Bacterial pneumonia
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| Bacterial pneumonia Classification and external resources | |
| ICD-10 | J13.-J16. |
|---|---|
| ICD-9 | 481-483 |
| eMedicine | emerg/465 med/1852 |
Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [1] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch. Bacterial pneumonia is an infection of the lungs by bacteria.
See pneumonia for a general overview of pneumonia and its other causes.
| PNEUMONIA |
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| Infectious pneumonias |
| Pneumonias caused by infectious or noninfectious agents |
| Noninfectious pneumonia |
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Streptococcus pneumoniae (J13.) is the most common bacterial cause of pneumonia in all age groups except newborn infants. Streptococcus pneumoniae is a Gram-positive bacteria which often lives in the throat of people who do not have pneumonia. Another important Gram-positive cause of pneumonia is Staphylococcus aureus (J15.2).
Gram-negative bacteria are seen less frequently; Haemophilus influenzae (J14.), Klebsiella pneumoniae (J15.0), Escherichia coli (J15.5), Pseudomonas aeruginosa (J15.1) and Moraxella catarrhalis are the most common. These bacteria often live in the gut and enter the lungs when contents of the gut (such as vomit) are inhaled.
The "atypical" bacteria are Coxiella burnetti, Chlamydophila pneumoniae (J16.0), Mycoplasma pneumoniae (J15.7), and Legionella pneumophila. They are "atypical" because they commonly affect teenagers and young adults, are less severe, and require different antibiotics than typical bacteria such as Streptococcus pneumoniae.
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 continually being inhaled into the alveoli. 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 which 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 often travel from the lung into the blood stream and can result in serious illness such as 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.
Treatment
Antibiotics are the treatment of choice for bacterial pneumonia. 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 who acquire 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 should always be considered when initiating pharmacotherapy. In hospitalized individuals or those with immune deficiencies, local guidelines determine the selection of antibiotics. These antibiotics are typically given through an intravenous line.
Treatment of gram-positive organisms
- Streptococcus pneumoniae - amoxicillin (or erythromycin in patients allergic to penicillin); cefuroxime and erythromycin in severe cases.
- Staphylococcus aureus - flucloxacillin (to counteract the organism's β-lactamase)
Treatment of gram-negative organisms
- Haemophilus influenzae
- Klebsiella pneumoniae
- Escherichia coli
- Pseudomonas aeruginosa
- Moraxella catarrhalis
Treatment of atypical organisms
Most atypical causes of pneumonia require treatment for 14-21 days.
- Chlamydophila pneumoniae - doxycycline
- Chlamydophila psittaci - erythromycin
- Mycoplasma pneumoniae - erythromycin
- Coxiella burnetti - erythromycin
- Legionella pneumophila - erythromycin, with rifampicin sometimes added.
People who have difficulty breathing due to pneumonia may require extra oxygen. An extremely sick individual may require artificial ventilation and intensive care as life-saving measures while his or her immune system fights off the infectious cause with the help of antibiotics and other drugs.
WikiDoc Research Resources for Bacterial pneumonia | |
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| Articles on Bacterial pneumonia | Most recent articles on Bacterial pneumonia • Most cited articles on Bacterial pneumonia • Review articles on Bacterial pneumonia • Articles on Bacterial pneumonia in N Eng J Med, Lancet, BMJ |
| Media (Slides, Video, Images, MP3) on Bacterial pneumonia | Powerpoint slides on Bacterial pneumonia • Images of Bacterial pneumonia • Photos of Bacterial pneumonia • Podcasts & MP3s on Bacterial pneumonia • Videos on Bacterial pneumonia |
| Evidence Based Medicine Regarding Bacterial pneumonia | Cochrane Collaboration on Bacterial pneumonia • Bandolier on Bacterial pneumonia • TRIP on Bacterial pneumonia |
| Cost Effectiveness of Bacterial pneumonia | Cost Effectiveness of Bacterial pneumonia |
| Clinical Trials Involving Bacterial pneumonia | Ongoing Trials on Bacterial pneumonia at Clinical Trials.gov • Trial results on Bacterial pneumonia • Clinical Trials on Bacterial pneumonia at Google |
| Guidelines / Policies / Government Resources (FDA/CDC) Regarding Bacterial pneumonia | US National Guidelines Clearinghouse on Bacterial pneumonia • NICE Guidance on Bacterial pneumonia • NHS PRODIGY Guidance • FDA on Bacterial pneumonia • CDC on Bacterial pneumonia |
| Textbook Information on Bacterial pneumonia | Books and Textbook Information on Bacterial pneumonia |
| Pharmacology Resources on Bacterial pneumonia | Dosing of Bacterial pneumonia • Drug interactions with Bacterial pneumonia • Side effects of Bacterial pneumonia • Allergic reactions to Bacterial pneumonia • Overdose information on Bacterial pneumonia • Carcinogenicity information on Bacterial pneumonia • Bacterial pneumonia in pregnancy • Pharmacokinetics of Bacterial pneumonia • |
| Genetics, Pharmacogenomics, and Proteinomics of Bacterial pneumonia | Genetics of Bacterial pneumonia • Pharmacogenomics of Bacterial pneumonia • Proteomics of Bacterial pneumonia |
| Newstories on Bacterial pneumonia | Bacterial pneumonia in the news • Be alerted to news on Bacterial pneumonia • News trends on Bacterial pneumonia |
| Commentary on Bacterial pneumonia | Blogs on Bacterial pneumonia |
| Patient Resources on Bacterial pneumonia | Patient resources on Bacterial pneumonia • Discussion groups on Bacterial pneumonia • Patient Handouts on Bacterial pneumonia • Directions to Hospitals Treating Bacterial pneumonia • Risk calculators and risk factors for Bacterial pneumonia |
| Healthcare Provider Resources on Bacterial pneumonia | Symptoms of Bacterial pneumonia • Causes & Risk Factors for Bacterial pneumonia • Diagnostic studies for Bacterial pneumonia • Treatment of Bacterial pneumonia |
| Continuing Medical Education (CME) Programs on Bacterial pneumonia | CME Programs on Bacterial pneumonia |
| International Resources on Bacterial pneumonia | Bacterial pneumonia en Espanol • Bacterial pneumonia en Francais |
| Business Resources on Bacterial pneumonia | Bacterial pneumonia in the Marketplace • Patents on Bacterial pneumonia |
| Informatics Resources on Bacterial pneumonia | List of terms related to Bacterial pneumonia |
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
