Pneumonia – Overview
An infection that inflames the air sacs in one or both lungs is known as pneumonia. Fluid or pus (purulent material) may be filled in the air sacs, causing cough with phlegm or pus, fever, chills, and difficulty breathing. Different types of organisms, including bacteria, viruses and fungi, can cause pneumonia.
Seriousness from mild to life-threatening can be ranged in pneumonia. For infants and young children, people older than age 65, and people with health problems or weakened immune systems it can be more serious.
The signs and symptoms of pneumonia differ from mild to severe, depending on factors such as the type of germ causing the infection, and age and overall health. Mild signs and symptoms often are same as that to those of a cold or flu, but may last longer.
Pneumonia signs and symptoms may include:
- Chest pain when breathing or coughing
- Confusion or changes in mental awareness such as in adults age 65 and older
- Cough, which may produce phlegm
- Fever, sweating and shaking chills
- Lower than normal body temperature found in adults older than age 65 and people with weak immune systems
- Nausea, vomiting or diarrhea
- Shortness of breath
Any signs of the infection may not be shown in newborns and infants or they may vomit, have a fever and cough, appear restless or tired and without energy, or have difficulty breathing and eating.
Doctor should be consulted if having difficulty in breathing, chest pain, persistent fever of 102 F (39 C) or higher, or persistent cough, especially if coughing up pus.
It’s especially essential that people in these high-risk groups consult a doctor:
- Adults older than age 65
- Children younger than age 2 with signs and symptoms
- People with an underlying health condition or weakened immune system
- People receiving chemotherapy or taking medication that suppresses the immune system
Pneumonia may become dangerous life-threatening condition for some older adults and people with heart failure or chronic lung problems
Many germs can cause pneumonia. The most common are bacteria and viruses in the air we breathe. Your body usually prevents these germs from infecting your lungs. But sometimes the immune system can be overpowered by these germs, even if health is generally good.
Pneumonia is characterized according to the kinds of germs that cause it and location of the infection.
The most common type of pneumonia is community-acquired pneumonia which occurs outside of hospitals or other health care facilities. It may be caused by:
- Streptococcus pneumoniae is the most common cause of bacterial pneumonia in the U.S. which is a type of pneumonia that can occur on its own or after having a cold or the flu. One part (lobe) of the lung may be affected, a condition known as lobar pneumonia.
- Pneumonia can also be caused by mycoplasma pneumoniae which typically produces milder symptoms than that of other types of pneumonia. An informal name given to this type of pneumonia is called walking pneumonia, which generally isn’t severe enough to require bed rest.
- Fungi are a kind of pneumonia which is most common in people having chronic health problems or weakened immune systems, and in people who have large doses of the organisms inhaled. The fungi that cause it can be found in soil or bird droppings and differ according to the geographic location.
- Colds and the flu can be due to some viruses which can cause pneumonia. The most common cause of pneumonia in children younger than 5 years are viruses. Viral pneumonia is generally mild. But in certain cases it may become very serious.
Pneumonia is caught by some people during a hospital stay for another illness. Hospital-acquired pneumonia can be serious as the bacteria causing it may be more resistant to antibiotics and because the people are already sick who are getting it. Risk of this kind of pneumonia is higher in people who are on breathing machines (ventilators), often used in intensive care units.
Health care-acquired pneumonia
A bacterial infection that occurs in people who live in long-term care facilities or who receive care in outpatient clinics, including kidney dialysis centers is known as health care-acquired pneumonia. Similar to hospital-acquired pneumonia, health care-acquired pneumonia can be caused by bacteria that are more resistant to antibiotics.
When inhaling food, drink, vomit or saliva into the lungs, aspiration pneumonia occurs. Aspiration is more probable if something disturbs the normal gag reflex, for example a brain injury or swallowing problem, or excessive usage of alcohol or drugs.
Anyone can be affected by pneumonia. But risk is higher for the two age groups are:
- Children who are aged 2 years old or younger
- People who are aged 65 or older
Other risk factors may include:
- Risk of pneumonia is greater if hospitalized in a hospital’s intensive care unit, especially if on a machine that helps in breathing (a ventilator).
- If having asthma, chronic obstructive pulmonary disease (COPD) or heart disease then it is more likely to get pneumonia.
- The body’s natural defenses against the bacteria and viruses that cause pneumonia are damaged by smoking.
- People with weakened or suppressed immune systems who have HIV/AIDS, who’ve had an organ transplant, or who receive chemotherapy or long-term steroids are at risk of having pneumonia.
Some people with pneumonia along with treatment especially those classified in high-risk groups may experience complications, including:
- Organ failure can be caused potentially when the bacteria that enter the bloodstream from the lungs can spread the infection to other organs
- If the pneumonia is severe or having chronic underlying lung diseases, with enough oxygen trouble in breathing might occur. Hospitalization may be required and breathing machine (ventilator) while the lung heals is used
- Fluid can build up in the thin space between layers of tissue that line the lungs and chest cavity (pleura) which can be a caused by pneumonia. If the fluid becomes infected, the requirement to have it drained through a chest tube or removed with surgery will be needed.
- If pus forms in a cavity in the lung, an abscess is occurred. Antibiotics are generally used to treat an abscess. Sometimes, a long needle or tube is placed into the abscess which is needed to remove the pus in surgery or drainage.
Pneumonia can be prevented by:
- To prevent some types of pneumonia and the flu, vaccines are available. The doctor should be consulted about getting these shots. The vaccinations guidelines have changed over time so make sure that vaccination status is reviewed with the doctor even if have recalled previously receiving a pneumonia vaccine.
