Pneumonia

summary about pneumonia

Pneumonia is an infectious disease that most often has a viral or bacterial origin. It can affect one or two lungs. It is a serious illness that can affect people of any age. Potentially deadly if poorly cared for or if it affects more fragile people, such as: very young children, the elderly, diabetics, people with chronic lung diseases or congestive heart disease.
The number of cases of pneumonia is higher during the winter, it occurs more frequently in smokers and men.
Pneumonia is one of the main causes of child death, it is estimated that around 156 million cases of pneumonia occur in children under 5 years of age worldwide and that approximately 1.6 million children die every year due to pneumonia (WHO ).

The main symptoms are: cough (usually with mucus), rapid breathing, fever, chest pain and fatigue.

The diagnosis is basically made through clinical examinations, analysis of symptoms and chest X-rays. Other complementary exams may be necessary.

Treatment will depend on the cause of the pneumonia. If it is caused by bacteria, the treatment is based on antibacterials, in this case it is very important to follow the treatment until the end, even if you already feel better. If it is caused by a virus, only the symptoms such as fever and pain are treated using paracetamol, ibuprofen, dipyrone, among others.

There are ways to prevent pneumonia: Always wash your hands, cover your nose and mouth when sneezing, avoid contact with infected people, stop smoking. In addition, there are vaccines against pneumococcus and influenza, two major causes of pneumonia. Usually only people at risk of complications get the vaccines.

Definition

Pneumonia is an infectious lung disease usually caused by bacteria, but it can also be caused by viruses and sometimes fungi.

In case of pneumonia, the alveoli fill with pus and fluid, making breathing painful and limiting the absorption of oxygen. Remember that the alveoli are the place where gas exchange takes place (oxygen, carbon dioxide).

This disease develops mainly in elderly or very young people. It occurs more frequently in men, smokers and during the winter. Pneumonia can be dangerous for frail patients and for these, treatment in a hospital setting is most often necessary. In a normal person, pneumonia can be treated at home and usually lasts two to three weeks.

Contamination of pneumonia can occur in various public places, such as schools, hospitals or in the workplace, among others. Pneumonia is spread through contact with respiratory secretions from an infected person. As always, for infectious diseases, preventive measures such as washing your hands thoroughly or putting your hand over your mouth before sneezing or coughing are highly recommended.

Epidemiology

– In 2015, the WHO ( WHO ) estimated that approximately 920,000 children under age 5 died of pneumonia.

– According to the WHO, pneumonia is estimated to cause 15% of the total number of deaths in children under 5 years of age.

Pneumonia in children
In children, pneumonia kills more than all other diseases combined, such as malaria, diarrhea and measles. The organization Save the Children , which helps children, highlighted the high infant mortality rate from pneumonia in a report published in 2017. It found that 99% of child deaths from pneumonia occurred in low-income countries such as several countries in Africa ( eg Somalia, Chad and Angola). Affected children mostly come from families that do not have access to vaccines and antibiotics. In 2017, antibiotic treatment cost only 0.34 euros.
According to Save the Children, in Somalia and Chad, about 32 out of every 1000 children die of pneumonia before their 5th birthday. The good news, however, is that between the year 2000 and 2015, the number of deaths dropped by 47%.

Causes

Pneumonia can be caused by bacteria (mainly), viruses and more rarely by fungi.

When inhaling, air enters the lungs to reach the alveoli, small elastic pockets. If germs like bacteria or viruses get in with the air, these alveoli can become inflamed and infected, leading to pneumonia.1.

Bacteria
Bacteria (bacterial pneumonia)
Different bacteria can cause pneumonia, such as pneumococci, Haemophilus influenzae type b (Hib), Legionella pneumophila (one of the bacteria that causes legionellosis ), Pneumocystis carinii , Chlamydia pneumoniae , staphylococcus, Streptococcus pneumoniae , Mycoplasma pneumoniae , etc. Sometimes, we distinguish the typical form from the atypical form, for bacterial pneumonias.
Typical form
In the United States the bacterium Streptococcus pneumoniaeis the main cause of bacterial pneumonia in any case of the typical form of bacterial pneumonia (in English Typical bacterial pneumonia ), usually occurs as a complication after a cold or flu ( in English)2 .
Atypical form
Atypical bacterialpneumoniacan be caused mainly byMycoplasma pneumoniae, which can lead to mild symptoms. On the other hand,Legionella pneumophilausually leads to severe symptoms.
Children
In children,Streptococcus pneumoniaeis the most common cause of bacterial pneumonia. The WHO estimates thatHaemophilus influenzaetype b (Hib) is the second most common bacteria causing pneumonia.

Viruses
There are also many viruses that can cause pneumonia, such as the chickenpox virus. However, the most common pathogen that causes viral pneumonia is respiratory syncytial virus (RSV). RSV is also the main cause of bronchiolitis , a respiratory disease that mostly affects babies.
In general, viruses lead to mild symptoms of pneumonia, except for SARS-CoV-2, which sometimes leads to hospitalizations and death.

