PNEUMONII
2
Tip Pneumonie Franc Lobara Bronhopneumon ie Streptococica (alti agenti decit Sttp.Pneumoni ae) Stafilococic a Cu “G Etiologie Sttp. Pneumoniae (aspiratie/inh alare) Diversi germeni Sttp.pyogenes beta- hemolitic A Sttp.viridans (rar, saprofit cav.bucal) Staphylococc us aureus (bronhogen/ hematogen) Klebsi pneumo Escher coli Haemop infl. (bronh hem.) Patogenie Alveolita exsudativa fibrinoasa cu evolutie stadiala Alveolita in diverse stadii de evolutie situate in jurul unei bronhii mici Post-virale/ sttp. De regula lobulare, cu abcedare. Pleurezie Coagul. i/vasc. – necroza - pneumatocele Abceda Clinica Frison,Febra,J unghi, Tuse,Dispnee,S emne de intoxicatie . Variata Stare generala ↓sever Intoxicatie marcata . Absenta sputei fetide si a fibr.elastic e in ea des So septic Detres respir acuta Explorari paraclini ce *Radiologic : sindrom de condensare *Leucocitoza , VSH↑ *Examen sputa *Rad. : opacitati diseminate,di ferite, contur difuz *Rad. :ca si bronhopneumon ia *Sttp.in lichid pleural si hemocul. *Rad. :ca si bronhopneumo .+ pneumatocele *Sputo a (dific Evolutie/ Complicat ii/ Pronostic *7-12 zile la sanatosi *Pleurezie,Abc es, Evolutie indelungata > franc lobara Ca si la Franc Lobara Evolutie severa, uneori 6-8 luni Evolut grava
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Transcript of PNEUMONII
TipPneumonie
Franc Lobara Bronhopneumonie Streptococica (alti agenti decit Sttp.Pneumoniae)
Stafilococica Cu “G-“
Etiologie Sttp. Pneumoniae(aspiratie/inhalare)
Diversi germeni Sttp.pyogenes beta-hemolitic ASttp.viridans(rar,saprofit cav.bucal)
Staphylococcus aureus(bronhogen/hematogen)
Klebsiella pneumoEscherichia coliHaemophilus infl.(bronho/rar hem.)
Patogenie Alveolita exsudativa fibrinoasa cu evolutie stadiala
Alveolita in diverse stadii de evolutie situate in jurul uneibronhii mici
Post-virale/sttp.De regula lobulare, cu abcedare.Pleurezie
Coagul. i/vasc. –necroza - pneumatocele
Abcedare
Clinica Frison,Febra,Junghi,Tuse,Dispnee,Semnede intoxicatie .
Variata Stare generala ↓sever
Intoxicatie marcata . Absenta sputei fetide si a fibr.elastice in ea
des Soc septic,Detresa respiratorie acuta
Explorariparaclinice
*Radiologic : sindrom de condensare*Leucocitoza ,VSH↑*Examen sputa
*Rad. : opacitati diseminate,diferite,contur difuz
*Rad. :ca si bronhopneumonia*Sttp.in lichid pleural si hemocul.
*Rad. :ca si bronhopneumo.+pneumatocele
*Sputocultura(dificila)
Evolutie/Complicatii/Pronostic
*7-12 zile la sanatosi*Pleurezie,Abces,Sepsis,Suprainfectie.
Evolutie indelungata > franc lobara
Ca si la Franc Lobara
Evolutie severa, uneori 6-8 luni
Evolutie grava
Tratament 1.Amoxicilina per os2.Vancomicina,Ofloxacina (pentru rezistenti la peniciline)
Conform antibiogramei
1.Penicilina G2.Ampicilina3.Cefalosporinede gen.III
1.Oxacilina2.Ampicilina/sulactam3.Cefixim4.Vancomicina
1.Cefuroxim2.Aminoglicozide3.Antipiocianice,penemi,ceftazidim(risc Pseudomona)