- A different pneumonia vaccine is suggested by the doctors for children younger than age 2 and for children ages 2 to 5 years who are at particular risk of pneumococcal disease. Vaccine should be given to children who attend a group child care center. Flu shots for children older than 6 months are also suggested by the doctor.
- Good hygiene should b practiced in order to protect yourself against respiratory infections that sometimes lead to pneumonia by washing hands regularly or using an alcohol-based hand sanitizer.
- Lungs’ natural defenses against respiratory infections are damaged through smoking.
- Immune system should be kept strong by getting enough sleep, exercising regularly and eating a healthy diet.
Diagnosis will be done by the doctor by starting to ask about the medical history and doing a physical evaluation, including listening to lungs with a stethoscope to check for abnormal bubbling or crackling sounds that suggest pneumonia.
Below tests may be suggested by the doctor is pneumonia is suspected:
- To confirm an infection and to try to identify the type of organism causing the infection, blood tests are conducted. However, exact identification isn’t always possible.
- Chest X-ray helps the doctor in diagnosing pneumonia and determining the extent and position of the infection. However what kind of germ is causing the pneumonia is not told to the doctor by the x-ray.
- Oxygen levels are measured in the blood through pulse oximetry. Prevention of lungs from moving enough oxygen into the bloodstream can be done by pneumonia.
- Sputum test is a test conducted where a sample of fluid from the lungs (sputum) is taken after a deep cough and evaluated to help pinpoint the cause of the infection.
Additional tests might be ordered by the doctor if age is older than 65, are in the hospital, or have serious symptoms or health conditions. Additional tests may include:
- A chest CT scan might be suggested by the doctor if the pneumonia isn’t clearing as quickly as expected so that a more detailed image of lungs is obtained.
- Pleural fluid culture is a test conducted where a fluid sample is taken by putting a needle between the ribs from the pleural area and evaluated to help determine the type of infection.
Curing the infection and preventing complications is involved in the treatment of pneumonia. People with community-acquired pneumonia generally can be treated at home with medication. Although symptoms ease in a few days or weeks mostly, the feeling of tiredness can be consistent for a month or more.
Depending on the type and severity of the pneumonia, age and the overall health, specific treatments are given. The options may include:
- Antibiotics are medicines which are used for the treatment of bacterial pneumonia. Identifying the type of bacteria causing the pneumonia and to choose the best antibiotic to treat it may take time. If the symptoms don’t improve, a different antibiotic may be recommended by the doctor.
- Cough medicine may be used to relax the cough so that rest can be taken. Because coughing helps loosen and move fluid from the lungs, not to eliminate the cough completely might be a good idea. Additionally, it should be kept in mind that very few studies have looked at whether over-the-counter cough medicines lessen coughing caused by pneumonia. If a cough suppressant is to be tried, the lowest dose that helps in resting should be used.
- Fever reducers/pain relievers may be taken as required for fever and discomfort which include drugs such as aspirin, ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others).
Hospitalization may be needed if:
- Aged older than 65
- Confused about time, people or places
- The kidney function has declined
- The systolic blood pressure is below 90 millimeters of mercury (mm Hg) or diastolic blood pressure is 60 mm Hg or below
- Breathing is rapid (30 breaths or more a minute)
- Breathing assistance is needed
- Temperature is below normal
- The heart rate is below 50 or above 100
Intensive care unit might be admitted to if required to be placed on a breathing machine (ventilator) or if symptoms are severe.
Children may be hospitalized if:
- Aged younger than 2 months
- Lethargic or excessively sleepy
- Trouble breathing
- Having low blood oxygen levels
- Appearing dehydrated
Lifestyle and home remedies
Below tips can help in recovering more quickly and can reduce the risk of complications:
- Plenty of rest should be done. Don’t go back to school or work until after the temperature returns to normal and coughing up mucus. Even when beginning to feel better, be careful not to overdo it. As pneumonia can recur, it’s better not to go back into the daily routine until completely recovered. Doctor should be contacted if you’re not sure.
- Drink plenty of fluids should be drank to stay hydrated, especially water, to help loosen mucus in lungs.
- The entire course of any medications should be taken which the doctor has prescribed. If medication is stopped too soon, bacteria may be continued to be harbored by the lungs that can multiply and cause pneumonia to recur.
Preparing for appointment
A primary care doctor or an emergency care doctor should be consulted at first, or may be referred to a doctor who specializes in infectious diseases or in lung disease (pulmonologist).
Below is some information to help in getting ready for the appointment:
- Record should be kept of any symptoms, including temperature.
- Key medical information should be written down, including recent hospitalizations and any medical conditions.
- Key personal information should be written down, including exposure to any chemicals or toxins, or any recent travel.
- A list of all medications, vitamins and supplements that being taken should be made, especially an antibiotic left over from a previous infection, as this can lead to a drug-resistant pneumonia.
- A family member or friend should be brought along, if possible, to help in remembering questions to ask and what the doctor said.
- Questions to ask the doctor should be written down.
Ask other questions without hesitation.
Doctor may ask several questions so be ready to answer questions:
- Beginning of having symptoms?
- History of pneumonia before? If so, in which lung?
- Symptoms are continuous or occasional? How severe are they?
- If anything seems to improve or worsen symptoms?
- Traveled or been exposed to chemicals or toxic substances?
- Been exposed to sick people at home, school or work?
- Smoker or have ever smoked?
- Alcohol consumption in a week?
- History of flu or pneumonia vaccines?
In the meantime in order to avoid making condition worse:
- Don’t smoke or be around smoke
- Plenty of fluids to be drank and get plenty of rest