Know all about pneumonia: Symptoms, causes, treatment

HAVE YOU HEARD OF PNEUMONIA: LET'S TALK ABOUT IT NOW!

We often get to hear from the medical persons or sometimes people around us, they say it might be pneumonia. In many rural parts of India, I have seen people talk about it with raised eyebrows and a tinge of fear in their voices; may be they feel it is something more dangerous.  When  a child coughs excessively, the village women would be seen advising to get medical help as it can be pneumonia.

So let us talk everything about pneumonia in this informational health post. I hope this one helps many get a coarse or general idea of pneumonia. 

Overview:

Pneumonia is a respiratory illness characterised by the consolidation of the lung lobes( patchy consolidation seen on chest x-ray), which makes breathing difficult.  It is a lung infection caused by germs such as bacteria, fungi and viruses and it affects the air sacs or the alveoli of the lung.  

These air sacs are responsible for oxygen exchange.  In pneumonia, our air sacs get filled with either pus or fluid due to the infection. This makes our breathing painful and difficult.  This reduces the oxygen supply and thus the symptoms appear. 

Chest pain and expectoration of mucus or sputum are the common symptoms of pneumonia. 

Streptococcal infection of the throat is the most common cause of pneumonia. There are however, different species of bacteria or viruses responsible for causing flu and common cold which can cause pneumonia, too. Fungi can cause pneumonia but bacterial and viral infections are more common.

Pneumonia can be mild to severe to life-threatening and it is mostly found in children and elderly people above 65 years as both have low/weakened immune system. 

What are the signs and symptoms of Pneumonia?

The signs and symptoms of pneumonia are:

• Fever with chills 
• Chest pain on breathing
• Excessive cough or sputum
• Dry coughing
• Shortness of breath
• Feeling fatigue or weakness
• Difficult breathing 
• Nausea or vomiting
• Reduced oxygen saturation (SpO2)

What are the causes and risk factors for pneumonia?

Pneumonia often occurs as a complication of upper or lower respiratory tract infections such as common cold or flu or covid -19, etc. 

The common causes of pneumonia are bacteria and viruses. Fungal pneumonia is rare and seen among people who have opportunistic infections due to weakened immune systems. Some parasites can also cause pneumonia. 

What are the types of pneumonia in adults/children based on the causes? 

• Community acquired pneumonia: It appears as an infection caused by germs which spreads by airborne transmission or droplet spread. Bacteria and viruses can cause pneumonia once a person catches cold or has flu. The germs attack when the immune levels go down. A person with cold or flu can transmit the germs to other person while coughing, talking, sneezing, etc. 
• Hospital acquired pneumonia is the one in which a person gets pneumonia due to the stay in hospital for treatment of other infections. ICU patients on ventilators are at more risk of getting hospital acquired pneumonia. Some people develop resistance to certain antibiotics and these put them at risk of getting pneumonia. 
• Aspiration pneumonia is the pneumonia that develops when a person accidentally ends up aspirating the contents of food pipe into the lungs. Poor gag reflex or less mental awareness while eating(such as being over drunk due to alcohol consumption,etc.) can cause the contents to spill inside the lungs and this becomes a site of infection later. 
• People who live in health-care facilities such as long-term care or people receiving certain therapies such as hemodilaysis or peritoneal dialysis or chemotherapy are at more risk of getting pneumonia as they spend a lot of time in the clinical setting which contains loads of germs. When the immunity levels drop down, it can cause pneumonia in such people. It is called health-care acquired pneumonia.

Who is at risk for pneumonia?

Risk factors: Let us know who is at risk for pneumonia:

Anyone in their lifetime can have pneumonia. It can occur in any age but there are certain risk factors that increase the occurrence. 

• Children below 5 years
• Elderly people above 65 years.
• People living with cancer or HIV/AIDS.
• People who have weakened or compromised immune systems. 
• People who smoke or consume alcohol more
• People who are on dialysis treatment. 
• People who stay for long time in hospital for treatment of their illness.
• People in long-term care and intensive care units, especially when put on ventilators. 
• People with recurrent respiratory tract infections.

How is pneumonia diagnosed? 

Diagnosis of pneumonia: 

Pneumonia can be diagnosed by:

• Physical assessment of the symptoms, Vital signs especially the breath rate or respiration rate.
• Auscultation of the chest: crackles are common in pneumonia
• Chest X-ray imaging. White patches on the chest x-ray is called consolidation.
• Complete blood count tests
• C-reactive protein test should not be more than 20 mg/L 
• Sputum culture test may be done to rule out the cause of infection.
• In children grunting, high and rapid respiration rate as well as lower chest in-drawing are most conclusive signs of pneumonia.
• Pulse oximetry to know the oxygen saturation of blood.
• ABG or arterial blood gas analysis may be ordered if a person is on ventilator or has other associated infections.
• CT scan to get a clear picture of your lung inflammation
• Pleural fluid aspiration may in done in severe cases to rule out the type of microorganisms involved in causing pneumonia.

What is the treatment of pneumonia? 

Treatment of pneumonia can be done by:

• Antibiotics or antiviral medications by mouth
• Cough expectorants
• Nebulisation therapy
• Steam inhalation
• Qxygen therapy
• Intravenous administration of fluids and medications
• Adequate rest
• Physical therapy

Most cases resolve with the above treatment strategies and oral medications. In severe cases, hospitalization may be recommended and intravenous administration of fluid and medications may be started. If there is severe breathing difficulty the person may need intensive oxygen therapy and other special care. 

What are the signs that show you are recovering or improving from pneumonia? 

You may recover slowly or rapidly depending upon the severity of your pneumonia symptoms. If you respond nicely to the treatment,the chances of improving are better. 

Some signs and symptoms that show you are improving from pneumonia:

• Respiration rate decreases and tends to remain within normal limit. 
• Less exertion while breathing
• Relief from exhaustion and fatigue
• Decrease in the chest pain while breathing
• Less difficulty in breathing or breathing normally as before
• No fever episodes
• No crackles or less crackle sounds on stethoscope
• SpO2 increases to near normal or normal 100%
• Weaning from oxygen therapy. Less requirement of O2 or assisted breathing.
• Feeling well and less sick. 
• Chest x-ray follow up shows reduced consolidation or patches gone. 
• No chest in-drawing or grunting in infants or children below 5 years of age. 
• Low or no sputum in cough

What is the prevention of pneumonia? 

Prevention of pneumonia:

It is possible to prevent pneumonia. Some precautionary measures can prevent the risk of pneumonia. 

• Vaccines: Get your child vaccinated for Hib vaccine. Vaccines play an important role in reducing the risk of infection. 
• Use of face masks can help you prevent inhalation of the microorganisms or germs. 
• Hand-washing for at least 20 seconds ensures your hands are germ-free. Most of the infections spread by direct contact. Hand washing is a universal precaution. 
• Healthy habits such as exercise and aerobics. Giving up smoking and alcohol can reduce the risk of pneumonia. 
• Balanced diet and adequate sleep
• Keep track of existing conditions such as asthma, bronchitis or any lung disease, heart disease or diabetes. Continue medications as ordered by your doctor.
• Cancer or HIV/AIDS patients need to take extra precautions as they are more susceptible to opportunistic pneumonia caused by fungi and other microorganisms.

Pneumonia is a respiratory disease and it mostly appears as a complication of some previous airborne illnesses. Pneumonia can be treated easily if detected early. Prompt treatment helps in preventing any further damage to the lungs.

Note: This post is for informational and educational purpose only, It is not a substitute to any medical or professional advice or treatment. See your doctor in any case.