Types of Pneumonia

  • Aspiration Pneumonia
    • Results from abnormal entry of secretions into lower airway
    • Major risk factors:
      • Decreased level of consciousness
      • Difficulty swallowing
      • Insertion of nasogastric tubes with or without tube feeding
    • Aspirated material triggers inflammatory response
    • Primary bacterial infection most common
    • Empiric therapy based on severity of illness, where infection acquired, and probable causative organism
    • Aspiration of acid gastric contents initially causes chemical (noninfectious) pneumonitis
  • Necrotizing Pneumonia
    • Rare complication of bacterial lung infection
    • Often results from CAP
    • Signs and symptoms
      • Immediate respiratory insufficiency and/or failure
      • Leukopenia
      • Bleeding into airways
  • Opportunistic Pneumonia
    • Patients at risk
      • Severe protein-calorie malnutrition
      • Immunodeficiencies
      • Chemotherapy/radiation recipients
      • Long-term corticosteroid therapy
    • Caused by microorganisms that do not normally cause disease
  • Pneumocystis jiroveci pneumonia (PJP)
    • Onset slow and subtle
    • Diffuse bilateral infiltrates to massive consolidation
    • Can be life threatening
    • Spread to other organs
    • Treat with trimethoprim/sulfamethoxazole IV or orally
  • Cytomegalovirus (CMV) pneumonia
    • Herpes virus
    • Asymptomatic and mild to severe disease
    • Life threatening in immunosuppressed person
    • Treat with antiviral medications and high-dose immunoglobulin