Pneumonia General Informations

What is pneumonia?

Pneumonia or pneumonia is a lung infection with microorganism growth inside the alveoli, which causes inflammation with pulmonary damage. The inflammatory reaction produces an occupation of alveoli displayed on a chest radiograph.

In developed countries it is the sixth leading cause of death. Observed approximately 7 to 15 cases per 1000 people per year.

What are its causes?

Pneumococcal infection occur when a germ invades the lung tissue.

These germs can reach the lungs by three different ways: by suction from the nose or throat, inhalation or through blood.

The most common mechanism is the aspiration of microorganisms from the upper airways. The upper respiratory tract (mouth, nose, throat) are often colonized by bacteria, but they are producing a disease. The airways have defense mechanisms that prevent bacteria reach the lung, such as cough, the presence of cells with cilia, removing charged particles that reach the bronchi, and cells and substances specially designed for immunity, such as lymphocytes, neutrophils, macrophages and antibodies. These defenses may be weakened by certain circumstances and facilitate these germs to reach the lung and infections occur.

This is the mechanism of pneumonia caused by bacteria such as pneumococcus, Haemophilus and some streptococci. Some processes that produce these changes in defense mechanisms are snuff consumption, chronic lung disease, alcoholism, malnutrition, diabetes, chronic kidney or liver problems, changes in level of consciousness and other immune deficiencies. A process viral or flu can cause damage to the hair cells to facilitate the further development of pneumonia.

Other microorganisms reach the lung from the inspired air, as occurs in pneumonia caused by Mycoplasma pneumoniae, Chlamydia pneumoniae, Chlamydia psitacii, Coxiella burnetii (Q fever), Legionella pneumophila, or viruses. Some of them are transmitted by animals (Q fever, psittacosis).

Finally, some bacteria may come from another region of the body (biliary tract, urinary tract, heart valves, etc.) And reach the lung through the bloodstream. Pneumonia acquired in hospitals, also called nosocomial or hospital-acquired generally have more severe and different characteristics.

What produce symptoms of pneumonia?

Symptoms of pneumonia vary, without always having regard to the type of germ causing the pneumonia. Some cases present with what is called a “typical pneumonia”, which consists of the appearance in several hours or 2-3 days of cough with purulent or rusty, sometimes with blood, chest pain and fever with chills. Pneumonia is most often caused by pneumococcus.

Other pneumonia, called “atypical” symptoms occur more gradual with grade fever, malaise, muscle and joint aches, fatigue and headache. The cough is dry, without expectoration, and chest pain less intense. Some patients may have mild gastrointestinal symptoms such as nausea, vomiting and diarrhea. These symptoms are more characteristic of Mycoplasma, Coxiella or Chlamydia. Most pneumonias have characteristics of both groups.

If pneumonia is extensive or there is a previous heart or lung disease may appear respiratory distress. Furthermore, if germs pass into the bloodstream that can cause bacteremia lead to a “septic shock” life-threatening. Pneumonias may be complicated by the development of a pleural effusion, respiratory failure or severe cases renal or cardiac failure. In elderly people filing initial symptoms may be less noticeable with slightly elevated or absent fever, cough scarce and behavioral disturbance.

How serious is pneumonia?

The severity of pneumonia depends on the extent of lung that is affected, the type of seed and the causes of aging and disease have already previously. Have a higher risk of pneumonia in older people, heart, kidney, liver or lung disease, diabetes and alcohol users.

Most pneumonia in healthy people if they are not cured with extensive oral antibiotic treatment, without the need hospitalization. Thus, in this group only 3 to 10% require admission.

However, if other diseases added, pleural effusion, is widespread or has not responded to initial correct treatment requires admission to a hospital for treatment. In severe cases may require intubation and connection to a respirator and admission to intensive care unit.

Can it be prevented?

There are few measures to prevent the occurrence of pneumonia. Rarely infection is acquired by another person and the most common are caused by germs that “live” normally in our airways. Since many of them begin after a viral or flu-like process, annual influenza vaccination is recommended for all those with increased risk (over 65 years, chronic lung or bronchial diseases, kidney disease, chronic heart or liver).

Also vaccination with pneumococcal vaccine prevents the onset of pneumonia caused by pneumococcal bacteremia. Its use is recommended for people aged 65 years or over 2 years with chronic cardiovascular or pulmonary disease, alcoholism, chronic liver disease, absence of spleen by surgery or trauma, or cerebrospinal fluid leaks, and people with immune deficiencies, widespread cancer , chronic renal failure or who have received a transplant.

People with asthma, chronic bronchitis or bronchiectasis, antibiotic treatment should be started early when symptoms of respiratory infection (cough with increased sputum or change and difficulty breathing), scheduled by a doctor. But this does not justify the use of antibiotics indiscriminately because most upper respiratory infections (rhinitis, common cold, pharyngitis) are caused by viruses, which do not require or improve with antibiotic treatment. The widespread use and overuse of antibiotics lead to the emergence of antibiotic-resistant bacteria.

How is it diagnosed and what is the treatment?

Suspecting pneumonia by symptoms and physical examination must be carried out x-ray to confirm the diagnosis. Once treatment should begin with the earliest possible.

Treatment of bacterial pneumonias are antibiotic drugs. There are a variety of antibiotics and very important decision on the type of antibiotic depends on the suspected germ, severity of pneumonia and the patient’s characteristics.

In most cases it is not necessary to find the seeds unless they are causing a severe pneumonia or not responding to treatment. In these cases it may be necessary to perform diagnostic tests such as culture of respiratory specimens or blood, bronchoscopy, or lung puncture serology.

If there are serious factors should be admitted to hospital and start intravenous treatment with antibiotics and other medications that may be required.