Michael Marcus, MD .. http://www.TheDoctorsVideos.com .. Director Pediatric Allergy & Pulmonary -Maimonides Medical Center .. Fellowship:Children’s Hospital of Philadelphia .. Castle Connolly Top Doctor
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Male Speaker: One of the biggest concerns once the kid starts coughing they take a chest X-ray and they see a pneumonia. First of all what does the word pneumonia mean? Dr. Michael Marcus: Pneumonia is an infection in the lungs by simply any bacteria, virus or parasite, which gets into the lungs either by being inhaled or through the blood stream, can cause a pneumonia. Male Speaker: There are different types of pneumonia, Lobar or hilar. Can you say a little bit about them -- types of them? Dr. Michael Marcus: The different types of pneumonia really relate to the area of the lung that's affected and sometimes relate to the type of organism that's causing the infection. A Lobar pneumonia means that an entire lobe, one large portion of the lung is affected and Interstitial pneumonia would be in that it's an area of the lung that's between the lobes, in the intercostal spaces; you can also have a Walking pneumonia, which is frequently caused by a virus perhaps Mycoplasma that indicates an X-ray appearance that somewhat milder and the patient who is not quite as sick as another patient with a more severe Bacterial pneumonia. Male Speaker: And there is also one we call aspiration pneumonia, which you see sometimes when you kids who maybe vomit, is that true? Dr. Michael Marcus: Aspiration pneumonia is an entirely different type of pneumonia. Some patients who either vomit or have problems swallowing properly such as patients who have neurologic disorders, they have some of the food where the acid in their stomach actually get through their upper airway and get into the lung. This aspirate will cause an inflammation in lungs leading to an aspiration pneumonia, which also I think was significant symptoms to the patient. Male Speaker: Is there anyway just looking it actually, you could be 100% sure it's bacterial or viral? Dr. Michael Marcus: It's been shown through several very well done studies, that X-ray is not diagnostic of the cause the pneumonia. There are certain patterns of the X-ray that make you think a certain organism is more likely, but when push comes to shove, the X-ray is not conclusive in any fashion in judging the cause of the pneumonia. With that in mind, when we have a patient with pneumonia, we need to take a number of different things into account to plan for the proper treatment of which the x-ray is merely one of them.

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