Thursday, April 10, 2014

Pneumonia In Depth

Pneumonia is an infection in one or both of the lungs.  The infection can be caused by fungi, bacteria, or viruses.  It causes inflammation in the lung's air sacs (alveoli).  The air sacs fill with fluid or pus, which makes it difficult to breathe.  Symptoms can range from mild to life threatening.  In fact, pneumonia causes more deaths worldwide than any other illness.  The severity usually depends on the cause of the inflammation or the type of organism causing the infection.  The severity can also be related to a person's age and/or their general health.

*There are 5 Types of Pneumonia Grouped by Cause*

1.) Bacterial Pneumonia:
Bacterial pneumonia can affect anyone at any age.  It can develop on its own or after a serious cold or flu.  The most common cause is streptococcus pneumoniae.  Bacterial pneumonia can also be caused by Chlamydophila pneumonia or legionella pneumophila.  Pneumocystis jiroveci pneumonia is sometimes seen in those who have weak immune systems, due to illnesses like, but not limited to, AIDS or cancer.
2.) Viral Pneumonia:
In most cases, respiratory viruses can cause pneumonia, especially in young children and the elderly.  Usually it's not serious and lasts a short time.  However, the flu virus can cause viral pneumonia to be severe, or even at times, fatal.  It's especially harmful to pregnant women or individuals with heart or lung issues.  Invading bacteria can also cause complications with viral pneumonia.
3.) Mycoplasma Pneumonia:
Mycoplasmas are not viruses or bacteria, but they have traits that are common to both.  They are the smallest agents of disease that affect humans.  Mycoplasmas generally cause mild cases of pneumonia, these cases are often in older children and young adults.

*Other Types of Pneumonia*

Many additional types of pneumonia affect immune-compromised individuals.  Tuberculosis (TB) and pneumocystis carinii pneumonia (PCP), generally affect persons with AIDS.  In fact, PCP can be one of the first signs of illness in people with AIDS.
Less common types of pneumonia can also be serious.  It can be caused by inhaling food, dust, liquid, gas, and various fungi.

*Who is at risk for developing Pneumonia?*

No one is immune to pneumonia, but there are certain factors that can raise your risks:
1. People who have had a stroke, have problems swallowing, or are bedridden 
2. Infants from birth to age 2 and individuals aged 65 or older, are more at risk
3. Weakened immune systems: This includes people on medications (steroid and anti-cancer drugs), people with HIV, AIDS, or cancer.
4. Drug abuse: This includes excessive alcohol consumption and smoking
5. Certain medical conditions: Asthma, cystic fibrosis, diabetes, and heart failure

*What are the Symptoms of Pneumonia?*

The general symptoms of bacterial pneumonia can develop quickly and may include:
1. Chest Pain
2. Shaking Chills
3. Fever
4. Dry Cough
5. Muscle Aches
6. Nausea/Vomiting
7. Rapid Breathing
8. Rapid Heartbeat 
9. Difficulty Breathing 
Some symptoms may indicate a medical emergency.  These symptomes include:
1. Skin with a bluish tone (from lack of oxygen)
2. Blood in sputum (coughed-up mucus)
3. Labored Breathing
4. High Fever (103 degrees F or higher)
5. Confusion
6. Rapid Heartbeat

*How is Pneumonia Diagnosed?*

Pneumonia can be easily overlooked as the cause of an illness because it often resembles a cold or the flu.  However, it usually lasts longer and symptoms seem more severe than these other conditions.

*Detailed Patient History*

To determine whether or not a patient has pneumonia, doctors generally inquire about a patient’s signs and symptoms.  Questions they may include:
1.) What are your symptoms and when did they begin?
2.)What were your recent travels and activities?
3.) What was your recent exposure to animals?
4.) What was your recent exposure to individuals who are sick?
5.) What are your past and current medical issues?
6.) What medications are you currently taking?
7.) What is your smoking history?
8.) Have you recently had any vaccinations or illnesses?

*Physical Exam*

Crackling and bubbling sounds in the chest during inhalation are usually indicators of pneumonia.  Wheezing may also be present.  Additionally, your doctor may have trouble hearing normal breathing sounds in different areas of the chest.

*Diagnostic Tests*

Chest X-rays can be used to determine if infection is present in your lungs.  However, chest X-rays won’t show your type of pneumonia.  Blood tests can provide a better picture of the type of pneumonia.  Also, blood tests are necessary to see if the infection is in your bloodstream.

*Other Tests*

Additional tests that may be required include:
Chest computed tomography (CT scan): A CT scan is similar to an X-ray, but the pictures provided by this method are highly detailed.  This painless test provides a clear and precise picture of the chest and lungs.
Sputum test: This test will examine the sputum (the mucus you cough up) to determine what type of pneumonia is present.
Pleural fluid test: If there is fluid apparent in the pleural space (the space between the tissue that covers the outside of your lungs and the inside of your chest cavity), a fluid sample can be taken to help determine if the pneumonia is bacterial or viral.
Pulse oximetry: This test measures the level of oxygen blood saturation by attaching a small sensor to your finger.  Pneumonia can prevent normal oxygenation of blood.
Bronchoscopy: When antibiotics fail, this method is used to view the airways inside the lungs to determine if blocked airways are contributing to the pneumonia.

*How Is Pneumonia Treated?*

The type of treatment prescribed for pneumonia primarily depends on what type of pneumonia is present and its severity.  In many cases, pneumonia can be treated at home.

*General Treatment*

The typical treatment plan for pneumonia includes taking all prescribed medications and participating in follow-up care.  A chest X-ray may be ordered to ensure your pneumonia has been successfully treated.

*Treating Bacterial Pneumonia*

Antibiotics are used to treat this type of pneumonia.  Antibiotics should be taken as directed.  If antibiotics are ceased before treatment is complete, the pneumonia may return.  Most people will improve after one to three days of treatment.

*Treating Viral Pneumonia*

Antibiotics are useless if a virus is the cause of pneumonia.  However, antiviral drugs can help treat the condition.  Symptoms usually improve within one to three weeks.

*Can Pneumonia Be Prevented?*

Anyone with diabetes, asthma, and other severe or chronic health problems, is at risk for pneumonia.  However, in many cases, it can be prevented with vaccines against bacterial pneumonia and flu.  Quitting smoking will definitely lower the risk of pneumonia.

Remember if you have any of the following symptoms or worries, seek medical attention at your physician or go to the nearest emergency room.  Stay Informed! 

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