Pneumonia is a prevalent infection worldwide. It has a broad scenario of presenting, from a controllable condition to a fulminating illness.
What precisely is this condition?
Pneumonia is a respiratory infection. It affects the lower respiratory tract that includes trachea, bronchioles, and even the smallest structures, such as the alveoli within the lung. The infection by multiple microorganisms causes a mild to severe inflammation. The inflammation needs to settle, especially in the lung’s alveoli; if not, it cannot be pneumonia.
This definition means that this illness gets it to the very-last of the lung’s road. If the bronchioles are the only ones affected, the name would be bronchitis and is an infection with quite different medical management and possible complications.
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What microorganism causes it?
Pneumonia is an infection by multiple possible microorganisms. It is pretty common to assume that this illness is only by bacteria. But, no, it can be from bacteria, viruses, parasites, fungi, or even some particular bacterial species “atypical bacteria,” which will be a matter of discussion further. Although, yes, the most common cause of bacterial pneumonia is the classical bacteria; even more, just one bacterium causes the majority of those infections the Streptococcus pneumoniae. But, pneumococcal pneumonia has seen a decrease throughout the years due to the implementation of a vaccine.
The thoughts on this illness being only a bacterial disease have changed over time. The most common cause of hospitalization due to pneumonia are viruses with rhinovirus and influenza virus as leading causes. Mostly in times of seasonal flu, the influenza virus would probably account for the vast majority of the cases. Nevertheless, there is an extensive list of the possible viruses, all of them similarly implicated in the common cold.
The classification takin into account where the illness arises is very important. It allows foreseeing which microorganism could be on the lung. Community-acquired pneumonia (CAP) includes all the lung infections without any recent healthcare exposure by medical visits, while healthcare-associated pneumonia has its own possible set of probable harmful microorganisms.
CAP, when bacterial, typically comes from S pneumoniae, H influenza, and M catarrhalis infection. However, this is continuously changing with new technologies. These days, it es usual to find in 3 of every ten patients a co-infection between bacteria and viruses. On the contrary, healthcare-associated pneumonia has a significant cause, the Pseudomonas aeruginosa.
What is healthcare-associated pneumonia?
Patients with close and constant contact with the healthcare system in many forms can develop different and more severe ways of pneumonia.
The close contact with the healthcare system includes any treatment through the vein in the last 30 days, living in a care facility for a long-period, recent visit to an acute-care facility within the precedent 90 days, or outpatient treatment in the preceding 30 days.
Does the person have an impaired immune system?
The characteristics of the patients and their immune systems are critical. This immunity susceptibility is a risk factor that requires attention. The propensity to CAP by any of the possible microorganisms varies, depending on which type of immunity isn’t well-functioning.
For illustrating my point, if a child is less or more than two years, the microorganism causing CAP varies widely. This variation in microorganisms happens because of various immune system functionality changes at certain ages. Furthermore, adults over 65 years are also vulnerable to get CAP.
Patients with human immunodeficiency virus (HIV) that don’t take the medication would experience a T cell reduction within their body. Specifically, one subtype, T CD4+, this cell is core for maintaining the immune system function. Therefore, in these people, it is possible to see a classic CAP or another illness rare for the general population but typical for these patients. Fungal pneumonia by Pneumocystis jiroveci which is a fungus, it is distinctive not only from HIV patients, but other patients with suppression of their immunity such as cancer patients receiving chemotherapy, and patients with transplants receiving suppression treatment.
The same situation exists for persons who no longer have a spleen. They are keener to develop CAP by “encapsulated bacteria” due to a lack of immune system well-function. Humoral immunity is a critical component of human immunity, and a large part of its functions takes place within the spleen. The humoral immunity is in exclusive dedication to producing a particular protein called antibodies that defend specifically from this type of bacteria; therefore, a weakened immune system would expose the patient to recurrent lung infection by this the encapsulated bacteria.
What are the 4 stages of pneumonia?
The lung’s division comprises lobes. The classical presentation of pneumonia is when the infection compromises one or more lobes, which is called lobar pneumonia. According to its progression, the condition can be further divided into four stages.
Firstly, there is congestion, which means that lung tissue fills up with fluid and harmful microorganisms. Secondly, red hepatization is when there is an activation of the immune response and migration of blood and white cells to the lung tissue. Thirdly, gray hepatization begins with the breaking of red blood cells, while white blood cells remain fighting the harmful germs. And, finally, the resolution phase when the illness starts to clear.
How the infection spreads from person to person?
The mechanisms by which CAP transmits are the same ones for a virus to spread. Both viral and bacterial germs have possibilities for transmission. It mainly occurs through the aspiration of airborne particles from infected people with germs in their nose and throat, that coughs or sneezes. Also, if people with CAP are in contact with surfaces, the germs can stick to it. And then, when healthy people touch those contaminated surfaces and afterward touch their nose or eyes, acquire the germs.
What are the biggest risks for developing the condition?
There is a subset of the population at a higher risk of acquiring it. And if present, there would be a more severe presentation of the lung disease. Age is crucial with people over 65 years and under two years being a high-risk population.
Tobacco smoking, asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis, chronic alcoholism, diabetes, and heart disease are in association with different despicable germs that also cause CAP and its complications.
When a patient is throwing up, and some of that material mistakenly goes into the lung, the likelihood of developing aspiration pneumonia increases. This infection has a different name due to its particular bacteria involved, therefore the need for a specific treatment.
People with an overall decrease in their immunity, such as receivers of transplantations, receiving chemotherapy, taking long-term steroids, and more, are keener to experience a severe case of chest infection.
Chronic diseases that require longterm healthcare, such as patients having dialysis. This condition exposes the people to a wide array of microbes that can utterly infect the patients and cause healthcare-associated pneumonia.
What are the symptoms and manifestations of pneumonia?
The symptoms division would be in the typical and atypical presentation of CAP. Also, CAP can cause complications; therefore, its classification into complicated and non-complicated cases. The variation would utterly depend on the underneath microorganism and its relationship with the vulnerable person. Typically, an overall healthy adult with no exposition to the healthcare system and a well-built immune system, the bacteria acquired would develop a CAP without complications. Still, in rarer instances, this could go further.
Classically, CAP symptoms are high fever, cough, shortness of breath, rapid breathing, and malaise. Also, the person could be coughing up mucus (of yellow or green color), chest pain, headache, abdominal pain, and signs of low oxygen in the blood due to lung misfunctions. However, this could vary upon the microorganism. These symptoms are the usual manifestation of patients with an uncomplicated CAP.
If you get an infection by another bacteria which is not that uncommon like Staphylococcus aureus, the symptoms could be a lot worse, to the point of formation of a giant abscess within the lung (a large mass of pus) that heighten the difficulty to breathe. Usually, a patient with this bacteria is in association with a worse presentation. The progression of the symptoms in this situation, and the alteration of basic vital signs such as heart and respiratory rate, usually lead the clinician to hospitalize the person for intravenous treatment.
Furthermore, pneumonia can manifest classically, or as “atypical pneumonia.” This form of CAP doesn’t display nearly any symptoms, maybe just a mild elevation of the temperature and cough. This infection is by atypical bacteria, such as Mycoplasma pneumoniae. Given the lack of bothering symptoms on this condition, it is known as “walking pneumonia.”
Can you have pneumonia without a fever?
Yes, atypical pneumonia can exist without fever and only mild symptoms like a cough. That is why a complete assessment, including auscultation by your medical doctor and a chest X-ray, is always a recommendation.
What are the complications of pneumonia?
Indeed, pneumonia is a significant reason for many possible complications. Let me illustrate some of complicated pneumonia to you.
Between the lungs and the inner portion of your thorax, there is a “pleural space.” This site is the leading player of the complications because it fills with whatever you think, even air. Well, some of the common difficulties in this condition are that this space fills up with liquid or pus, which difficult, even more, to breathe. This condition is known as pleural effusion. Besides, this complication causes pneumonia’s treatment impairment, which halts a possible resolution and the effectiveness of the medication.
Another lung complication of bacterial pneumonia possible in some microorganisms more than others is a lung abscess. The lung abscess is a pus mass within the lung tissue, that dramatically increases the symptoms and severity of the illness.
Acute respiratory distress syndrome (ARDS) development can happen from multiple conditions, including pneumonia (bacterial, fungal, parasitic, or viral pneumonia). It is an acute lung injury due to overwhelming inflammation. The progression of the symptoms and lung failure is around the corner. This complication is associated with an increase in lousy outcomes.
Other rarer but possible complications include sepsis and organ failure. When these are present, death chances increase significantly.
Can a cold of flu turn into pneumonia?
The vast set of viruses implicated in the common cold similarly can cause CAP. It is unlikely to see a common cold progressing from the upper airway to the inferior part until it converts in a full pneumonia infection, though. What, indeed, is a very prevalent case. It is to see after a viral infection like the common cold or the flu. A new bacterial infection in the lungs that produce bacterial pneumonia.
Can you die from pneumonia?
Yes, pneumonia is the most deathly infectious disease in the world. It accounts for approximately 3,5 million deaths annually worldwide. Pneumonia deaths in the united states are on the top 10 causes of overall death, mostly in adults aging 65 to 79 years.
What is the treatment for pneumonia?
The treatment would focus on what microorganism is infecting the patient; therefore, identifying them is the foundation of the therapy. However, when a patient has a CAP diagnosis is due to their typical symptoms rather than a specific microorganism identification.
Only the microbiologic exams could tell what microorganism is causing CAP. But this process could take several days. For that, the physician starts a standard antibiotic therapy. This treatment is for the many possible microorganisms causing pneumonia; therefore, it is broad. It is very likely that when the microbiologic exam results arrive, the treatment will change towards a specific medication for the causing microorganism.
If the suspicion is for viral pneumonia, then, what the patient would need is antiviral drugs. It would slightly vary between viruses, but for the most common, which is the rhinovirus, and the influenza virus requires medication only in critically ill patients.
If there is no suspicion of possible complications, typical pneumonia without risk factors, treatment should take place at home with oral pills. If signs of alarm are identified, then the patient must have venous antimicrobial therapy and stay in a hospital setting.
How long does it take to cure pneumonia?
Symptoms would start improving by the third day of treatment in most of the infections. However, treatment should last 10 to 14 days. This length depends on the type of CAP and a continued assessment by a physician.
There is a pneumonia vaccine?
Throughout the years, several vaccines for different microorganisms are used for preventing pneumonia.
The pneumococcal vaccine has shown to reduce streptococcal pneumonia, complications, and deaths. Two vaccines are approved, and a recommendation depending on the age. The PCV13 is used in children from 6 weeks to 17 years, and adults older than 50 years. The PPSV23 utilization is only for adults over 65 years and children two years or older that have a high risk of illness by this bacteria.
The annual influenza vaccination decreases the diagnosis and the severity of CAP by the influenza virus. This vaccine is highly recommended for all people aging for more than six months. However, some recommendations by the Centers for Disease Control and Prevention (CDC) about the many options available for vaccine types require assessment by a physician.
The special population that has a reduced immunity can benefit from these vaccines, including the Haemophilus vaccine that is also available.
Do you are experiencing pneumonia?
There is no need to worry. This tool is a pneumonia symptoms checker that will help you determine how likely it is that you have this disease; it would not take more than a few minutes and is free.