Pneumonia is an inflammation of one or both lungs, typically due to a bacterial, viral, or fungal infection. With pneumonia, the tiny air sacs inside the lungs become filled with fluid or pus, leading to coughing, chest pain, and breathing difficulties. Anyone can develop pneumonia. The people most at risk of developing pneumonia are young children, older adults, and people with pre-existing medical conditions that weaken the immune system. These same groups of people are also at increased risk of developing complications of pneumonia.
Pneumonia is, worldwide, the leading cause of death due to infection in children younger than 5 years of age.
RISK FACTORS
People most at risk of developing pneumonia are those who:
• Are under 5 years old or over 65 years old
• Have recently recovered from a cold or influenza infection.
• Have developed cystic fibrosis
• Have chronic obstructive pulmonary disease (COPD)
• Are suffering from asthma
• Have conditions that affect the kidneys, heart, or liver
• Are suffering from diabetes
• Have contracted HIV
• Are suffering from AIDS
• Have cancer
• Take medicines for gastroesophageal reflux disease (GERD)
• Experience malnutrition
• Smoke tobacco, consume large amounts of alcohol, or both.
• Are exposed to certain chemicals or pollutants.
• Have recently been hospitalized in an intensive care unit
SYMPTOMS
The first symptoms of pneumonia usually resemble those of a cold or flu. A person may then develop other symptoms, which can vary depending on the type of pneumonia a person has. Common symptoms include:
• Cough that may produce green, yellow, or even bloody phlegm.
• Fast breathing and shortness of breath
• Chest pain that usually worsens when taking a deep breath
• Fast heartbeat
• Fever, sweating, and chills
• Fatigue
• Confusion or delirium, especially in older adults
• Loss of appetite
• Nausea and vomiting
TYPES
Pneumonia types differ depending on their cause. The different types and their associated causes include:
• Bacterial pneumonia: Many bacterial strains can cause pneumonia, but the most common is Streptococcus pneumoniae (S. pneumoniae). A doctor may refer to pneumonia resulting from this strain as pneumococcal pneumonia.
• Viral pneumonia: Viral causes of pneumonia include the respiratory syncytial virus and influenza types A and B.
• Fungal pneumonia: This can result from a condition such as valley fever, caused by the Coccidioides fungus.
The way of human infecting the virus
• Aspiration pneumonia: This type occurs because of inhaling food, liquids, or stomach contents into the lungs. Aspiration pneumonia is not contagious.
• Hospital-acquired pneumonia: This can occur in people receiving hospital treatment for other conditions that involve the use of a respirator or breathing machine.
• Walking pneumonia: Walking pneumonia is a non-medical term that describes a mild case of pneumonia with cold-like symptoms. The condition is so-called because people with this type of pneumonia typically do not require bed rest, and can continue their usual daily activities.
TREATMENT
Treatment for pneumonia depends on the type and severity of the pneumonia. The main types and their associated treatments include:
• Bacterial pneumonia: Treatment is usually with antibiotics.
• Viral pneumonia: Treatment is not usually necessary, though a doctor may prescribe antiviral medications if influenza is the cause.
• Fungal pneumonia: Treatment usually involves antifungal medications.
Doctors commonly prescribe OTC medications to help manage the symptoms of pneumonia. Whatever the cause of pneumonia, people must rest and drink plenty of fluids. Staying hydrated helps thin out thick phlegm and mucus, making it easier to cough these up.
• Hospitalization
Hospitalization for pneumonia may be necessary if symptoms are severe, or if a person has a weakened immune system or other serious illness. In the hospital, people may receive intravenous antibiotics and fluids. They may also need a supplemental oxygen supply.
IN CHILDREN
In most cases, a child’s immune system would protect that child from developing pneumonia. If a child does develop pneumonia, it is usually due to a virus. Symptoms in children may include:
• Difficulty breathing, or breathing loudly.
• Not feeding as they usually do
• Coughing
• Fever
• Irritability
• Dehydration
Toddlers may complain of pain in their chest or stomach, and vomit after coughing. Treatment includes plenty of rest and a regular fluid intake. A doctor may suggest OTC medications to help ease symptoms such as abdominal problems or coughing, but those medicines would not help treat pneumonia. Adults should not smoke around children, especially if the child has pneumonia.
COMPLICATIONS
Pneumonia can cause complications. These are more common among the following groups of people: young children, older adults, people with certain pre-existing health conditions. According to the Centers for Disease Control and Prevention (CDC), some potential complications of pneumococcal pneumonia include:
• Empyema: An infection of the space between the membranes that surround the lungs and chest cavity.
• Pericarditis: Inflammation of the sac, or pericardium, surrounding the heart.
• Endobronchial obstruction: A blockage of the airway that allows air into the lungs.
• Atelectasis: A complete or partial collapse of an entire lung or an area within the lung.
• Lung abscess: A collection of pus in the lungs. This is a rare complication that mostly occurs in people with serious underlying medical conditions or a history of alcohol misuse.
• Pleurisy: Inflammation of the thin membranes between the lungs and ribcage; it can lead to respiratory failure.
• Septicemia: An infection in the blood that originated elsewhere in the body.
• Sepsis: A life-threatening immune reaction to septicemia, which can lead to tissue damage, organ failure, and death.
PREVENTION
There are two different vaccines to help prevent pneumococcal disease, the most common bacterial cause of pneumonia. The vaccines protect against a wide variety of pneumococcal infections. While they may not completely protect older adults from pneumonia, they can significantly reduce the risk of pneumonia and other infections caused by S. pneumoniae, including blood and brain infections. There are two pneumonia vaccines available.
Other preventative measures
Along with vaccinations, doctors recommend the following measures to help prevent pneumonia:
• Regular hand washing
• Covering the mouth and nose when coughing or sneezing
• Refraining from smoking
• Eating a balanced, nutritious diet
• Exercising regularly
• Staying away from people who have pneumonia, or being extra vigilant about hygiene when around unwell people.
DIAGNOSIS
To diagnose pneumonia, a doctor would usually ask about a person’s symptoms and medical history, and carry out a physical examination. The physical exam may include listening to the chest through a stethoscope and measuring blood oxygen levels using a pulse oximeter attached to the finger. A doctor may suspect pneumonia if they hear the following when listening to the chest through a stethoscope: coarse breathing, wheezing, crackling, and decreased breath sounds. If doctors suspect pneumonia, they may order additional tests, including:
• Chest X-rays: These can confirm a pneumonia diagnosis and show which areas of the lungs are affected.
• A chest CT scan: This scan can provide more detailed images of the lungs.
• White blood cell (WBC) count: A blood test that measures levels of WBCs in the blood. This helps determine how severe the infection is, and whether bacteria, virus or fungus is the likely cause.
• An arterial blood gas test: A blood test that can provide a more accurate reading of the body’s oxygen and carbon dioxide levels and other factors.
• Blood cultures: These may reveal whether the micro-organism from the lungs has spread into the bloodstream.
• Sputum analysis: Testing of the sputum to determine which pathogens are responsible for the pneumonia.
• Bronchoscopy: A procedure that involves passing a bronchoscope into the lungs while a person is under anesthesia. The bronchoscope is a thin, flexible tube with a light and camera attached, which enables the doctor to directly examine infected parts of the airways and lungs. A doctor may recommend this procedure when further investigation is necessary.
