Chemical pneumonitis: Difference between revisions

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==Treatment==
==Treatment==
[[Chemical pneumonitis medical therapy#Chemical pneumonitis site of care decision|Site of care decision]] | [[Chemical pneumonitis medical therapy|Medical Therapy]] | [[Chemical pneumonitis medical therapy#Other treatments consideration|Other treatments consideration]] | [[Chemical pneumonitis prevention|Prevention]] | [[Chemical pneumonitis medical therapy#Management of non-responding Chemical pneumonitis|Management of non-responding Chemical pneumonitis]]
[[Chemical pneumonitis medical therapy#Chemical pneumonitis site of care decision|Site of care decision]] | [[Chemical pneumonitis medical therapy|Medical Therapy]] | [[Chemical pneumonitis medical therapy#Other treatments consideration|Other treatments consideration]] | [[Chemical pneumonitis prevention|Prevention]] | [[Chemical pneumonitis medical therapy#Management of non-responding Chemical pneumonitis|Management of non-responding Chemical pneumonitis]]
[[Category:Diseaase]]
[[Category:Diseaase]]
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{{Chemical pneumonitis}}
'''Editor(s)-in-Chief:''' [[C. Michael Gibson, M.S., M.D.]] [mailto:mgibson@perfuse.org] Phone:617-632-7753; [[Philip Marcus, M.D., M.P.H.]][mailto:pmarcus192@aol.com]


==Natural History, Complications and Prognosis==
==Natural History, Complications and Prognosis==

Revision as of 17:27, 8 September 2012

File:Streptococcus Chemical pneumonitise.jpg
Chemical pneumonitis
ICD-10 J12, J13, J14, J15, J16, J17, J18, P23
ICD-9 480-486, 770.0
DiseasesDB 10166
MeSH pneumonitis&field=entry#TreeC08.381.677 C08.381.677

Chemical pneumonitis Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Chemical pneumonitis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Chemical pneumonitis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Chemical pneumonitis

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X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Chemical pneumonitis

CDC onChemical pneumonitis

Chemical pneumonitis in the news

Blogs on Chemical pneumonitis

Directions to Hospitals Treating Chemical pneumonitis

Risk calculators and risk factors for Chemical pneumonitis

For patient information click here

Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753; Associate Editor(s)-In-Chief: Priyamvada Singh, M.D. [2]; Philip Marcus, M.D., M.P.H.[3]

Overview

Historical Perspective

Pathophysiology

Causes

Specific causes: Bacterial | Fungal | Parasitic | Viral
Classification scheme: Community-acquired Chemical pneumonitis | Health-care associated Chemical pneumonitis
Other types: Severe acute respiratory syndrome | Bronchiolitis obliterans organizing Chemical pneumonitis | Eosinophilic Chemical pneumonitis | Aspiration Chemical pneumonitis (Chemical pneumonitis | Aspiration Chemical pneumonitis bacterial infection | Airway obstruction)

Differentiating Chemical pneumonitis from other Diseases

Epidemiology and Demographics

Risk factors

Natural History, Complications and Prognosis

Prognosis predictor scores: CURB-65 | Chemical pneumonitis severity index | Criteria for severe community acquired Chemical pneumonitis

Diagnosis

Diagnostic criteria | History and Symptoms | Physical Examination | Laboratory Findings | Chest X Ray

Treatment

Site of care decision | Medical Therapy | Other treatments consideration | Prevention | Management of non-responding Chemical pneumonitis

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Natural History, Complications and Prognosis

Prognosis

  • Approximately, 3 in 5 patients have clinical improvement with clearing of chest Xray.
  • Approximately, 1 in every 3rd patient shows a rapid improvement followed with a new progressive infiltrate suggesting secondary superimposed bacterial infection or the development of ARDS.
  • The least common course but with worst prognosis is the development of fulminant disease resulting in acute death.

History & Symptoms

Physical examination

Vitals

General

Lung

Auscultation

Diagnosis

  • Documented aspiration may be absent or present
  • History, symptoms, physical examination
  • CXR with infiltrates in dependent pulmonary lobe
  • Bronchoscopy - Bronchial inflammation

Chest XRay

  • Infiltrates on chest Xray
    • Either unilateral or bilateral
    • Commonly in the dependent pulmonary segment
    • Dependent lobes in the upright position are the lower lobes
    • Dependent lobes in recumbent position are superior segments of the lower lobes and the posterior segments of the upper lobes.

Bronchoscopy

  • Erythema of the bronchi

Medical therapy

  • Tracheal suction (observed aspiration). However, the initial lung injury can't be prevented as it occurs rapidly

Supportive Pulmonary therapy

  • Positive pressure ventilation
  • Intravenous fluids (high molecular weight colloid)
  • Sodium nitroprusside infusion in the pulmonary artery
  • Mechanical ventilation (if respiratory failure)
  • Antimicrobial agents prophylactically for superimposed bacterial infection
  • Use of steroids is controversial

References

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