Pneumonia Symptoms, Causes And Treatment

Pneumonia is defined as the inflammation of the lung parenchyma. The alveoli are inflamed rather than the bronchi or bronchioles of infective origin. It is the infection of the lower respiratory tract. It is a highly contagious disease. It can be transmitted from one person to another person easily through sneeze and cough droplets. Pneumonia is characterized by consolidation which means that the alveoli are filled with a mixture of inflammatory exudates.

Types of Pneumonia

The major types of pneumonia are classified by the cause of infection, where the infection was transmitted and how the infection was acquired.

1. Types by germs

1. Bacterial pneumonia
2. Viral pneumonia
3. Mycoplasma pneumonia/ atypical pneumonia/ walking pneumonia
4. Fungal pneumonia

2. Types by location

1. Hospital Acquired Pneumonia (HAP)/Nosocomial Pneumonia:
2. Community Acquired Pneumonia(CAP)
3. Health Care Associated Pneumonia(HCAP)

3. Types by how they are acquired

1. Aspiration Pneumonia
2. Ventilator Associated Pneumonia (VAP)

Symptoms

There are two types of sign and symptoms in the patients of pneumonia,

1. Respiratory symptoms
2. Non-Respiratory symptoms

Respiratory Symptoms

The respiratory sign and symptoms of pneumonic patients are,

• