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Pneumonia - Diseases

What is this condition?

Pneumonia is an acute lung inflammation in which the lungs fill with a fibrous material, impairing gas exchange. With poor gas exchange, the blood has too much carbon dioxide and too little oxygen.

People with normal lungs and adequate immune defenses usually recover fully. However, pneumonia is the sixth leading cause of death in the United States.

Classifying pneumonia


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 Pneumonia can be classified by location or type, as well as cause .

" Location: Bronchopneumonia involves the lungs and small airways of the respiratory tract. Lobular pneumonia involves part of a lobe of the lung. Lobar pneumonia involves an entire lobe .

" Type: Primary pneumonia occurs when a person inhales or aspirates a disease-producing microorganism; it includes pneumococcal and viral pneumonia. Secondary pneumonia may occur in someone who's suffered lung damage from a noxious chemical or other insult, or it may be caused by the blood-borne spread of bacteria from a distant site.

What causes it?

Pneumonia can be caused by a virus, bacterium, fungus, protozoa, mycobacterium, mycoplasma, or rickettsia.

Certain factors can predispose a person to bacterial and viral pneumonia-chronic illness and debilitation, cancer (especially lung cancer), abdominal or chest surgery, atelectasis (the collapse of air sacs in the lung), the flu, common colds or other viral respiratory infections, chronic respiratory disease (such a, emphysema, chronic bronchitis, asthma, bronchiectasis, or cystic fibrosis), smoking, malnutrition, alcoholism, sickle cell disease, tracheostomy, exposure to harmful gases, aspiration, and drugs that suppress the immune system.

Factors that predispose a person to aspiration pneumonia include old age, debilitation, nasogastric tube feedings, an impaired gag reflex, poor oral hygiene, and a decreased level of consciousness.

What are its symptoms?

In the early stage, a person with bacterial pneumonia may have these classic symptoms - coughing, sputum production, chest pain, shaking, chills, and fever.

On examination, the doctor may hear an abnormal breath sound called crackles and discover signs of pleural effusion, abnormal fluid buildup in the lungs. Effusion is responsible for fever, chest pain, shortness of breath, and a nonproductive cough.

Complications of pneumonia include respiratory failure, pus accumulation in the lungs, and lung abscess. Some people develop a bacterial infection in the blood; if the infection spreads to other parts of the body, it can lead to inflammation of the brain and spinal cord membranes, inflammation of the heart's interior lining, and inflammation of the sac surrounding the heart.

 
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How is it diagnosed?

The doctor suspects pneumonia if the person has typical symptoms and physical exam results, along with a chest X-ray showing pulmonary infiltrates (abnormal substances in the lungs), and sputum containing acute inflammatory cells. If the person has pleural effusions, the doctor withdraws some fluid from the chest to analyze for signs of infection. Occasionally, the doctor obtains a sample of respiratory airway secretions or inserts an instrument called a bronchoscope into the airway to obtain materials for smear and culture. The person's response to antibiotics also provides important dues to the presence of pneumonia.

How is it treated?

Pneumonia is treated with antimicrobial drugs, which vary with the cause of the disease. Humidified oxygen therapy is given if the person has too little oxygen in the blood, and mechanical ventilation is used to treat respiratory failure. Other supportive measures include a high-calorie diet, adequate fluid intake, bed rest, and pain relievers to relieve chest pain. These supportive measures can increase the person's comfort, avoid complications, and speed recovery. To help remove secretions, the person may be taught to cough and perform deep-breathing exercises.

What can a person with pneumonia do?

" To avoid giving others your infection, dispose of secretions properly. Sneeze and cough into a disposable tissue .

" To prevent a recurrence of pneumonia, don't use antimicrobial drugs during minor viral infections, because this may lead to antibiotic-resistant bacteria in the upper airway. If you then develop pneumonia, you may need to take more toxic drugs to get rid of the orgamsms.

" Get yearly flu shots and Pneumovax (pneumococcal vaccine) if you have asthma, chronic bronchitis, emphysema, chronic heart disease, or sickle cell disease.



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