PATHOPHYSIOLOGY

WRITTEN

Pediatric Community Acquired Pneumonia (CAP) is most commonly caused by

aspiration or inhalation of microorganisms (Streptococcus pneumoniae) through the
nasopharynx or oropharynx. Due to failure of primary defense, a microorganism invades
the lower respiratory tract wherein there is a release of antibodies by the activation of B-
cell. Antigen- antibodies have 2 reactions which its complex adheres to the mucosal
lining of the lower respiratory tract and initiation in the immune system. When antibody
adheres to the mucosal lining of lower respiratory tract, it irritates the mucosa that
increases the mucus production and it accumulates the mucus which causes a
productive cough.
In initiation of the immune system, there will be a vasodilation and increased
blood flow leads to vaso-congestion that increases the hydrostatic pressure of the
plasma and capillary permeability. When this happens, there will be an escape of
plasma which causes edema, escape of RBC, Serum and fibrin which forms exudates,
and a transportation of the phagocyting cells. Edema and Exudate formation may
initiate a narrowing of airway and filling of the bronchi and alveoli. Narrowed airway
causes use of accessory muscles and increased respiration where asymmetrical chest
expansion noted. Accumulation of exudates can lead to consolidation and decreased
lung inflation.
Transportation of phagocyting cells may manifest a fever or hyperthermia. The
phagocytes will engulf the antigen and infects a cell. When the cell was being infected, it
will be detected by the T-cell and destroy the antigen. This T-cell is an effector cell that
was strengthens by the regulatory T-cell. The effector and regulatory cell will synthesize
and release a cytokines. There will be altered temperature maintenance in the
hypothalamus that causes a fever.
To be able to treat Pneumonia, vaccination is the primary mode of prevention,
antibiotics are essential, vasodilators. Other medications and oxygen must be readily
given to the patient to easily ease his/her complication. If left untreated, pneumonic
consolidation, septicemia, empyema, lung abscess and pleural effusion may occur
within the lungs; and in rare cases, respiratory failure, and hypoxia and soon, death may
occur if becomes severe.
 DIAGRAM

Precipitating factors:
Predisposing factor:
- Environment
- Age
- Previous diagnosis of
Respiratory Infections
- Immuno-compromised

Inhalation of Microorganism

Failure of Defense

Invasion of the Lower

Respiratory Tract

Activation of B-cells

Release of Antibodies

Antigen-Antibody Reaction

Antigen Antibody Complex Initiation of Immune system

adheres to the mucosal lining
of the lower respiratory tract
Vasodilation and increased blood
flow
Mucosal irritation
Vaso-congestion

Increase Mucus production

Increase plasma Hydrostatic Pressure
 Accumulation of mucus Increase capillary permeability

Productive Cough

Escape of Plasma Escape of RBC, Serum Transportation of

and Fibrin phagocyting cells

Edema
Exudate formation Engulfing the Antigen

Narrowing of airways
Filling of Bronchi and Cell becomes infected
Alveoli
Use of accessory
muscles Detection of the
Consolidation of lung infected cell by the
T-cells
Increased Respiration
Decreased lung
inflation Effector T-cells
Asymmetrical chest destroys antigen
expansion

Regulatory T-cell
strengthen act of
effector cell

Altered Temperature Effector and

Regulating Regulatory cells
Fever
maintenance in the synthesize and
Hypothalamus release cytokines
Vaccination is the primary mode of Immune system will weaken
prevention

Pneumonic consolidation,
Antibiotics, vasodilators and other septicemia, empyema, lung
medications must be given to the
abscess and pleural effusion may
patient immediately.
occur within the lungs.

Oxygen would be given to assist

in breathing. Respiratory failure, hypoxia and
soon, death may occur if it
becomes severe.