PNEUMONIA

Definisi:

Suatu kondisi inflamasi pada paru, yang biasanya terjadi akibat infeksi (paling sering oleh S.Pneumoniae, H.Influenza) ataupun inhalasi zat kimia. Kondisi ini dapat menyebabkan pertukaran gas terganggu

Klasifikasi Pneumonia:

a) Menurut agen penyebabnya: Pneumococcal Pneumonia Anaerobic Pneumonia Staphylococcal Pneumonia Atypical Pneumonia Gram negative enteric Pneumonia

b) Menurut anatomis (radiology): Lobar Pneumonia Segmental Pneumonia Broncho Pneumonia Interstitial Pneumonia

c) Menurut klinik: Community acquired Pneumonia Hospital acquired Pneumonia Aspiration Pneumonia Ventilator associated Pneumonia Pneumonia immunocompromised host

Factor resiko:

1. Usia tua >70 tahun2. Perokok3. Kondisi immunosupresi

Pathogenesis penyakit:

Terjadi kongesti inflamasi hiperemia paru berwarna merah-gelap terjadi eksudasi cairan perdarahan (pada alveolus & bronchus) Membentuk konsistensi hepar (red hepatization) Permukaan paru menjadi kuning keabuan pada eksudat, sel merah digantikan neutrofil (grey hepatization)

Pada pasien immunocompetent, masa infeksi selama 7-10 hari

Manifestasi klinik:

a) Gejala mayor Demam mengigil Batuk

b) Gejala minor Nyeri dada pleuritic Dyspnea Tachypnea Perubahan status mental Auskultasi:- konsolidasi paru, pernafasan bronchial, bunyi krepitasi Gejala extra-pulmoner seperti diare

Foto thorax:

Chest X-Ray AP/PA, lateral

Kavitasi

Infiltrat unilateral / bilateral

Gambaran coin lesion

Air bronchogram

Gambaran spesifik:

Legionella : Infiltrasi bilateral ruang udara

Pneumococcal : Nekrosis pneumonia

Hospital-acquired : Radioopaque padat

Lobar pneumonia in the right upper lobe

Lobar pneumonia. Posteroanterior (a) and lateral (b) chest radiographs demonstrate lobar pneumonia of the left upper lobe. The left major fissure is seen as an interface on the lateral view (arrows).

Lobar pneumonia. Posteroanterior (a) and lateral (b) chest radiographs demonstrate lobar pneumonia of the left lower lobe. The left major fissure is seen as an interface on the lateral view (arrows)

Image in a 49-year-old woman with pneumococcal pneumonia. The chest radiograph reveals a left lower lobe opacity with pleural effusion.

Interstitial pneumonia appears as reticular and ground-glass opacities in both lungs in lower lobes with decreased lung volumes

A 53-year-old patient with severe Legionella pneumonia. Chest radiograph shows dense consolidation in both lower lobes.