Pneumonia, hospital acquired

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Hi there!

You’re looking at a short reference article from Explain Medicine (one of four distinct learning formats available in Clinical Odyssey). Try it out, and have fun improving your clinical skills.

Medicine

Last updated on:
February 1^st, 2021

Medicine

Last updated on:
February 1^st, 2021

Hi there!

You’re looking at a short reference article from Explain Medicine (one of four distinct learning formats available in Clinical Odyssey). Try it out, and have fun improving your clinical skills.

Clinicals - History

Fact	Explanation
Introduction	Hospital-acquired pneumonia (HAP) is a nosocomial lung infection that occurs 48 hours after hospital admission. Common causative organisms include aerobic gram-negative bacilli (e.g., Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Enterobacter, Acinetobacter, Legionella pneumophila) and gram-positive cocci (such as Staphylococcus aureus, and Streptococcus spp.).
Cough	Cough is a common complaint in patients with pneumonia. Cough occurs reflexively in response to the presence of secretions caused by the infection and resulting inflammatory process.
Shortness of breath	Patients usually have a history of shortness of breath. This is caused by the presence of secretions in the alveoli, which leads to ineffective gaseous exchange.
Pleuritic chest pain	Patients with pneumonia may complain of chest pain. This is often described as stabbing, intense, and worsened by deep breathing, coughing, and sneezing. While the visceral pleura does not contain pain receptors, involvement of the somatic nerves in the parietal pleura leads to pleuritic chest pain.
Fever	Patients with pneumonia typically present with fever and night sweats. This is due to cytokine release following the initial inflammatory reaction.
Headache	Patients with pneumonia may complain of headache. This is caused by the action of cytokines, prostaglandins, and other immune mediators.
Confusion	Patients with pneumonia can present with confusion due to disturbances in the frontal cortex and reticular activating system. Elderly patients are more likely to present with altered mental status.
Sputum	Patients with HAP may present with sputum production. This is due to the exudative inflammatory infiltrate.
Risk of multidrug resistant pathogens	Risk factors for infection by a multidrug resistant (MDR) pathogen include: intravenous antibiotic use in last 90 days, use of mechanical ventilation, presence of structural lung disease, alcoholism, septic shock, and immunocompromised states.
Risk factors	Risk factors include: old age, malnutrition, pre-existing lung diseases, thoracic and abdominal surgery and immunocompromised states.

Introduction

Hospital-acquired pneumonia (HAP) is a nosocomial lung infection that occurs 48 hours after hospital admission.

Common causative organisms include aerobic gram-negative bacilli (e.g., Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Enterobacter, Acinetobacter, Legionella pneumophila) and gram-positive cocci (such as Staphylococcus aureus, and Streptococcus spp.).

Cough

Cough is a common complaint in patients with pneumonia. Cough occurs reflexively in response to the presence of secretions caused by the infection and resulting inflammatory process.

Shortness of breath

Patients usually have a history of shortness of breath. This is caused by the presence of secretions in the alveoli, which leads to ineffective gaseous exchange.

Pleuritic chest pain

Patients with pneumonia may complain of chest pain. This is often described as stabbing, intense, and worsened by deep breathing, coughing, and sneezing. While the visceral pleura does not contain pain receptors, involvement of the somatic nerves in the parietal pleura leads to pleuritic chest pain.

Fever

Patients with pneumonia typically present with fever and night sweats. This is due to cytokine release following the initial inflammatory reaction.

Headache

Patients with pneumonia may complain of headache. This is caused by the action of cytokines, prostaglandins, and other immune mediators.

Confusion

Patients with pneumonia can present with confusion due to disturbances in the frontal cortex and reticular activating system. Elderly patients are more likely to present with altered mental status.

Sputum

Patients with HAP may present with sputum production. This is due to the exudative inflammatory infiltrate.

Risk of multidrug resistant pathogens

Risk factors for infection by a multidrug resistant (MDR) pathogen include: intravenous antibiotic use in last 90 days, use of mechanical ventilation, presence of structural lung disease, alcoholism, septic shock, and immunocompromised states.

Risk factors

Risk factors include: old age, malnutrition, pre-existing lung diseases, thoracic and abdominal surgery and immunocompromised states.

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