All About Pneumonia

Posted January 1st, 2018

Pneumonia is a lung infection wherein the air sacs in one or both lungs are affected. The air sacs are inflamed and filled with fluid or pus which bring about coughing with pus or phlegm, chills, high body temperature and struggle in breathing. Pneumonia can be caused by bacteria, viruses, or fungi. It is transmitted through inhalation of bacteria and viruses from droplets of individual’s sneeze or a cough. It can also be transmitted thru the bloodstream.

Infants, young children, people with old age, people with health issues and with weak immune system are susceptible to this acute respiratory infection.

Causes of Pneumonia
Bacteria and viruses are the most common causative agent of pneumonia although fungi may also be the cause of the infection. The most common causative agent of pneumonia in healthy individuals are Streptococcus pneumonia, Haemophilus influenzae type b (Hib) and respiratory syncytial virus. For an immunocompromised infant, Pneumocystis jiroveci is the most common causative agent of pneumonia.

Pneumonia is categorized based on the microorganism causing the infection and where the infection is acquired. 

The most common type of pneumonia and the leading cause of death around the world is community-acquired pneumonia. People outside hospitals or other healthcare facilities develop this type of pneumonia. Hospital-acquired pneumonia is the type of pneumonia that develops in people that are hospitalized due to another sickness. Patients who are in intensive care units and uses ventilators (breathing machines) are at high risk of this pneumonia. Pneumonia that occurs in patients who are in long-term care facilities, or frequently visits output clinic like dialysis institutions; is referred as to Healthcare-acquired pneumonia. Both hospital-acquired and healthcare-acquired pneumonia caused by bacteria are more resistant to antibiotics. Aspiration pneumonia is when food, liquids, saliva, or vomit is inhaled into the lungs instead of being gulp into the esophagus. Factors that may contribute to inhaling foreign matter into the lungs are old age, poor gag reflex due to brain injury or stroke, excessive alcohol intake, comatose patients, problems with swallowing, and less alert people because of present illness or effect of a medication.

Manifestations of Pneumonia
The signs and symptoms of pneumonia may vary depending on the causative factor of the infection as well as the overall health condition of the patient. Signs and symptoms of pneumonia may include coughing which may be productive (with phlegm), difficulty and painful breathing, chest pains especially when coughing, fever, sweating, and chills. In infants, the occurrence of convulsions, hypothermia, unconsciousness and may incapable of eating and drinking indicates that they are severely ill.

Clinical Diagnosis
Following a physical exam, the doctor will order some clinical tests to confirm if the patient has pneumonia. This tests may include chest x-ray, blood test, pulse oximetry, and sputum test. Chest x-ray indicates the extent and location of the infection. Blood test confirms an infection and may identify the causative agent of the infection. Pulse oximetry quantifies the amount of oxygen level in the blood since pneumonia will keep the lungs from providing enough oxygen in the blood. Sputum test is used to identify the cause of infection by analyzing the fluid from the lungs. 

Treatment for pneumonia will depend on the severity, age of the patient, type of pneumonia and the overall health condition of the patient. 
Antibiotics are for the treatment of bacterial pneumonia. The antibiotic to be given to a patient depends on the bacteria that causes the infection. The doctor may give different antibiotic if the first medication was not able to improve symptoms of the infection. An antipyretic and pain reliever is given to reduce body temperature in patients with fever and discomfort. A cough helps loosen fluid from the lungs. It is advisable not to completely eliminate but rather calm a cough in order for the patient to rest.  Hospitalization is needed if the patient is older than 65, patient’s kidney function declined, the patient is experiencing tachypnea or rapid breathing, the patient needs breathing assistance, patient's body temperature is below normal (hypothermia), patient’s systolic blood pressure is below 90 mm Hg and diastolic blood pressure is 60 mm Hg. Children are hospitalized if they are younger than 2 months, having trouble breathing, lethargic, blood oxygen level is low, and appear dehydrated. 

There are available vaccines for the prevention of some types of pneumonia as well as the flu. Pneumococcal conjugate vaccine, Hib vaccine, measles and pertussis vaccine are the most important and available vaccines to prevent pneumonia. Children up to 5 years are at risk of having pneumonia, therefore, doctors recommend having them vaccinated against pneumonia. Flu shots are also recommended for children 6 months and above. Visit your physician and discuss getting vaccinated.

Adequate nutrition is a must to be able to strengthen immunity. Have enough sleep, eat a healthy diet and exercise. This also adds zinc supplementation.

Good hygiene decreases the likelihood of having respiratory infections. Observe proper hand washing with soap and use alcohol and hand sanitizers.

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