Difficult to find the cause
It is not always easy to associate or find a pathogenic agent causing pneumonia. In an article published in February 2020 in the Wall Street Journal at the time of the coronavirus (Sars-CoV-2) epidemic , a Chinese doctor explained that in only 20% to 30% of cases of pneumonia it is possible to find the causative agent through of tests (for example, viruses, bacteria).

Fungi
The fungus Pneumocystis jiroveci can cause pneumonia, it is one of the main causes of pneumonia in children younger than 6 months infected with HIV/AIDS. According to the WHO, this fungus is responsible for at least a quarter of deaths in HIV-positive infants.
In general, pneumonia caused by fungi (in English: Fungal pneumonia ) is more common in people with weakened immune systems.

Risk factors

Being 65 years or older and children under 2 years old are most at risk of suffering from pneumonia. In addition, certain factors can aggravate and promote the development of pneumonia, as agents enter the lungs more easily, this is the case if you suffer mainly from:

– from a flu

– a common cold (the human rhinovirus or HRV , as the origin of these diseases, increases the risk of suffering from pneumonia, especially of bacterial origin)

– from bronchitis

– from measles

– of asthma

– from a heart disease, mainly chronic

– AIDS (especially in children under 6 months, after an infection with the fungus Pneumocystis jiroveci , also read above) or a weakened immune system (eg chemotherapy)

– cancer (e.g. lung cancer )

– of diabetes

– a hospitalization (in general)

Other risk factors
– Smoking increases the risk of suffering from pneumonia, as the defense system of the airways is weakened by the smoke. There is an facilitated entry of viruses and bacteria into the body.
– Taking certain medications that weaken the immune system, such as corticosteroids or chemotherapy, can also favor the development of this infectious disease.
– A heart transplant contributes to an increased risk.

Winter and pneumonia
It is estimated that in winter the number of cases of pneumonia increases by 30%.

Transmission of pneumonia
Pneumonia is usually transmitted through the air we breathe and through contact with sick people, for example in hospital.
It is known that cases of hospital transmission of pneumonia are usually more aggressive and resistant to antibiotic treatment.

Groups of risk

Elderly people, young children, people who have had a heart transplant and those with weak immune systems (eg people with AIDS) are at particular risk of developing pneumonia and especially of experiencing complications. See also above under Risk Factors

Symptoms

Symptoms of pneumonia can be as follows:

– A severe (productive) cough . This cough is almost always associated with a green, brown or blood-colored mucus coming out of the lungs (the feeling is that this comes from the “bottom” of the bronchi).

– A high fever (39-40°C)

– Rapid, labored breathing

– Fatigue  and muscle aches.

 Chest pain (which increases when you take a deep breath)

 Gastrointestinal disorders: diarrhea , nausea, vomiting, etc.

 Confusion or delirium (especially in older people)

– Chills

– From headaches

Note on symptoms
– In case of bacterial pneumonia, the symptoms appear very quickly, however in case of viral pneumonia, the symptoms take longer to manifest. This is the main symptomatic difference between bacterial pneumonia and viral pneumonia.
– The symptoms of pneumonia can vary depending on the severity of the disease, but also depending on the cause of pneumonia (bacteria, viruses and fungi). In general, pneumonia symptoms last longer than a cold or flu.
– Infants, toddlers, and children sometimes have no symptoms of pneumonia (an asymptomatic profile of the disease) or have symptoms that are small compared to adults. These young patients may, for example, have symptoms such as vomiting, fever, cough, fatigue and lack of energy, or difficulty eating and breathing.
– The elderly, in addition to the symptoms mentioned above, may have mental disorders (eg mental confusion).

When to see a doctor?

– If your cough gets worse

– When you experience difficulty breathing while performing routine activities or resting

– You have a fever equal to or above 38.8 Cº

– Suddenly getting worse after having just gotten better from a cold or flu

Diagnosis

The diagnosis of pneumonia, always made by a doctor, is based at first on a clinical or physical examination of the symptoms and, eventually, on an X-ray of the lungs in search of signs of inflammation in the lungs. Blood tests can also be done.

The doctor can also measure the oxygen level in some more serious or specific cases, can perform a culture of pleural fluid, phlegm or even a bronchoscopy.

Complications

Complications of pneumonia can be numerous and in certain cases it can lead to death. Therefore, it is important not to make light of the disease and take it very seriously, especially if it affects fragile people (young children, elderly people, people with AIDS, etc.).

Here are some complications of pneumonia:

– Septicemia (blood infection)

– Lung abscess

– Fluid between the lung and chest (pleural effusion)

– Meningitis

– Infections of the heart and surrounding tissues

Treatments

Treatment varies according to the cause, whether bacterial, viral or caused by a fungus:

1. Treatment of bacterial pneumonia

An antibiotic therapy will be necessary. Depending on the bacterium responsible for pneumonia, the doctor has different classes of antibiotics available, such as penicillin or its derivatives (amoxicillin), macrolides (eg azithromycin ), 3rd generation cephalosporins, etc.

The treatment differs depending on the severity and the affected person (see risk groups), in severe cases, the treatment will initially consist of an injection of antibiotics and then an oral treatment. In less problematic cases, an oral antibiotic therapy will be used directly.

It is very important that you take all the medicines until the end of the treatment, even if you are feeling well.

After 3 or 5 days of therapy, the symptoms (as well as the high fever) should have disappeared, if not, contact your doctor again. It is normal to feel tired or cough for a month after treatment.

In the United States, the American College of Physicians3 estimated in 2021, based on a study, that treatment with antibiotics against bacterial pneumonia should last a maximum of 5 days. A longer treatment may be considered depending on the type of infection and the clinical course of the patient. A short but effective course of antibiotics makes it possible to limit antibiotic resistance in our societies.

Association of cortisone and antibiotics
A Swiss study carried out in January 2015 by the University Hospital of Basel and other Swiss hospitals showed that the combination of cortisone and antibiotics makes it possible to cure pneumonia faster.

The use of cortisone allows the patient to heal on average 1 day and a half faster than without this medicine, that is, using only antibiotics. Through this association, the patient can leave the hospital one day earlier, instead of staying an average of 7 days, now 6 days are enough.

Thanks to this drug association, the administration of intravenous antibiotics can be reduced by 5 to 4 days. Another advantage of this method is the lower risk of aggravating the disease. The results of this study were published in the leading scientific journal The Lancet .

2. Treatment of viral pneumonia

No causal treatment is available (since antibiotics have no effect against viruses). In this case, it will be necessary to treat the symptoms, drink plenty of fluids to dilute the virus and stay in bed. Your doctor will decide which treatments to use, such as paracetamol, ibuprofen, dipyrone to reduce fever .

Cough
suppressants Sometimes cough medicines (eg cough suppressants or expectorants) can be helpful, but as coughing eliminates mucus (if we find mostly mucus), it’s best to use these medicines with caution. Use the lowest dose of antitussives (cough suppressants) that will give you a good rest4 .
Also read below the section onPhytotherapy(especially those against cough).

Fever
Against fever, it is possible to take ibuprofen or paracetamol to lower the temperature.

Vaccination against pneumonia 

There are vaccines against certain bacteria that cause pneumonia such as:

– Vaccine against Hib (Haemophilus influenzae b), one of the main causes of pneumonia.

– Vaccine against pneumococcus.

Vaccination against Covid-19 reduces the risk of suffering from pneumonia caused by this infectious disease, caused by the SARS-CoV-2 virus.

Herbal medicine

Since pneumonia is a potentially serious disease, it is not advisable to treat this disease exclusively through phytotherapy (especially if it is bacterial pneumonia, in which case it will be necessary to use antibiotics). However, certain medicinal plants can help and complement the treatment, especially in case of cough . Here are some plants with expectorant action that may be of interest:

– Mullein , a plant with an expectorant action, can be found on sale mainly in the form of an infusion.

– Pine bud , a plant with an expectorant action, which can be found on sale in the form of syrup or tablets.

– Eucalyptus , a plant that can be found on sale mainly in the form of an infusion, drops, syrup or essential oil.

– Ivy , a plant with an expectorant action, available in the form of ready-to-use medicines (do not try to make a medicine yourself with this plant!)

– Pulmonaria , a plant with an expectorant and emollient action, useful in case of cough, can be found on sale mainly in the form of an infusion.

– Thyme , a plant with a strong disinfectant action, can be found on sale mainly in the form of an infusion, cough syrup or essential oil.

Tips

As with all infectious diseases, rest is strongly advised. In fact, the body needs a lot of energy to fight infectious agents, so rest is an excellent therapy to let the body “work”.

– Drink plenty of liquids, as this also has a very favorable effect, especially if the pneumonia is viral, as the act of drinking liquids offers a significant dilution of the virus and favors its elimination.

– Avoid smoking ( stop smoking ).

Prevention

– It is advisable to wash your hands thoroughly in case of pneumonia contagion periods, this is certainly the best means of prevention. Use disinfectant soaps if possible, this is particularly recommended in closed places such as hospitals, schools or military barracks. Gel alcohol can also be very useful.

– Quitting smoking is one way to prevent pneumonia.

– The control of infections in communities and hospitals is the main means of prevention, as it is transmitted through droplets of saliva during breathing, infected people should avoid contact. The mouth and nose must be covered when sneezing or coughing.

– To prevent bacterial pneumonia there are some vaccines. In general, they are recommended for people who are hospitalized (talk to your doctor).

It is also advisable for people at risk (over 65 years of age, etc.) to be vaccinated against the flu , since, with a fragile immune system, pneumonia can be a consequence of seasonal flu. As we have seen, vaccination against Covid-19 is also recommended to reduce the risk of viral pneumonia.

– Having a strong immune system (good nutrition, physical exercise, quality sleep, etc.) reduces the risk of suffering from pneumonia.

– Try to stop smoking, a major risk factor for pneumonia.

Prevention of childhood pneumonia

– Breastfeed (breast milk) for at least six months of life.

– Avoid exposing the child to air pollution, so avoid places with a lot of traffic.

– Do not smoke around children.

– Vaccinate your baby against pneumococcus and influenza.

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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