What are the symtems with pneumonia?

Answer 1

I'm assuming you mean the infectious kind. Typically:

Pneumococcal (most common): Sudden onset of shaking chills, fever (especially 101-105 F), productive cough (sputum often brown), stabbing pains in the chest, v. often a history of recent respiratory illness can be elicited.

Patients appear acutely ill, have marked tachypnea w/o orthopnea. Patient often lies on affected side and respirations are grunting with flared nares. Signs of consolidation may be absent in the initial stages, fine rales will manifest soon over the involved area. Pleural friction rub may often be heard early. Frank consolidation with possible multilobar involvement will be found later.

Leukocytosis 20-35 k cu. mm. Gram stain of sputum will show many RBC, WBC, and pneumococci.

Predisposing factors: malnutrition, exposure to cold, alcohol, noxious gases, drugs, cardiac failure, viral respiratory diseases.

Klebsiella: Sudden onset of chills, fever, dyspnea, cyanosis, profound toxicity, sputum often mucoid and sticky + difficult to expectorate (also a [usually deep] red in color).

All symptoms and WBC counts can be highly variable, diagnosis by microscopy.

You need a good, well stained smear to differentiate from pneumococci: the predominate organism will be a short, encapsulated, gram negative bacterium.

Predisposing factors: 40-60 yrs w/ a history of Alcoholism or debilitating disease.

Staphylococcal: Usually a history of minor illness with cough, headache, and generalized aches and pains; then abrupt onset of severe illness w/ chills, high fever, deep cyanosis, and exaggerated cough (sputum commonly blood streaked or purulent).

Early signs of empyema, pleural effusion, or tension pneumothorax may be present. WBC typically ~ 20 k cu. mm. Gram stain of sputum reveals masses of WBCs and gram+ cocci, many of which will be intracellular.

Predisposing factors: recent viral infection of the respiratory tract, hospitalized infants (usually after antimicrobial therapy), post surgical patients = typically post influenza or nosocomial.

Streptococcal: Severe toxicosis + cyanosis. Pleural effusion develops often and early, left untreated will progress to empyema in 1/3 of patients. Dx by finding of large number of streptococci in gram-stained sputum.

Predisposing factors: Usually a recent viral infection of the upper respiratory tract (especially influenza or measles), underlyin pulmonary disease.

Viral: Slow (relatively) but progressive symptoms. Cough dry or productive w/ mucoid or watery sputum. Typically, there are associated signs of viral syndrome - rashes, myalgia, conjunctivitis , sore throat, runny nose, etc., etc.). Pleuritic pain sometimes present but usually far less severe than in bacterial pneumonia. Dyspnea is rare.

No findings of consolidation, patient will not appear as "sick", may be mildly febrile but no fever also common, rales and coarse breath sounds may be heard.

WBC usually normal but can reach 12 k, gram stain of sputum should reveal few (mixed) or no organisms.

Mycoplasmal: Similar to viral but with more severe symptom expression and somewhat more acute onset. Cough usually more productive, sputum similar. Myalgia and malaise may be more prominent. May occur as a limited epidemic (camps, schools, etc.).

Signs of consolidation in chest, patient may look mildly sick, fever usually low grade (can be high).

Leukocytosis up to 15 k in 25% of cases.

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