Pneumonia refers to inflammation of the terminal airways, alveoli and pulmonary interstitium, which can be caused by pathogenic microorganisms, physical and chemical factors, immune damage, allergies and drugs.

① Air inhalation

② Blood dissemination

③Spread adjacent to the infected site

④Aspiration of upper respiratory tract colonized bacteria

anatomical classification

Cause classification

Environmental classification

clinical diagnosis

condition assessment

Identify the pathogen

empiric treatment

Antipathogenic therapy (targeted therapy)

efficient

invalid

① Toxicity is only related to the polysaccharide structure and content in the capsule

② Before the onset, there was often a history of exposure to rain, cold, excessive fatigue, alcoholism, etc.

③ Does not produce toxins, does not cause tissue necrosis or formation of cavities, and is most likely to form lobar pneumonia (not involving the bronchi)

Congestive phase, red liver transformation phase, gray liver transformation phase and dissipation phase

Symptoms: Acute onset, high fever (residual fever)/chills with systemic symptoms, cough and sputum (rusty-colored sputum), dyspnea, chest pain

Signs: Acute illness appearance, nasal flaring, cyanosis, oral herpes, pulmonary consolidation, pleural friction rub

The natural course of the disease is approximately 1-2 weeks

Antibacterial treatment: Penicillin G is preferred (the course of treatment is usually 14 days), fluoroquinolones and cephalosporins are used for allergic patients, and vancomycin is used for multi-drug resistance

Supportive therapy: Respiratory support is provided in severe cases; aspirin antipyretics are prohibited (to prevent collapse due to excessive sweating and interference with heat type); encourage drinking 1 to 2L of water per day, and infusions can be given to those who lose water; fasting and drinking should be avoided in patients with paralytic ileus gastrointestinal decompression

Treatment of complications: High fever subsides within 1 day after antibacterial treatment, otherwise extrapulmonary infection, such as axillary chest, pericarditis, meningitis or arthritis, needs to be considered; pleural fluid examination and culture should be taken as appropriate to determine its nature

Staphylococcus aureus (coagulase positive), Staphylococcus epidermidis, and Staphylococcus saprophyticus (coagulase negative)

Toxins and enzymes (hemolytic toxins, leukocidins, enterotoxins) have the effects of hemolysis, necrosis, leukocyte killing and vascular healing.

Primary inhalation infection is the most common and can also reach the lungs through the blood circulation

Symptoms: Acute onset, high fever/chills with systemic symptoms (obvious symptoms of toxemia), cough and sputum (a large amount of yellow purulent sputum/purulent and bloody sputum)

Chest X-ray shows consolidation of lung segments or lobes, which can form cavities or lobular infiltrates with fluid and air cysts.

The variability of shadows in X-ray images: manifested as the disappearance of inflammatory infiltrates in one place and the appearance of new lesions in another place, or the development of a small single lesion into a large shadow.

For early removal and drainage of primary lesions, enzyme-resistant penicillin is used; for MRSA, vancomycin is used

Damage to airway epithelium and ciliary activity, pathogenicity may be related to allergic reactions to pathogens or their metabolites

The incubation period is 2-3 weeks, and the onset is slow; children and young adults are the main susceptible groups

Lack of specificity, similar to symptoms of upper respiratory tract infection, with irritating cough as the prominent symptom

It is segmentally distributed, often seen in the lower lung fields, and disappears spontaneously after 3 to 4 weeks.

Mainly serological tests: cold agglutination test, mycoplasma IgM antibody test, mycoplasma antigen PCR test

Preferred macrolide antibiotics: erythromycin (<8 years old), tetracyclines (8-18 years old), quinolones (>18 years old)

Penicillins and cephalosporins are ineffective - Mycoplasma has no cell wall

It is self-limiting and most cases will resolve without treatment.