肺炎球菌肺炎模板ppt课件.ppt

重庆医科大学附一院肺科 陈 虹 Pneumococcal pneumonia Definition 肺炎球菌 Pneumococcus 肺大叶性炎变 肺炎链球菌 streptococcus pneumoniae 院外感染最常见的肺炎 多见于青壮年 Inflammation vessel congestion serum RBC /WBC fibrin exudation absorption (血管充血) (渗出 实变) (吸收) （荚膜致病） Cohn 支气管充气征 Pathology Congestion(充血) Red Hepatization(红色肝样变) Gray Hepatization(灰色肝样变) Resolution (消散) acute onset of II. X-ray findings complications  ◇Pluaritis（胸膜炎） ◇ Shock : BP, cold extremities, sweat, cyanosis (紫绀), tachycardia(心动过速) ◇ Toxic myocarditis（中毒性心肌炎） II. X-ray findings  Left lower lobe pneumonia Diagnosis Typical features Consolidation signs or rales WBC X-ray findings Sputum and blood culture(+) Differential diagnosis Caseous pneumonia(干酪性肺炎) Obstructive pneumonia（阻塞性肺炎） III. Pneumonia caused by other micro-organisms Caseous pneumonia(干酪性肺炎) (Tuberculosis) ◇Low fever ◇ Night sweat(盗汗) ◇ Lack of chill ◇ Insensitive to antibiotics ◇ Tubercle bacilli 结核菌素试验（+） II. Obstructive pneumonia Foreign body / Neoplasm ◇ slow absorption ◇ recurrent (复发) ◇ fibrobrochoscopy(纤维支气管镜检查) III. Pneumonia caused by other microorganisms staphylococcus staphylococcus pneumonia ( 葡萄球菌肺炎) klebsiella klebsiella pneumonia ( 克雷伯杆菌肺炎) legionella legionaires disease （军团菌肺炎） mycoplasma mycoplasmal pneumonia （支原体肺炎） Treatment ◇ Pinicillin(青霉素) ◇ Allergic or resistant to Pinicillin： Erythromycin(红霉素) or Vancomycin(万古霉素) Qinolones（喹诺酮类）or Cephalothins(头孢菌素) I. Antibiotics Duration: 5—7 days or 3 days after defeverness(退热) Treatment Duration: 5—7 days