A‌‍‍‍‌‍‍‌‌‍‍‍‌‍‍‍‍‌‍‍ student post this as a discussion post, please reply with

A‌‍‍‍‌‍‍‌‌‍‍‍‌‍‍‍‍‌‍‍ student post this as a discussion post, please reply with 1 reference. Nonbacterial and bacterial pneumonia Pneumonia is a serious condition for children and the elderly. Bacterial pneumonia is often cause by S. pneumoniae, S. aureus, H. influenzae, and M. catarrhalis. Non-bacterial pneumonia can be caused by a virus or fungus. Common viral causes are the Adenovirus, Influenza a and b, Parainfluenza, and RSV. Common fungal causes are Blastomycosis, Coccidioidomycosis, and Histoplasmosis (Dunphy et al., 2019). Bacterial pneumonia Can be divided into two categories lobar pneumonia where there is consolidation in one lobe of the lung, and bronchopneumonia where there is consolidation in multiple lobes. The infecting agent breaks down the protective mucosa of your lungs allowing bacteria to colonize. As white blood cells attack the infecting agent the air sacs within the lungs become filled, making it difficult to breath and causing pneumonia (Norris, 2019). Epidemiology According to the Centers for Disease Control (CDC) (2020) an estimated 150,000 patients are hospitalized with pneumonia every year. Approximately 30% of patients with pneumonia will develop bacteremia, and an approximated 7% of patients will die from pneumonia, with the very young and old being more susceptible (CDC, 2020). In children 70% of pneumonia cases have been found to be viral with only 15% being caused by bacteria (Garzon et al., 2020) Physical exam findings With pneumonia typical physical exam findings include nasal flaring, grunting, retractions. The most common and sometimes only symptom is tachypnea. It is important to watch for more than 60 breaths per minute (BPM) in infa‌‍‍‍‌‍‍‌‌‍‍‍‌‍‍‍‍‌‍‍nts younger than two months, more than 50 BPM in children two to 11 months, and more than 40 BPM in children one to five years old. Tachycardia, air hunger, and cyanosis are also significant findings to watch for. Upon auscultation lung sounds may be fine crackles, dullness, and diminished breath sounds. Findings associated with bacterial pneumonia are fever and hypoxia, tachypnea and retractions, progression to delirium, circumoral cyanosis, and posturing, abdominal distention, downward displacement of the liver or spleen, and signs of effusion or congestive heart failure. Splinting the affected side to minimize pleuritic pain or lying on the side in a fetal position helps compensate for decreased air exchange and improves ventilation. Signs associated with viral pneumonia include wheezing, and downward displacement of the liver or spleen (Garzon et al., 2020). Differential diagnosis and rational There are several differential diagnoses to consider with pneumonia. They are bronchiolitis, congestive heart failure, acute bronchiectasis, FB aspiration, pulmonary abscess, parasitic pneumonia, and endotracheal tuberculosis. Without doing proper diagnostics it can be easy to confuse with these diagnoses as they have similar symptoms (Garzon et al., 2020). Management The majority of healthy children will be able to be treated as outpatients with supportive care, such as antipyretics, hydration, and rest. Serious infections will require hospitalization for respiratory therapy, pulmonary therapy, and or intubation. The treatment for bacterial pneumonia will be either Azithromycin 10mg/kg/day on day one then 5mg/kg daily for four days, or Amoxicillin 90mg/kg/day divided into two doses every 12 hour‌‍‍‍‌‍‍‌‌‍‍‍‌‍‍‍‍‌‍‍s

Leave a Reply

Your email address will not be published. Required fields are marked *