What is that?
Pneumonia: Pneumonia can also be caused by infections that spread to the lungs
The lungs are two spongy organs in the chest wrapped in a thin membrane called the pleura. About 90% of the lungs are filled with air, only 10% are solid tissue. When a person inhales, the air moves down the windpipe or the windpipe into its branches called bronchi. These branch out again into a million tiny air passages called bronchioles that connect to over three million miniature air-filled sacs called alveoli. It is in the alveoli that oxygen and carbon dioxide are exchanged between the inhaled air and the blood leading to oxygenation of the blood and removal of carbon dioxide from the body. Pneumonia is inflammation of the lungs caused by infection with bacteria, viruses or other organisms. Usually, these organisms enter the lungs through the air we breathe. Pneumonia can also be caused by infections that spread to the lungs from the bloodstream to other parts of the body. The body’s defense mechanisms normally protect the lungs from infection. If these mechanisms are weakened as in patients with chronic diseases such as malignancy, diabetes, HIV infection, alcoholism, cirrhosis of the liver and asthma, then bacteria or other organisms produce a pneumonia.
What are the causes ?
Pneumonia: Tuberculosis is also one of the major causes of pneumonia
Bacteria are the most common cause, but pneumonia can also be caused by viruses and other organisms. Streptococcus pneumoniae or pneumococcus is the most common bacteria, accounting for almost half of cases. Other bacteria can cause pneumonia in hospitalized or very ill patients, in children with cystic fibrosis, and in people with chronic lung disease. Tuberculosis is also one of the main causes of pneumonia.
What are the symptoms?
Symptoms of bacterial pneumonia include fever, chest pain, cough, chills, shortness of breath, and rapid breathing. Older people can be very sick but have few symptoms. Coughing up or phlegm containing pus or blood is an indication of a serious infection. In very sick cases, the skin may appear bluish (cyanosis), breathing is labored and heavy, and the patient is confused due to a lack of oxygen in the blood.
What are the risk factors?
People with weakened immune systems and those over 65 are more prone to pneumonia than others. Even those who smoke may have a higher chance of catching the disease. Infections such as the common cold and the flu also increase the risk of pneumonia. If you’ve recently had surgery or suffered trauma, even this can increase your risk of getting pneumonia. The other risk factors for pneumonia are:
1. Alcohol and drug abuse
5. Liver disease
7. Cardiovascular disease
What are the types?
There are almost 8 types of pneumonia – some caused by germs, some caused by location, and some are acquired. The different types of pneumonia caused by germs are:
1. Viral pneumonia – It is caused by respiratory viruses.
2. Bacterial pneumonia – It is caused by Streptococcus pneumoniae.
3. Fungal pneumonia – This is caused by soil fungi.
Pneumonia can also be influenced by location. Nosocomial pneumonia (PAH) can be caused while a person is in hospital. Community-acquired pneumonia (CAP) is pneumonia that is caused in a community setting.
Aspiration pneumonia can occur when a person inhales bacteria into their system through food, drink, or saliva. Ventilator-associated pneumonia (VAP) can occur in those who use the ventilator to get pneumonia.
How is the diagnosis made?
In many cases, the doctor is able to make a diagnosis based on the clinical history and physical examination. Sometimes the doctor may advise blood tests and a sample of sputum or phlegm that is coughed up. A chest x-ray is done to confirm the diagnosis and identify if there is a pleural effusion. A CT scan may be necessary in some cases. Sometimes, drawing fluid from the pleural space (with a syringe and needle) or inserting a flexible bronchoscope into the trachea under local anesthesia may be necessary for diagnosis and treatment.
what is the treatement?
For severe pneumonia, antibiotics are given into the vein (intravenously). These can be administered for 5-10 days or even longer. All antibiotics carry some risk of allergic reactions, which can be serious in some cases. Some commonly used antibiotics include penicillins, ampicillin, amoxicillin, cephalosporins, and aminoglycosides. The fever may need to be controlled with acetaminophen or ibuprofen. Inhaling steam helps soothe the airways and relieve coughs. Patients with lung abscess, empyema, or other complications may require surgery. Chest physiotherapy, including coughing, deep breathing exercises, and chest tapping, are important in helping clear mucus and pus from inside the lungs.
What are the preventions?
A healthy diet, regular physical exercise and deep breathing exercises help maintain the body’s defense mechanisms. Close contact with people who have the flu or cold, or who have a cough, should be avoided.
What are the complications?
Bacteremia – Bacteria can enter the bloodstream, making the patient very sick. It is the most common complication. Pleural effusion and empyema – The pleura has two thin layers enveloping the lung. Between layers there is normally a small amount of fluid that helps lubricate the lungs. In some patients with pneumonia, this fluid increases (pleural effusion) and can even become infected and become pus, a condition called empyema. Pneumothorax and collapsed lung – Air can seep into the space between the pleural membranes causing pneumothorax. This puts pressure on the lungs causing them to collapse. Other complications – In rare cases, the infection can spread from the lungs to other parts of the body, causing abscesses or collections of pus in the brain and elsewhere. Acute Respiratory Distress Syndrome or ARDS is a specific condition in which the lungs are unable to function and oxygen is so severely reduced that the patient’s life is in danger. For support, the patient should be placed on a ventilator, a machine that artificially helps the patient breathe.