that result in respiratory tract obstruction, trauma, (abdominal) surgery, medications, diminished lung volumes, or decreased clearance of secretions may diminish the defenses of the lung.  Also poor hand-washing and inaqeuate disinfection of respiratory devicescauses [[cross-infection]] and is an important factor.<ref name="Mandell"/><ref name="Harrison"/>
-==Clinical Features==
-[[Image:Pneumonia_x-ray.jpg|thumb|left|175px|'''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).]]
-New or progressive infiltrate on the chest X-Ray with one of the following:<ref name="Harrison"/>
-* [[Fever]] > 37.8 °C (100 °F)
-* Purulent sputum
-* [[Leucocytosis]] > 10.000 cells/μl
 ==Diagnosis==
-In hospitalised patient who develop respiratory symptoms and fever one should consider the diagnosis.  The likelyhood increases when upon investigation symptoms are found of [[respiratory insufficiency]], purulent secretions, newly developed infiltrate on the [[chest X-Ray]], and increasing [[leucocytosis|leucocyte count]].  If pneumonia is suspected material from sputum or tracheal aspirates are sent to the [[microbiology department]] for cultures.  In case of [[pleural effusion]] [[thoracentesis]] is performed for examination of [[pleural fluid]].  In suspected ventilator-associated pneumonia it has been suggested that [[bronchoscopy]]([[BAL]]) is necessary because of the known risks surrounding clinical diagnoses.<ref name="Mandell"/><ref name="Harrison"/>
+[[Hospital-acquired pneumonia diagnostic criteria|Diagnostic Criteria]] | [[Hospital-acquired pneumonia diagnostic algorithm|Diagnostic Algorithm]] | [[Hospital-acquired pneumonia history and symptoms| History and Symptoms]] | [[Hospital-acquired pneumonia physical examination | Physical Examination]] | [[Hospital-acquired pneumonia laboratory tests|Laboratory Findings]] | [[Hospital-acquired pneumonia chest x ray|Chest X Ray]] | [[Hospital-acquired pneumonia CT|CT]] | [[Hospital-acquired pneumonia other imaging findings|Other Imaging Findings]]
-===Diagnostic criteria of hospital acquired pneumonia===
-[[Community acquired pneumonia]] should be distinguished from healthcare-associated pneumonia as these diseases have different causative organism, prognosis, diagnostic and treatment guidelines.
-According to the Infectious Diseases Society of America and the American Thoracic Society healthcare-associated pneumonia includes any patient who meet the below criteria <ref name="pmid21663884">{{cite journal |author=Attridge RT, Frei CR |title=Health care-associated pneumonia: an evidence-based review |journal=[[The American Journal of Medicine]] |volume=124 |issue=8 |pages=689–97 |year=2011 |month=August |pmid=21663884 |doi=10.1016/j.amjmed.2011.01.023 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(11)00291-9 |accessdate=2012-09-02}}</ref>
-* Hospitalized in an acute care hospital for 2 or more days within 90 days of the infection;
-* Resided in a nursing home or long-term care facility;
-* Received recent intravenous antibiotic therapy, chemotherapy, or wound care within the past 30 days of the current infection;
-* Attended a hospital or hemodialysis clinic
-==Differential diagnosis==
-* [[Atelectasis]]
-* [[Congestive heart failure]]
-* [[Pulmonary embolism]]
 ==Treatment==
-Usually initial therapy is empirical.<ref name="Harrison"/> If sufficient reason to suspect [[influenza]] one might consider [[amantadine]] or [[rimantadine]]. In case of [[legionellosis]] [[erythromicin]] or [[fluoroquinolone]].<ref name="Mandell"/>
+[[Hospital-acquired pneumonia medical therapy|Medical Therapy]] | [[Hospital-acquired pneumonia prevention|Prevention]] | [[Hospital-acquired pneumonia cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Hospital-acquired pneumonia future or investigational therapies|Future or Investigational Therapies]]
-A third generation [[cephalosporin]] (ceftazidime) + [[carbapenems]] (imipenem) + beta lactam & beta lactamase inhibitors (piperacillin/tazobactum)
+==Case Studies==
-==References==
+[[Hospital-acquired pneumonia case study one|Case #1]]
-{{reflist|2}}
-[[Category:Diseaase]]
+[[Category:Disease]]
 [[Category:Pulmonology]]
-[[Category:Infectious disease]]
-[[Category:Pneumonia|Pneumonia]]
+[[Category:Pneumonia]]
 [[Category:Emergency medicine]]
 {{WH}}
 {{WS}}

Hospital-acquired pneumonia: Difference between revisions

Latest revision as of 18:02, 18 September 2017

Diagnosis

Treatment

Case Studies

Navigation menu