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Pneumonia

Overview

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Pneumonia is an infection that inflames the air sacs (alveoli) in one or both lungs. These air sacs may fill with fluid or pus, causing symptoms like cough, fever, and difficulty breathing. Pneumonia can be caused by various microorganisms, including bacteria, viruses, fungi, and parasites. It can range from mild to life-threatening, particularly in vulnerable populations such as the elderly, infants, and individuals with chronic health conditions.

These air sacs may fill with fluid or pus, causing symptoms like cough, fever, and difficulty breathing. Pneumonia can be caused by various microorganisms, including bacteria, viruses, fungi, and parasites. It can range from mild to life-threatening, particularly in vulnerable populations such as the elderly, infants, and individuals with chronic health conditions.

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Symptoms
  • Cough: Persistent cough, which may produce phlegm or mucus that can be green, yellow, or even blood-streaked.
  • Fever: High fever and chills, which can be accompanied by sweating.
  • Shortness of Breath: Difficulty breathing or rapid breathing, often worsened by physical activity.
  • Chest Pain: Sharp or stabbing pain that may worsen with breathing or coughing.
  • Fatigue: Feeling unusually tired or weak.
  • Confusion or Delirium: Especially in older adults, confusion or altered mental state can occur.
  • Loss of Appetite: Reduced interest in eating, nausea, or vomiting.
Complications
  • Pleural Effusion: Accumulation of fluid between the layers of tissue lining the lungs and chest cavity, which can cause additional breathing problems.
  • Abscess: Formation of a pus-filled cavity in the lung due to severe infection.
  • Sepsis: A life-threatening systemic response to infection that can lead to organ failure.
  • Respiratory Failure: Severe cases may lead to an inability to breathe adequately, requiring mechanical ventilation.
  • Lung Damage: Persistent pneumonia or recurrent infections can cause long-term damage to lung tissue.
Causes
  • Bacterial Infections: Common bacteria that cause pneumonia include Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus.
  • Viral Infections: Viruses such as influenza (flu), respiratory syncytial virus (RSV), and coronaviruses can cause pneumonia.
  • Fungal Infections: Fungi such as Histoplasma, Coccidioides, and Cryptococcus can cause pneumonia, particularly in individuals with weakened immune systems.
  • Parasitic Infections: Rare, but certain parasites can cause pneumonia, such as Toxoplasma or Strongyloides.
  • Aspiration: Inhaling food, liquids, or vomit into the lungs can lead to aspiration pneumonia.
Prevention

Vaccination:

  • Pneumococcal Vaccine: Protects against Streptococcus pneumoniae and is recommended for children, older adults, and individuals with certain health conditions.
  • Influenza Vaccine: Reduces the risk of flu-related pneumonia; recommended annually.
  • COVID-19 Vaccine: Helps prevent COVID-19-related pneumonia.
  • Good Hygiene: Regular handwashing and avoiding close contact with people who are sick.
  • Healthy Lifestyle: Maintaining a healthy diet, regular exercise, and avoiding smoking to keep the immune system strong.
  • Avoiding Aspiration: For individuals at high risk, ensuring proper swallowing techniques and avoiding drinking alcohol or taking medications that affect swallowing.
Risk Factors
  • Age: Infants and young children, as well as older adults, are at higher risk.
  • Chronic Conditions: Individuals with chronic illnesses such as asthma, diabetes, heart disease, or chronic obstructive pulmonary disease (COPD) are more susceptible.
  • Smoking: Tobacco use damages the respiratory system and increases vulnerability to infections.
  • Weakened Immune System: Conditions or treatments that weaken the immune system, such as HIV/AIDS, cancer treatments, or immunosuppressive medications.
  • Hospitalization: Being in a hospital, particularly with a ventilator, increases the risk of hospital-acquired pneumonia.
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How is it treated?

  • Antibiotics: For bacterial pneumonia, appropriate antibiotics based on the specific bacteria causing the infection. The choice of antibiotic may be guided by local resistance patterns and the patient's health status.
  • Antivirals: For viral pneumonia, antiviral medications may be used if the pneumonia is caused by influenza or other specific viruses.
  • Antifungals: For fungal pneumonia, antifungal medications are prescribed based on the type of fungus and the patient’s condition.
  • Supportive Care: Includes rest, hydration, and over-the-counter medications to manage symptoms like fever and pain.
  • Hospitalization: Severe cases or individuals with complications may require hospitalization for intravenous antibiotics, oxygen therapy, and other supportive treatments.
  • Respiratory Therapy: Techniques such as chest physiotherapy and breathing exercises to help clear mucus and improve lung function.
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How is it Diagnosed?

Pneumonia is an infection that inflames the air sacs in one or both lungs, potentially leading to fluid or pus accumulation. Diagnosis is made through clinical evaluation, imaging, and laboratory investigations.

The diagnostic process starts with a thorough medical history and physical examination. Common symptoms include fever, cough (with or without sputum), shortness of breath, chest pain, and fatigue. During auscultation, the physician may detect crackles, bronchial breath sounds, or dullness to percussion in the affected lung area.

The cornerstone of diagnosis is chest X-ray, which can reveal infiltrates, consolidation, or pleural effusion indicative of pneumonia. If uncertainty persists or complications are suspected, CT scans may be performed for better clarity.

    Laboratory investigations include:

  • Complete Blood Count (CBC): To assess leukocytosis indicating infection.
  • Sputum Gram stain and culture: To identify causative organisms.
  • Blood cultures: Especially in hospitalized or severely ill patients.
  • Pulse oximetry or arterial blood gases (ABG): To evaluate oxygenation status.
  • Procalcitonin levels or C-reactive protein (CRP): May assist in differentiating bacterial from viral pneumonia.
  • In some cases, tests for specific pathogens (e.g., influenza, SARS-CoV-2, Legionella, Mycoplasma) may be required using PCR assays, urine antigen tests, or serologic studies.
  • For immunocompromised patients or non-responders, bronchoscopy with bronchoalveolar lavage (BAL) may be indicated. Accurate diagnosis helps determine appropriate treatment—typically antibiotics for bacterial causes and supportive care for viral infections.

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FAQs

  • Pneumonia is an infection of the lungs caused by bacteria, viruses, or fungi. It causes inflammation of the air sacs (alveoli) in one or both lungs, which may fill with fluid or pus.

Symptoms include:

  • Cough (with mucus or phlegm)
  • Fever and chills
  • Shortness of breath
  • Chest pain
  • Fatigue or weakness

  • Pneumonia is diagnosed through a physical exam, chest X-ray, and sometimes sputum or blood tests to identify the cause of the infection.

Treatment depends on the cause:

  • Bacterial pneumonia: Antibiotics are prescribed.
  • Viral pneumonia: Rest, fluids, and antiviral medications if needed.
  • Hospitalization may be necessary for severe cases, especially in older adults or people with weakened immune systems.

  • Vaccines, such as the pneumococcal vaccine and the flu vaccine, can help prevent certain types of pneumonia. Good hygiene practices, such as regular handwashing and avoiding contact with sick people, can also reduce the risk.
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