Pneumonia

Infection of the lung tissue, causing inflammation of the lungs and sputum filling the airways and alveoli

Aetiology

  • Bacterial - Streptococcus pneumonia is most common, others include Group A and B strep, Staph. aureus and H. influenza
  • Viral - RSV is the most common viral cause

Clinical presentation

Symptoms

  • Cough (typically wet and productive)
  • High fever (> 38.5ºC)
  • Tachypnoea
  • Tachycardia
  • Increased work of breathing
  • Lethargy
  • Delirium (acute confusion associated with infection)

Signs

  • Bronchial breath sounds - harsh breath sounds that are equally loud on inspiration and expiration, caused by consolidation of the lung tissue around the airway
  • Focal coarse crackles - caused by air passing through sputum
  • Dullness to percussion - due to lung tissue collapse and/or consolidation

Investigations

  • CXR
  • Blood cultures if signs of sepsis

Management

  • Amoxicillin first line
  • Macrolide antibiotics e.g. erythromycin can be added to cover atypical pneumonia, or as a monotherapy in penicillin allergic patients