non resolving pneumonia MD

non resolving pneumonia MD - Non Resolving pneumonia...

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1 Non Resolving pneumonia Introduction • Pneumonia- Not cured easily • 10% -CAP,60% of HAP have inadequate responses to the empirical therapy initiated • Necessitates Pulmonary specialist opinion bronchoscopic evaluation, • 10% of diagnostic bronchoscopies and 15% of pulmonary consultations • Variously defined
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2 Definition • Non resolving pneumonia is a clinical syndrome in which focal infiltrates begin with some clinical association of acute pulmonary infection and despite a minimum of 10 days of antibiotic therapy patients either don’t improve or worsen or radiographic opacities fail to resolve within 12 weeks J Am Geriatr Soc 04;54:224-29 Contd • Non responding pneumonia,Progressive pneumonia,Non resolving pneumonia • Non responding-absence of clinical response antibiotic treatment after 3-5 days • Clinical stability- HR<100/min BP->90mm of Hg RR<24 /min Temp-37.2
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3 Contd • Progressive- increase in radiographic abnormalities and clinical deterioration during first 72 hours of treatment • Median time to stability 3 days • 6% have progressive pneumonia • Evolution depends – Host factors, Severity of initial present,Causal organism • Non resolving- Persistence of radiographic infiltrates at 30 days after initial clinical response Causes of non resolution • Complications • Host factors • Delayed radiological recovery • Presence of resistant organisms • Presence of unusual organisms • Defects in defense • Diseases mimicking pneumonia
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4 Complications • Empyema/Para pneumonic effusion
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This note was uploaded on 12/03/2011 for the course MEDICINE 350 taught by Professor Dr.aslam during the Winter '07 term at Medical College.

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non resolving pneumonia MD - Non Resolving pneumonia...

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