10 yrs old male child presented with progressive dyspnea and cough. n acetyl cysteine and cefuroxime given for 5 days along with steam inhalation. patient is Clinicoradiologicaly improved.

28 year old male with high grade fever since 7 days, alcoholic, presented with breathlessness and hypoxemia. presently on ventilator support abg shows Respiratory acidosis, rft is deranged lft is normal tlc 38000

64 yrs male presented with cough fever anorexia dyspnea since last 10 days. spo2 93% BP 140/80mmhg left basal crepts heard. wbc 4400 plt 158000 creat 1.2 bsl 160. sputum sent from analysis.

16 days old neonate presented with the respiratory distress. Chest x ray is attached. what are the interpretations and management for the child.

Dear Friends, PLEASE FIND AN UPDATE ON ASPIRATION PNEUMONIA DIAGNOSIS We must consider the diagnosis of aspiration pneumonia when a patient presents with risk factors and radiographic evidence of an infiltrate suggestive of aspiration pneumonia. COMPLICATIONS  include acute respiratory failure, ARDS parapneumonic effusion, empyema, lung abscess, etc. ANTIBIOTICS CHOICE…. FOR PATIENTS WITHOUT A TOXIC APPEARANCE…. The antibiotic chosen should cover typical community-acquired pathogens. Ceftriaxone plus azithromycin, levofloxacin, or moxifloxacin are appropriate choices. Co-amoxiclav may also be used. FOR PATIENTS WITH A TOXIC APPEARANCE OR ARE RECENTLY HOSPITALIZED , Community-acquired pathogens are still the most common. But we should consider antibiotics coverage for.. gram-negative bacteria including Pseudomonas aeruginosa and Klebsiella pneumoniae as well as methicillin-resistant Staphylococcus aureus (MRSA) Piperacillin/tazobactam or imipenem/cilastatin plus vancomycin would be appropriate.. The presence of chronic aspiration risks, yellow expectoration and necrotizing pneumonia should raise the possibility of anaerobic infection. We must consider adding clindamycin to the antibiotic regimen. Alternatively Metronidazole may also be used. PREVENTION OF ASPIRATION PNEUMONIA… Aspiration pneumonia is mostly preventable.. It is at times due to negligence in nursing care provided to the patient who are susceptible to Aspiration.. (1)Position patients in a semirecumbent position with the head of the bed at a 30-45° angle. This reduces the risk of aspiration leading to pneumonia. (2)For patients with dysphagia and/or a poor gag reflex, soft diet smaller bite,chin tucked, head turned, and repeated swallowing helps. (3)Feeding through a nasogastric or gastric tube may be required for patient with severe dysphagia. (4)A recent study found that treatment of patients with gastrostomy tubes with a pro kinetic agents was associated with a lower risk. (5)gastric acid suppression and consequent loss of the acid barrier to bacteria is associated with a higher rate of pneumonia. (6) Those on Ryles tube feeding… residual volume should not exceed 150 mL before the next bolus feed. (7)Avoid over sedations. So friends I have shared the most relevant information about the ASPIRATION PNEUMONIA. IT SHOULD BE USEFUL TO YOU. Thanks Dr K N Poddar