Bacterial pneumonia

Bacterial pneumonia
3D medical animation still showing Streptococcus pneumoniae bacteria (causative bacteria of much bacterial pneumonia and meningitis).
Specialty	Infectious disease
Causes	Bacterial infection

Bacterial pneumonia is a type of pneumonia caused by bacterial infection.^[1]

Types

Signs and symptoms

• Pneumonia
• Fever
• Rigors
• Cough
• Runny nose (either direct bacterial pneumonia or accompanied by primary viral pneumonia)
• Dyspnea – shortness of breath
• Chest pain
• Shaking chills^[3]
• Pneumococcal pneumonia can cause coughing up of blood, or hemoptysis, characteristically associated with "rusty" sputum^[4]

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 continuously being inhaled into the alveoli, the cavities deep in the lungs where gas exchange takes place. 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 (neutrophils) to the lungs. The neutrophils engulf and kill the offending organisms but also release cytokines that 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.

Bacteria can travel from the lung into the blood stream (bacteremia) and can result in serious illness such as sepsis and eventually 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.

Diagnosis

Infiltrates in segments of lobes and separate focuses in lingular lobes of left lung reveals the signs of bacterial pneumonia

The diagnosis of bacterial pneumonia is based on the following:^[5]

• Clinical exam
• Lab test
• Chest X-ray

Prevention

Prevention of bacterial pneumonia is by vaccination against Streptococcus pneumoniae (pneumococcal polysaccharide vaccine for adults and pneumococcal conjugate vaccine for children), Haemophilus influenzae type B, meningococcus, Bordetella pertussis, Bacillus anthracis, and Yersinia pestis.

Treatment

Antibiotics are the treatment of choice for bacterial pneumonia, with ventilation (oxygen supplement) as supportive therapy. 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 acquiring 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 always need to be considered when initiating pharmacotherapy. In hospitalized individuals or those with immune deficiencies, local guidelines determine the selection of antibiotics.

References

External links