Islamic Quotes and Pneumonia Overview

Islamic Quotes

• Two words are light on the tongue, heavy in the scales, and beloved by the Merciful: "Subḥān Allāh wa bihamdihi" (Glory be to God, and praise be to Him) and "Subḥān Allāh al-'azīm" (Glory be to the great God).
• These are agreed upon (by the Prophet's companions).

Respiratory Infections-Pneumonia

• Definition: Pneumonia is an inflammation of the substance of the lungs. It can be caused by bacteria, viruses, or fungi.
• Types:
  • Community-acquired pneumonia (CAP)
  • Hospital-acquired pneumonia (Nosocomial pneumonia)
  • ICU-acquired pneumonia
  • Non ventilated intensive care acquired pneumonia (NV-ICUAP)
  • Ventilator associated pneumonia (VAP)
  • Typical pneumonia
  • Atypical pneumonia
  • Lobar pneumonia
  • Bronchopneumonia
  • Interstitial pneumonia
• Causes (bacteria): Streptococcus pneumoniae, Mycoplasma pneumoniae, Legionella pneumophila, Chlamydia pneumoniae, Haemophilus influenzae, Staphylococcus aureus, etc.
• Causes (viruses): Influenza, parainfluenza, Measles, Herpes simplex, Varicella.
• Causes (risk factors): Alcoholism, COPD and/or smoking, Nursing home residency, Poor dental hygiene, exposure to bats or soil enriched with bird droppings, Exposure to birds, Exposure to rabbits.
• Symptoms:
  • Fever (typically productive)
  • Cough (typically productive)
  • Shortness of breath
  • Fever with chills and sweats
  • Chest pain
  • Crackles/rhonchi on lung exam
  • Leukocytosis
• Additional symptoms (extra-pulmonary):
  • Myalgia, arthralgia and malaise (particularly in Legionella and Mycoplasma infections)
  • Myocarditis and pericarditis (cardiac manifestations)
  • Headache (common with Legionella pneumonia)
  • Abdominal pain, diarrhea and vomiting
  • Labial herpes simplex reactivation
  • Skin rashes (erythema multiforme, erythema nodosum, Stevens- Johnson syndrome)
• Epidemiology: 4th leading cause of death globally, 2-3 million cases/year, 60,000+ deaths/year (2014 US data).
• Clinical stability criteria: Heart rate ≤ 100/min, Respiratory rate ≤ 24/min, Systolic blood pressure ≥ 90 mm Hg, Body temperature ≤ 37.8°C, Ability to take food by mouth, Normal state of consciousness, No hypoxemia (pO2 ≥ 60 mmHg, SaO2 ≥ 90%).
• ICU admission criteria: Invasive mechanical ventilation, Septic shock requiring vasopressors, Confusion/disorientation, Blood urea nitrogen ≥20 mg/dL, Respiratory rate ≥30 breaths/min, Hypotension requiring aggressive fluid resuscitation, PaO2/FiO2 ratio ≤250, Multilobar infiltrates, WBC <4000 cells/mm, Platelet count <100,000 cells/mm, Core temperature <36°C
• Diagnosis investigations: Blood tests (CBC, serum creatinine, electrolytes, CRP, ESR ), sputum samples (Gram stain, culture, NAAT), chest X-ray
• Treatment: Empirical therapy; consider outpatient or inpatient treatment based on severity, comorbid conditions, age, and symptoms.. Specific antibiotic treatments are given based on the likely pathogen (e.g., Strep. pneumoniae, Mycoplasma).
• Complications: Septicemia, Lung abcess, Para-pneumonic effusions, Hypotension, Empyema, Respiratory failure/renal failure.
• Differential Diagnosis: Pulmonary infarction, Pulmonary/pleural tuberculosis, Pulmonary oedema, Pulmonary eosinophilia, Malignancy (bronchoalveolar cell carcinoma), Cryptogenic organising pneumonia, etc
• Risk factors: Age (<16 or >65), co-morbidities (HIV, diabetes, chronic kidney disease, malnutrition ), viral infections, other respiratory conditions (cystic fibrosis, bronchiectasis), lifestyle (smoking, excess alcohol, IV drug use), latrogenic factors (immunosuppressants)