II. Epidemiology

  1. Most common cause of community acquired Pneumonia

III. Classic Symptoms

  1. Shaking rigors
  2. Fever
  3. Purulent Sputum
    1. Rust colored
  4. Pleuritic Chest Pain
  5. Dyspnea
  6. Chest Splinting

IV. Lab

  1. Complete Blood Count
    1. White Blood Cell Count elevated with Left Shift
  2. Gram Stain
    1. Gram Positive encapsulated organisms
    2. Elongated lancet shaped diplococci
  3. Blood Culture
    1. Positive in only 33% of cases
  4. Sputum Culture
    1. Positive in only 40% of Pneumococcal Pneumonias

V. Radiology

  1. Chest XRay
    1. Lobar consolidation (often lower lobe)
    2. Patchy infiltrates

VI. Management

  1. Increasing Penicillin Resistance
    1. See Penicillin Resistant Pneumococcus
  2. Penicillin Sensitive
    1. Ampicillin IV or Amoxicillin PO
    2. Erythromycin
    3. Azithromycin
    4. Clarithromycin
    5. Penicillin G IV
    6. Doxycycline
    7. Oral second generation Cephalosporin
    8. Parenteral third generation Cephalosporin
  3. High-Level Penicillin Resistance
    1. Broad spectrum Fluoroquinolone
      1. Levofloxacin
      2. Gatifloxacin
      3. Grepafloxacin
      4. Moxifloxacin
      5. Sparfloxacin
    2. Parenteral third generation Cephalosporin
    3. High dose Ampicillin
    4. Vancomycin IV with or without Rifampin

VII. References

  1. Gilbert (2001) Sanford Antimicrobial, p. 28

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Ontology: Lobar Pneumonia (C0032300)

Concepts Disease or Syndrome (T047)
MSH D011014
ICD10 J18.1
SnomedCT 155550005, 266392005, 278516003, 54339004
English PNEUMONIA LOBAR, Lobar pneumonia, unspecified, lobar pneumonia, lobar pneumonia (diagnosis), Pneumonia, Lobar, Lobar Pneumonia, Lobar pneumonia NOS, Pneumonia lobar, pneumococcal pneumonia, Pneumonia;lobar, pneumonia pneumococcal, Lobar pneumonia, Lobar pneumonia (disorder), lobar; pneumonia, pneumonia; lobar
Portuguese PNEUMONIA LOBAR, Pneumonia lobar NE, Pneumonia Lobar, Pneumonia lobar
Spanish NEUMONIA LOBAR, Neumonía lobar NEOM, Neumonía Lobar, neumonía lobular (trastorno), neumonía lobular, Neumonía lobar
Dutch lobaire pneumonie NAO, pneumonie lobair, lobair; pneumonie, pneumonie; lobair, Lobaire pneumonie, niet gespecificeerd, lobaire pneumonie
French Pneumonie lobaire SAI, PNEUMONIE LOBAIRE, Pneumopathie lobaire, Pneumonie lobaire
German Pneumonie lobulaer NNB, Lobaerpneumonie, nicht naeher bezeichnet, PNEUMONIE LOBAER, Lobaerpneumonie, Pneumonie, lobaere, Lobärpneumonie, Pneumonie, lobäre
Italian Polmonite lobare NAS, Polmonite lobare
Japanese 大葉性肺炎NOS, 大葉性肺炎, ダイヨウセイハイエン, ダイヨウセイハイエンNOS, タイヨウセイハイエンNOS, タイヨウセイハイエン
Czech Lobární pneumonie NOS, Lobární pneumonie, lobární pneumonie
Korean 상세불명의 대엽성 폐렴
Hungarian lobaris pneumonia k.m.n., Pneumonia lobaris, Lobaris pneumonia