Pneumonia

Overview

Pneumonia is a general term that refers to an infection and inflammation of one or both lungs. There are more than 50 kinds of pneumonia and while many forms are mild others can be life-threatening. Older adults and those with chronic illnesses are the most vulnerable. However pneumonia can also strike young healthy people especially after they've just had a cold or the flu. Pneumonia can be effectively treated and in many cases it can be prevented.

Causes

Pneumonia can be caused by different types of germs including bacteria viruses fungi and parasites which for reasons that are still sometimes unclear get past bodily defenses and infect the lungs. Pneumonia affects the lungs in two ways. Lobar pneumonia attacks a lobe of the lungs and bronchial pneumonia can affect patches throughout both lungs. In both cases the lungs' air sacs fill with pus mucus and other liquid restricting the flow of oxygen to the blood. Without sufficient oxygen cells in the body cannot function properly.

Viral pneumonia is responsible for half of all cases of pneumonia. Some viruses that cause pneumonia are adenoviruses rhinovirus influenza virus (flu) respiratory syncytial virus (RSV) and parainfluenza virus (the virus that causes croup).

Streptococcus pneumoniae is the most common cause of bacterial pneumonia. If the immune system is weakened and the bacterium is breathed in it can multiply and cause serious infections of the lungs (pneumonia) the bloodstream (bacteremia) the covering of the brain (meningitis) and other parts of the body.

Mycoplasma (also called ·walking pneumonia') shares the characteristics of both bacterial and viral pneumonias and is responsible for about 20 per cent of all cases of pneumonia. Its most prominent symptom is a violent cough that produces sparse white coloured mucus.

There are many less common pneumonias that are caused by the inhalation of food liquid gases dust or some other foreign particles.

Risk Factors

The viruses and bacteria that cause pneumonia are contagious and are usually found in fluid from the mouth or nose of an infected person. If your own immune system is temporarily weakened you could be at risk when an infected person coughs or sneezes near you or if you share drinking glasses and eating utensils or touch the used tissues or handkerchiefs of an infected person.

You're at increased risk of pneumonia if you're age 65 or older. Very young children whose immune systems aren't fully developed also are at risk of pneumonia. You're also more likely to develop pneumonia if you:

Have certain diseases

These include immune deficiency diseases such as HIV/AIDS and chronic illnesses such as cardiovascular disease emphysema or diabetes. You're also at increased risk if you've had your spleen removed or your immune system has been impaired by chemotherapy or long-term use of immunosuppressant drugs.

Smoke or abuse alcohol or drugs

Smoking damages your airways and alcohol interferes with the action of white blood cells that fight infection. If you inject illegal drugs there's a chance you may develop injection-site infections that can travel through your bloodstream to your lungs.

Are exposed to certain chemicals or pollutants

Your risk of developing some uncommon types of pneumonia increases if you work in agriculture construction or around certain industrial chemicals. Exposure to air pollution or toxic fumes can also contribute to lung inflammation.

Symptoms

Some common symptoms of pneumonia:

  • fever
  • chills
  • cough
  • unusually rapid breathing
  • breathing with grunting or wheezing sounds
  • labored breathing that makes the rib muscles retract
  • vomiting
  • chest pain
  • abdominal pain
  • decreased activity
  • loss of appetite or poor feeding
  • in extreme cases bluish or gray color of the lips and fingernails

Symptoms of pneumonia vary depending on the age of the patient and the cause of the pneumonia. When pneumonia is caused by bacteria an infected child usually becomes sick quickly and experiences the sudden onset of high fever and unusually rapid breathing. When pneumonia is caused by viruses symptoms tend to appear more gradually and are often less severe than in bacterial pneumonia. Wheezing may be more common in viral pneumonia.

Some types of pneumonia cause symptoms that help identify which germs are causing the illness. For example in older children and adolescents pneumonia due to mycoplasma causes a sore throat and headache in addition to the usual symptoms of pneumonia.

Treatment

If you develop pneumonia your chances of prompt recovery are greatest under certain conditions:

  • you are young
  • your pneumonia is diagnosed early
  • your defenses against disease are working well
  • the infection has not spread
  • you are not suffering from any other illness

There is no effective treatment yet for viral pneumonia. However prompt treatment with antibiotics usually cures bacterial and mycoplasma pneumonia. The drug or drugs used are determined by the germ causing the pneumonia. The drugs lower body temperature within a day or two and produce a dramatic recovery. After temperature returns to normal medication must be continued according to your doctor's instructions otherwise the pneumonia may recur. Relapses can be far more serious than the first attack.

You should also know that bacteria such as streptococcus pneumoniae are now capable of resisting and fighting off the powers of antibiotics to destroy them. Such antibiotic resistance is increasing worldwide because these medicines have been overused or misused. Therefore if you are at risk of getting pneumococcal pneumonia you should talk with your doctor about ways to prevent it. (See below).

Most cases of pneumonia are treated successfully at home. However children may be hospitalized if they have chronic illnesses that affect the immune system if they are vomiting so much that they cannot take medicine by mouth or if they have recurrent episodes of pneumonia. Hospital treatment may also be required for those who need supplemental oxygen or if a lung infection has spread into the bloodstream.

A vigorous young person may recover from pneumonia within a week. Older adults however may require several weeks before regaining their strength and a general feeling of well-being. To get better and avoid complications:

  • Get plenty of rest
  • Drink lots of fluids especially water
  • Take the entire course of any prescribed medications
  • Keep all follow-up appointments with your doctor

Prevention

Get vaccinated

Getting a yearly flu shot is a good way to prevent pneumonia. In addition pneumococcal vaccine can prevent pneumonia and other infections caused by 23 types of the Streptococcus pneumoniae bacteria. These 23 types account for approximately nine out of 10 cases of pneumococcal disease. The vaccine is recommended for people with certain serious medical conditions (See below) and those 65 years of age and older. About eight out of 10 cases occur in these high- risk groups. The vaccine protects about 50 to 80 per cent of people against pneumococcal infection. Vaccination also makes the disease milder for those who may catch it. For further information read: Immunization : Pneumococcal Vaccine (Polysaccharide - for age 2 years and over)

Wash your hands

Your hands come in daily contact with germs that can cause pneumonia. These germs enter your body when you touch your eyes or rub your nose. Washing your hands thoroughly and often can help reduce your risk.

Don't smoke

Smoking damages your lungs' natural defenses against respiratory infections.

Take care of yourself

Proper rest and a diet rich in fruits vegetables and whole grains along with moderate exercise all help keep your immune system strong.

Protect others from infection

If you have pneumonia try to stay away from anyone with a compromised immune system. When that isn't possible you can help protect others by wearing a face mask and always coughing into a tissue.