Pneumoni - Infektion.net

Innehållsförteckning
• Inledning ............................................................................................................................ 3
- Definition .......................................................................................................................... 3
• Samhällsförvärvad pneumoni - bakgrundsfakta ............................................................... 3
• Klinisk diagnostik .............................................................................................................. 4
- Symtom och fynd ............................................................................................................... 4
- Anamnes ........................................................................................................................... 4
- Status ............................................................................................................................... 4
- Differentialdiagnoser ......................................................................................................... 4
- Provtagning och röntgen .................................................................................................... 5
• Preliminär bedömning och initial behandling .................................................................. 5
- Inläggningsindikationer ..................................................................................................... 5
- Riskfaktorer för mortalitet ................................................................................................. 5
- Indikationer för Intensivvård ............................................................................................. 5
- Relativa kontraindikationer för intensivvård ...................................................................... 5
- Indikationer för bronkoskopi ............................................................................................. 5
- Antibiotikabehandling ....................................................................................................... 6
- Syrgasbehandling .............................................................................................................. 7
- Smittsamhet vid lunginflammation .................................................................................... 7
- Isoleringsbehov ................................................................................................................. 8
• Mikrobiologisk diagnostik ................................................................................................. 8
- Bakteriologisk diagnostik .................................................................................................. 8
Blododling .................................................................................................................... 8
Sputumprov ................................................................................................................. 8
Nasopharynxprov ......................................................................................................... 8
Bakre svalgväggsprov ................................................................................................... 9
BAL (bronkoalveolärt lavage) ........................................................................................ 9
Antigenpåvisning i urin ................................................................................................ 9
Serum för antikroppsanalys ......................................................................................... 9
Diagnostik av legionella ................................................................................................ 10
Diagnostik av pneumocystis jiroveci ............................................................................. 10
Diagnostik av mykobakterier ........................................................................................ 10
- Virologisk diagnostik ......................................................................................................... 10
- Etiologisk diagnostik, översikt ........................................................................................... 12
• Övrig behandling ................................................................................................................ 13
- Sjukgymnastik .................................................................................................................. 13
- Omvårdnad ....................................................................................................................... 14
- Hostmediciner ................................................................................................................... 15
• Radiologi ............................................................................................................................ 16
• Behandlingssvikt och komplikationer .............................................................................. 17
• Uppföljande kontroll .......................................................................................................... 18
• Prevention/förebyggande åtgärder ................................................................................... 18
• Fakta om specifika pneumonier ........................................................................................ 19
- Pneumokockpneumoni....................................................................................................... 19
- Mykoplasmapneumoni ...................................................................................................... 20
- Klamydiapneumoni (TWAR) ................................................................................................ 21
- Klamydiapneumoni (psittacos) ........................................................................................... 22
- Legionellapneumoni ........................................................................................................... 23
- Influensapneumoni ............................................................................................................ 24
• Bilagor ................................................................................................................................ 25
- Sputumprovtagning ........................................................................................................... 25
- Karakteristika vid olika agens till pneumoni ...................................................................... 26
- Patientinformation ............................................................................................................ 27
- Referenser ......................................................................................................................... 29
• Författare ........................................................................................................................... 35
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