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{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.D.]] [mailto:psingh13579@gmail.com]; {{AL}}
{{Pneumonia}}
{{Pneumonia}}
{{CMG}}; {{AE}} [[Priyamvada Singh|Priyamvada Singh, M.D.]] [mailto:psingh13579@gmail.com]; {{AL}}; {{Ochuko}}
==Overview==
==Overview==
Pneumonia can result from a variety of causes, including infection with [[bacteria]], [[viruses]], [[fungi]], [[parasites]], and chemical or physical injury to the lungs. The etiology will depend upon various factors such as age, immune status, geographical area, and comorbidities.
Pneumonia can result from a variety of causes, including infection with [[bacteria]], [[viruses]], [[fungi]], [[parasites]], and chemical or physical injury to the lungs. The etiology will depend upon various factors such as age, immune status, geographical area, and comorbidities.


==Causes==
==Causes==
===Life Threatening Causes===
===Common Causes===
===Causes by Organ System===
===Causes in Aphabetical Order===
====Microbiological Etiology====
====Microbiological Etiology====
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==Causes by Pathogen==
===Causes by Pathogen===


:'''''[[Bacterial pneumonia|Click here for bacterial pneumonia]]'''''<br>
:'''''[[Bacterial pneumonia|Click here for bacterial pneumonia]]'''''<br>
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:'''''[[Fungal pneumonia|Click here for fungal pneumonia]]'''''<br>
:'''''[[Fungal pneumonia|Click here for fungal pneumonia]]'''''<br>


==Causes by Age==
===Causes by Age===


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==References==
==References==
{{reflist|2}}
{{Reflist|2}}


[[Category:Disease]]
[[Category:Disease]]
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[[Category:Pneumonia|Pneumonia]]
[[Category:Pneumonia|Pneumonia]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Crowdiagnosis]]


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Revision as of 17:17, 17 March 2016

Pneumonia Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Priyamvada Singh, M.D. [2]; Alejandro Lemor, M.D. [3]; Ogheneochuko Ajari, MB.BS, MS [4]


Overview

Pneumonia can result from a variety of causes, including infection with bacteria, viruses, fungi, parasites, and chemical or physical injury to the lungs. The etiology will depend upon various factors such as age, immune status, geographical area, and comorbidities.

Causes

Life Threatening Causes

Common Causes

Causes by Organ System

Causes in Aphabetical Order

Microbiological Etiology

Typical Bacteria Atypical Bacteria Viruses
  1. Streptococcus pneumoniae
  2. Haemophilus influenzae
  3. Staphylococcus aureus
  4. Escherichia coli
  5. Klebsiella pneumoniae
  6. Pseudomonas aeruginosa
  1. Mycoplasma pneumoniae
  2. Chlamydophila pneumoniae
  3. Legionella pneumophila
  1. Influenza
  2. Parainfluenza
  3. Respiratory syncytial virus (RSV)
  4. Metapneumovirus
  5. Adenovirus

Most Common Etiologies for Community-Acquired Pneumonia [1][2][3]

Outpatient Inpatient (non-ICU) Inpatient (ICU)
  1. Streptococcus pneumoniae
  2. Mycoplasma pneumoniae
  3. Haemophilus influenzae
  4. Chlamydophila pneumoniae
  5. Influenza A and B, adenovirus, respiratory syncytial virus, parainfluenza
  1. Streptococcus pneumoniae
  2. Mycoplasma pneumoniae
  3. Haemophilus influenzae
  4. Legionella
  5. Aspiration
  6. Influenza A and B, adenovirus, respiratory syncytial virus, parainfluenza
  7. Yersinia enterocolitica
  1. Streptococcus pneumoniae
  2. Staphylococcus aureus
  3. Legionella
  4. Gram-negative bacilli
  5. Haemophilus influenzae
  6. Acinetobacter baumannii

Causes by Pathogen

Click here for bacterial pneumonia
Click here for viral pneumonia
Click here for fungal pneumonia

Causes by Age

Common Causes by Age Group
Pathogen Neonates Children Adults
Bacteria
  1. Listeria monocytogenes
  2. Mycobacterium tuberculosis
  1. Mycoplasma pneumoniae
  2. Chlamydophila pneumoniae
  3. Legionella pneumophila
  4. Chlamydia trachomatis

Typical Bacteria

  1. Streptococcus pneumoniae
  2. Haemophilus influenzae
  3. Escherichia coli
  4. Klebsiella pneumoniae
  5. Pseudomonas aeruginosa

Atypical Bacteria

  1. Mycoplasma pneumoniae
  2. Chlamydophila pneumoniae
  3. Legionella pneumophila
Virus
  1. Herpes simplex virus
  2. Adenovirus
  3. Mumps
  4. Enterovirus
  1. Respiratory syncytial virus (RSV)
  2. Metapneumovirus
  3. Adenovirus
  4. Parainfluenza
  5. Influenza
  6. Rhinovirus
  1. Influenza
  2. Parainfluenza
  3. Respiratory syncytial virus (RSV)
  4. Metapneumovirus
  5. Adenovirus
  • Newborn infants, children, and adults are at risk for different spectrums of disease causing microorganisms.
  • In addition, adults with chronic illnesses, who live in certain parts of the world, who reside in nursing homes, who have recently been treated with antibiotics, or who are alcoholics are at risk for unique infections.

