Pneumonia
Pneumonia is a disease of the lungs that makes breathing difficult and limits oxygen levels in the body. It is mostly caused due to an infection by microbes such as bacteria, viruses, and fungi. In pneumonia, the air pouches which usually fill with air when breathing, gets filled with infective material, mucus and fluid. This can lead to symptoms such as cough, fever, shortness of breath, and chest pain.
Other names
Also known as Lung infection, Respiratory infection, Lower respiratory tract infection (LRTI) and Bronchopneumonia
Causes
Pneumonia is caused by a number of infectious agents and is classified based on the organisms that cause the infections. The common causes and types of pneumonia include:
Bacterial pneumonia, caused by bacteria such as Streptococcus pneumoniae, Haemophilus influenzae type b (Hib) and Klebsiella pneumoniae.
Viral pneumonia, caused by viruses such as the respiratory syncytial virus and coronavirus.
Fungal pneumonia, caused by fungi such as candida, aspergillus, and mucor.
Atypical pneumonia or mycoplasma pneumonia, caused by mycoplasma (organisms that have traits similar to bacteria and viruses but do not belong to either category).
Types Of Pneumonia
Pneumonia can be acquired during hospital stay (known as hospital-acquired pneumonia) or outside any medical setting (known as community-acquired pneumonia). Other forms of pneumonia can be aspiration and atypical pneumonia.
Hospital-acquired pneumonia (HAP)
Also known as nosocomial pneumonia, hospital-acquired pneumonia can be serious because the bacteria causing it may be more resistant to antibiotics and because the people who get it are already sick. People who are on breathing machines (ventilators), often used in intensive care units, are at higher risk of this type of pneumonia. It is mostly caused by bacteria such as staphylococci & pseudomonas aeruginosa.
Community-acquired pneumonia (CAP)
If you get pneumonia not related to your hospital stay, then it is known as community-acquired pneumonia. It is usually caused by organisms present in the environment like pneumococcus bacteria.
Symptoms Of Pneumonia
The signs and symptoms of pneumonia can have some common presentation or vary from person to person depending on the type of pneumonia, age, and overall health.
Some of the common pneumonia symptoms in adults are:
Cough with sputum
Fever
Shaking & chills
Rapid shallow breathing
Shortness of breath
Chest pain
Low energy
Loss of appetite
Nausea & vomiting
Risk factors
Anyone can get pneumonia, however the risk is higher in people:
Above 65 years of age
With chronic lung diseases like COPD, cystic fibrosis, bronchial obstruction, or lung cancer or those with a previous episode of pneumonia
Suffering from conditions that cause any alteration in level of consciousness (eg stroke, seizure, anesthesia, drug or alcohol intoxication) or dysphagia
With immunocompromised conditions like HIV infection, organ/stem cell transplantation, diabetes or those on immunosuppressive medicines
Suffering from metabolic disorders like malnutrition, uremia, and acidosis
With lifestyle risk factors such as smoking, alcohol & toxic inhalants
With intubation or bronchoscopy
With viral respiratory tract infection like influenza
Diagnosis
Sputum test: It is recommended to detect various respiratory tract diseases caused by fungi or bacteria including pneumonia.
Chest X-ray: It is used to diagnose any problems like infections, inflammations or abnormal growth in the lungs.
Complete blood count (CBC): This test may be required to evaluate if the patient is suspected of having a severe infection or inflammation.
Pulse oximetry: It helps to check the oxygen levels of the blood in a non-invasive way that too within seconds.
Arterial blood gas: This test measures the acidity (pH) and the levels of oxygen and carbon dioxide in the blood from arteries.
Bronchoscopy: It provides direct visualization of the lungs including the bronchioles and airway passages to detect for any infection or tumors.
Urine test: This test is used to check for the presence of the bacteria streptococcus pneumoniae in the urine.
Imaging tests: It includes tests such as chest CT scan and lung ultrasound might be recommended to check for any damage in the lungs.
RT-PCR: It is the most reliable and accurate test to diagnose COVID-19 infection complicated with pneumonia. It helps to detect the genetic material of the virus present in the sample (usually a throat or nasal swab).
Viral serology: It helps to detect viral pneumonia and confirm the presence of antibodies targeted against the virus. It also helps to measure the quantity of the viral antigens in the blood sample confirming the presence of viral infection.
Treatment
Antibiotics
Your doctor might recommend antibiotics if he/she suspects bacterial infection. Some of the commonly prescribed antibiotics include:
Amoxycillin + clavulanic acid
Ciprofloxacin
Cefepime
Cefuroxime
Azithromycin
Levofloxacin
Antifungals
These medicines are recommended if you have fungal infection along with pneumonia, which is mostly seen in patients with comorbidities such as diabetes.
Fluconazole
Itraconazole
Amphotericin B
Antivirals
These medicines help to fight the viruses that are responsible for worsening the condition thereby improving the effectiveness of the treatment.
Oseltamivir (influenza virus)
Remdesivir (COVID-19)
Mucolytics
Acetylcysteine is one of the commonly used mucolytics that helps to treat respiratory diseases with excessive mucus such as pneumonia, COPD, and bronchitis.
It loosens and thins mucus in the respiratory tract or airways thereby making it easier to cough out.
In severe cases, most people respond to treatment and recover from the condition.
However, in some cases, such as diabetes, a weak immune system, or heart failure, complications can arise.
This is why it is important to consult your doctor the moment you spot the symptoms of pneumonia.