Advertisement

Pneumonia

  • Thomas P. Hellyer
  • Anthony J. Rostron
  • A. John Simpson
Chapter

Abstract

The chapter will begin with an overview of pathological-clinical correlates in pneumonia, and of the principles of diagnosis and treatment that can be broadly applied to all pneumonias. Thereafter, community-acquired pneumonia, hospital-acquired and ventilator-associated pneumonia, and aspiration pneumonia will be considered separately, considering aspects of management specifically relevant to each. The chapter will end by discussing preventive strategies, and with a brief outline of future challenges for the management of pneumonia.

Keywords

Immunity Pathology Cellular responses Repair Pneumococcus Atypical organisms Influenza Hospital-acquired pneumonia Ventilator-associated pneumonia Prevention Bronchoalveolar lavage Antibiotic regimens 

Notes

Acknowledgements

The authors are very grateful to Drs Anna Beattie, Fiona Black, and Joaquim Majo (all Newcastle upon Tyne Hospitals NHS Foundation Trust) for supplying images, and to Dr. Wendy Funston, Newcastle University, for help in reviewing the manuscript.

References

  1. 1.
    National Institute for Health and Care Excellence. Pneumonia in adults: diagnosis and management. Clinical guideline [CG191] Published date: December 2014. Available at: https://www.nice.org.uk/guidance/cg191.
  2. 2.
    Lim WS, Baudouin SV, George RC, Hill AT, Jamieson C, Le Jeune I, et al. BTS guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax. 2009;64(Suppl 3):iii1–55.CrossRefPubMedGoogle Scholar
  3. 3.
    Harris M, Clark J, Coote N, Fletcher P, Harnden A, McKean M, et al. British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011. Thorax. 2011;66(Suppl 2):ii1–23.CrossRefPubMedGoogle Scholar
  4. 4.
    Black RE, Morris SS, Bryce J. Where and why are 10 million children dying every year? Lancet. 2003;361(9376):2226–34.CrossRefPubMedGoogle Scholar
  5. 5.
    Chastre J, Fagon JY. Ventilator-associated pneumonia. Am J Respir Crit Care Med. 2002;165:867–903.CrossRefPubMedGoogle Scholar
  6. 6.
    Fagon JY, Chastre J, Wolff M, Gervais C, Parer-Aubas S, Stéphan F, et al. Invasive and noninvasive strategies for management of suspected ventilator-associated pneumonia. Ann Intern Med. 2000;132(8):621–30.CrossRefPubMedGoogle Scholar
  7. 7.
    Canadian Critical Care Trials Group. A randomized trial of diagnostic techniques for ventilator-associated pneumonia. N Engl J Med. 2006;355:2619–30.CrossRefGoogle Scholar
  8. 8.
    Lim WS, van der Eerden MM, Laing R, Boersma WG, Karalus N, Town GI, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003;58(5):377–82.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Fine MJ, Auble TE, Yealy DM, Hanusa BH, Weissfeld LA, Singer DE, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med. 1997;336(4):243–50.CrossRefPubMedGoogle Scholar
  10. 10.
    Masterton RG, Galloway A, French G, Street M, Armstrong J, Brown E, et al. Guidelines for the management of hospital-acquired pneumonia in the UK: report of the working party on hospital-acquired pneumonia of the British Society for Antimicrobial Chemotherapy. J Antimicrob Chemother. 2008;62:5–34.CrossRefPubMedGoogle Scholar
  11. 11.
    Rotstein C, Evans G, Born A, Grossman R, Light RB, Magder S, et al. Clinical practice guidelines for hospital-acquired pneumonia and ventilator-associated pneumonia in adults. Can J Infect Dis Med Microbiol. 2008;19:19–53.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Kalil AC, Metersky ML, Klompas M, Muscedere J, Sweeney DA, Palmer LB, et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis. 2016;63:e61–e111.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Torres A, Ewig S, Lode H, Carlet J, European HAP Working Group. Defining, treating and preventing hospital acquired pneumonia: European perspective. Intensive Care Med. 2009;35(1):9–29.CrossRefPubMedGoogle Scholar
  14. 14.
    Chastre J, Wolff M, Fagon JY, Chevret S, Thomas F, Wermert D, et al. Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial. JAMA. 2003;290:2588–98.CrossRefPubMedGoogle Scholar
  15. 15.
    Kett DH, Cano E, Quartin AA, Mangino JE, Zervos MJ, Peyrani P, et al. Implementation of guidelines for management of possible multidrug-resistant pneumonia in intensive care: an observational, multicentre cohort study. Lancet Infect Dis. 2011;11:181–9.CrossRefPubMedGoogle Scholar
  16. 16.
    Pugin J. Clinical signs and scores for the diagnosis of ventilator-associated pneumonia. Minerva Anastesiol. 2002;68:261–5.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Thomas P. Hellyer
    • 1
  • Anthony J. Rostron
    • 1
  • A. John Simpson
    • 1
  1. 1.Institute of Cellular MedicineNewcastle UniversityNewcastle upon TyneUK

Personalised recommendations