Hospital-acquired pneumonia: Difference between revisions

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Revision as of 20:19, 5 September 2012

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

Treatment

Medical Therapy

Prevention

Diagnosis

Differential diagnosis

Treatment

Usually initial therapy is empirical.^[1] If sufficient reason to suspect influenza one might consider amantadine or rimantadine. In case of legionellosis erythromicin or fluoroquinolone.^[2]

A third generation cephalosporin (ceftazidime) + carbapenems (imipenem) + beta lactam & beta lactamase inhibitors (piperacillin/tazobactum)

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[Harrison-1] ↑

[Mandell-2] ↑

[1]

[2]

@@ Line 22: / Line 22: @@
 ==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"/>
-===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==

Hospital-acquired pneumonia: Difference between revisions

Revision as of 20:19, 5 September 2012

Contents

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

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

Treatment

Medical Therapy

Prevention

Diagnosis

Differential diagnosis

Treatment

References

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