Pathophysiology of Pneumonia

Pneumonia is defined as acute infection of the alveoli and the surrounding

tissues that is life threatening to most of the population. It affects all ages of both sexes,
especially the immunocompromised, chronically- ill and aged clients. It is the 6 th most
common cause of death in general and the most fatal of all infectious diseases acquired
in the hospital setting.

It is a result of invasion of bacteria, viruses, mycoplasmas, fungal agents, and

protozoa. The portal of entry for these pathogens could be because of inhalation of toxic
chemicals, smoke, dusts, and gases or aspiration of foods, fluids, or vomitus.
Furthermore, pneumonia could be classified into two: hospital- acquired and
community- acquired. It could be considered nosocomial or hospital- acquired if its
onset occurs 48 hours or more after hospital admission. Streptococcus pneumonia is
the most frequent cause of community- acquired pneumonia while Pseudomonas
aeruginosa is the most common pathogen found in hospital- acquired pneumonia
occurrences.

The risk factors for pneumonia may involve smoking, exposure to air pollution,
previous history of respiratory tract infection, prolonged immobility, malnutrition,
debilitating disease, advanced age, and being immunocompromised.

Clinical Manifestations of Pneumonia:

 Fever with chills

 Tachypnea
 Cough
 Pleuritic chest pain
 Sputum production, hemoptysis
 Dyspnea, shortness of breath
 Headache and easy fatigability
 Crackling breath sounds
 Increased tactile fremitus

Complications of pneumonia involving the pleural portion may include pleuritis

and empyema, development of lung abscess and bacteremia.

Schematic Diagram of Pneumonia

Alteration in net bacterial lung resistance caused by either:

Decreased bactericidal ability of the alveolar

macrophages

Extreme virulence of the bacteria

Increased susceptibility of host to infection

Acute inflammation occurs that causes excess water and

plasma proteins go to the dependent areas of the lower
lobes

RBCs, fibrin, and polymorphonuclear

leukocytes infiltrate the alveoli

Containment of the bacteria within the

segments of pulmonary lobes by cellular
recruitment

Consolidation of leukocytes and fibrin within

the affected area

Stage of congestion:

Engorgement of alveolar spaces with

fluid and of
Stage hemorrhagic exudates
gray hepatization:

The decrease in number of RBC in the

exudates
Stageis of
replaced by neutrophils;
red hepatization:
Proliferation and rapid spread of
which infiltrate the alveoli making the
organism throughoccurs
Coagulation the lobe
lung tissueoftoexudates resulting
be solid and grayish in
to the red appearance
color. of the affected
lung

PNEUMONIA