Infants

Source of Infection

  • Aerosol
  • Aspiration of amniotic fluid
  • Blood-borne infection across the placenta
Newborn

Children

Adults

Viruses

Atypical Organisms

  • Mycoplasma pneumoniae, chlamydophila pneumoniae, and legionella pneumophila are often grouped as atypical pneumonia. Community acquired pneumonia caused by these agents present insidiously, with a non-productive cough and prominent extra-pulmonary complaints, such as myalgias and diarrhea (lack the typical pneumonia symptoms of fever, cough, and sputum).
  • Mycoplasma pneumonia is often called is "walking pneumonia." It is transmitted via respiratory droplets and is common among healthy individuals in close contact with one another, such as dormitories or military barracks.
  • Atypical organisms are more difficult to grow, respond to different antibiotics, and were discovered more recently than the typical bacteria discovered in the early twentieth century.

Streptococcus Pneumoniae

  • Streptococcus pneumoniae is the most common cause of community acquired pneumonia.
  • Aspiration pneumonia is most commonly caused by anaerobic organisms.
  • Prior to the development of antibiotics and vaccination, it was a leading cause of death.
  • Traditionally, it was highly sensitive to penicillin, but during the 1970s resistance to multiple antibiotics began to develop.
  • Current strains of "drug resistant Streptococcus pneumoniae" or DRSP are common, accounting for twenty percent of all streptococcus pneumoniae infections.
  • Adults with risk factors for DRSP including being older than 65, having exposure to children in day care, alcoholism, other severe underlying disease, or recent treatment with antibiotics should initially be treated with antibiotics effective against DRSP.[8]

Hemophilus Influenzae

  • Another common bacterial cause of CAP.
  • First discovered in 1892, it was initially believed to be the cause of influenza because it commonly causes CAP in people who have suffered recent lung damage from viral pneumonia.

Enteric Gram Negative Bacteria

Pseudomonas Aeruginosa

  • Uncommon cause of CAP, but it is a particularly difficult bacteria to treat.
  • Individuals who are malnourished, have bronchiectasis, are on corticosteroids, or have recently had strong antibiotics for a week or more, should initially be treated with antibiotics effective against Pseudomonas aeruginosa.[9]

Special Situations

Aspiration Pneumonia Causes

  • Incompetent swallowing mechanism, such as in neurological disease (a common cause being strokes) or while a person is intoxicated.
  • Iatrogenic causes such as general anaesthesia for an operation. Patients are therefore instructed to be nil per os (NPO) for at least four hours before surgery.
  • Whether aspiration pneumonia represents a true bacterial infection or a chemical inflammatory process remains the subject of significant controversy.

Drug Side Effect

References

  1. Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM, Musher DM, Niederman MS, Torres A, Whitney CG (2007). "Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults". Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 44 Suppl 2: S27–72. doi:10.1086/511159. PMID 17278083. Retrieved 2012-09-06. Unknown parameter |month= ignored (help)
  2. Wong, KK.; Fistek, M.; Watkins, RR. (2013). "Community-acquired pneumonia caused by Yersinia enterocolitica in an immunocompetent patient". J Med Microbiol. 62 (Pt 4): 650–1. doi:10.1099/jmm.0.053488-0. PMID 23242642. Unknown parameter |month= ignored (help)
  3. Oh, YJ.; Song, SH.; Baik, SH.; Lee, HH.; Han, IM.; Oh, DH. (2013). "A case of fulminant community-acquired Acinetobacter baumannii pneumonia in Korea". Korean J Intern Med. 28 (4): 486–90. doi:10.3904/kjim.2013.28.4.486. PMID 23864808. Unknown parameter |month= ignored (help)
  4. Webber S, Wilkinson AR, Lindsell D, Hope PL, Dobson SR, Isaacs D (1990). "Neonatal pneumonia". Arch Dis Child. 65 (2): 207–11. PMC 1792235. PMID 2107797.
  5. Wubbel L, Muniz L, Ahmed A, Trujillo M, Carubelli C, McCoig C; et al. (1999). "Etiology and treatment of community-acquired pneumonia in ambulatory children". Pediatr Infect Dis J. 18 (2): 98–104. PMID 10048679.
  6. Abzug MJ, Beam AC, Gyorkos EA, Levin MJ (1990). "Viral pneumonia in the first month of life". Pediatr Infect Dis J. 9 (12): 881–5. PMID 2177540.
  7. de Roux A, Marcos MA, Garcia E, Mensa J, Ewig S, Lode H; et al. (2004). "Viral community-acquired pneumonia in nonimmunocompromised adults". Chest. 125 (4): 1343–51. PMID 15078744. Check |pmid= value (help).
  8. Ruhe JJ, Myers L, Mushatt D, Hasbun R (2004). "High-level penicillin-nonsusceptible Streptococcus pneumoniae bacteremia: identification of a low-risk subgroup". Clin Infect Dis. 38 (4): 508–14. doi:10.1086/381197. PMID 14765343.
  9. Lieberman D, Schlaeffer F, Boldur I, Lieberman D, Horowitz S, Friedman MG; et al. (1996). "Multiple pathogens in adult patients admitted with community-acquired pneumonia: a one year prospective study of 346 consecutive patients". Thorax. 51 (2): 179–84. PMC 473032. PMID 8711652.

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