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Causes, Symptoms and Treatments of Pneumonia

August 28, 2017 - Oluwaseun Olowoyeye

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Do you know that pneumonia is responsible for 16% of all deaths of children under 5 years old, killing 920 136 children in 2015 worldwide? Pneumonia is the single largest infectious cause of death in children worldwide. Here, we go through the causes, symptoms and treatments of Pneumonia.

Pneumonia is a serious infection that affects one or both lungs especially the lung sacs otherwise known as alveoli where the exchange of gases like carbon dioxide and oxygen takes place. This infection is caused by bacteria, viruses and fungi which cause inflammation in the airway. This makes the sacs to be filled with pus or fluid. Symptoms can be mild or severe which may include chest pain, difficulty in breathing, cough, chills and fever.  Pneumonia can be classified based on the bacteria, virus or fungi that cause it, where it is acquired and degree of inflammation they cause in the lungs. It includes:

  • Community acquired pneumonia
  • Hospital acquired pneumonia
  • Health practitioner acquired pneumonia
  • Aspiration acquired pneumonia

 

Community acquired pneumonia: Community-acquired pneumonia is the most common type of pneumonia. It found outside of hospitals or health care facilities. It may be caused by:

Bacteria. The most common cause of bacterial pneumonia in the U.S. is Streptococcus pneumoniae. This type of pneumonia can occur on its own or after you’ve had a cold or the flu. It may affect one part (lobe) of the lung; a condition called lobar pneumonia.

Bacteria-like organisms. Mycoplasma pneumonia can cause pneumonia. It typically produces milder symptoms than other types of pneumonia. Walking pneumonia is an informal name given to this type of pneumonia, which typically isn’t severe enough to require bed rest.

Fungi. This type of pneumonia is most common in people with chronic health problems or weakened immune systems. It is common in people who have inhaled large doses of the organisms. The fungi that cause it can be found in soil or bird droppings and vary depending upon geographic location.

Viruses. Some of the viruses that cause colds and flu can cause pneumonia. Viruses are the most common cause of pneumonia in children younger than 5 years. Viral pneumonia is usually mild. But in some cases, it can become very serious.

Hospital acquired pneumonia: This is the type of pneumonia is common among people who are sick in the hospital. It is caused by bacteria which very often are resistant to antibiotics. Tests and investigations are carried out at regular intervals when one is admitted to the hospital. This type is common among patients on ventilators (breathing machines) in the intensive care units and dialysis centres.

Health practitioner acquired pneumonia: This pneumonia is caused by bacteria and is common among health workers like nurses, doctor, cleaners and health workers in the hospitals or any health facilities especially those who live in long term care facilities.

Aspiration pneumonia: Aspiration pneumonia occurs when you inhale food, drink, vomit or saliva into your lungs. Aspiration is more likely if something disturbs your normal gag reflex, such as a brain injury or swallowing problem, or excessive use of alcohol or drugs.

Pneumonia can be further classified based on the inflammatory process in the lungs.

Lobar pneumonia: This affects one or two of the lobes of the lungs. It affects the entire alveoli space.

Bronchopneumonia: This pneumonia is characterised by inflammatory processes around the bronchi throughout the lungs. It is more diffuse than lobar pneumonia.

Lipid pneumonia: This is characterised by the accumulation of fats in the airspaces which cause airway obstruction.

 

 Signs and Symptoms

The signs and symptoms of pneumonia may vary from mild to life threatening. These depend on the factors or microorganisms causing the infection and your age and overall health. Mild signs and symptoms often are close to those of cold or flu, but they last longer. Signs and symptoms of pneumonia may include:

  • Chest pain when you breathe or cough;
  • Confusion or changes in mental awareness (in adults age 65 and older);
  • A cough, which may produce phlegm;
  • Fatigue;
  • Fever, sweating and shaking chills;
  • Lower than normal body temperature (in adults older than age 65 and people with weak immune systems);
  • Nausea, vomiting or diarrhoea;
  • Shortness of breath

Those at Risk of Developing Pneumonia

  • Hospitalized patients especially those who use ventilators for breathing at the intensive care units
  • Children under the age of 5
  • Adults over the age of 65
  • Immunosuppressed people or those with any underlying condition like heart disease, asthma, tuberculosis, sickle cell anaemia and chronic obstructive pulmonary disease (COPD).
  • People who have just undergone a surgery or an invasive procedure
  • People receiving chemotherapy or any medication that suppresses the immune system
  • Cigarette smoking
  • People with swallowing problems

 

Diagnosis

Pneumonia is detected after a thorough physical examination and history have been taken by the doctor or nurse. This is followed by some tests and investigations to determine the causative organism of the disease. These tests include:

  • Chest X-ray. This test helps your doctor to diagnose pneumonia and determine the extent and location of the infection.
  • Pulse oximetry. This measures the oxygen level in your blood. Pneumonia can prevent your lungs from moving enough oxygen into your bloodstream.
  • Sputum test. A sample of fluid from your lungs (sputum) is taken after a deep cough and analyzed to help pinpoint the cause of the infection.
  • Blood test: This test helps to identify the causative organism responsible for the disease if it is a virus, bacteria or fungi infection.
  • CT scan: This scan can be carried out if the disease process still progresses it shows the image of the lungs to determine the extent of damage caused by the offending organism.
  • Pleural fluid culture: A study is carried out on the fluid in the pleural space to determine the type of infection. This is done by inserting a needle into the space between the ribs at the pleural area.
  • Bronchoscopy: This is a procedure where a thin light tube is inserted into the airways to visualize the trachea and bronchi. It can be used to take tissue samples if needed.

Treatment

Pneumonia is treated by curing the infection, relieving symptoms and preventing the complication of the disease.

  • Cough expectorants: This drug helps to expectorate mucus in dried irritated areas of the respiratory tract.
  • Pain relievers: Analgesics are used to relieve pain, reduce fever and discomfort caused by the infection process such drugs include: Ibuprofen, acetaminophen, aspirin and others.
  • Antibiotics: These drugs help to control the disease process caused by the microorganism. They are used mainly for bacterial pneumonia.
  • Anti -viral agents: These medications such as oseltamivir and zanamir can be used to treat influenza infections.
  • Antifungal agents: These medications treat most fungi infections.

Prevention

Vaccination against certain diseases that can lead to pneumonia is important. These vaccines include:

  • Pneumococcal vaccine (PCV): This prevents septicemia which is a complication of pneumonia.
  • Measles vaccine: This protects the body against measles infection.
  • Flu vaccine: This keeps you from getting flu which leads to pneumonia.
  • Chicken pox vaccine: The chicken pox (varicella zoster virus) shot can protect most cases that lead to pneumonia.
  • Avoid smoking this increases the risk of pneumonia
  • Wash hands regularly to reduce the spread of bacteria and virus that cause pneumonia.
  • Avoid people who have infections that can lead to pneumonia e.g. flu, chicken pox, measles
  • If you haven’t had vaccines against certain diseases that can cause pneumonia, stay away from people who have them.
  • Seek urgent medical attention if symptoms become severe and life threatening.
  • Take enough drinks to hydrate the body and increase sputum production
  • Take enough rest to conserve your energy.
  • Eat foods rich in vitamins and minerals like vegetables and fruits.
  • Perform deep breathing exercises regularly by inhaling deeply and exhaling slowly.
  • Reduce cold drinks as this causes more irritation to the dried and irritated areas of the respiratory tract.
  • Adhere strictly to drug regimen prescribed by the doctor ‘
  • Adhere to follow up visit scheduled by the doctor.

 

Complication

These complications might occur if prompt treatment is not carried out to attack the infectious process.

Pleural effusion: it is characterised by the accumulation of fluid in the pleural space (between the ribs).

Septicemia: This is an increased level of infection in the blood.

Chronic obstructive pulmonary disease: this results due to pleural effusion in the lungs which causes breathing difficulty and cough.

 

 

 

 

Sources:

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0015652/

http://www.who.int/mediacentre/factsheets/fs331/en/ 

Oluwaseun Olowoyeye

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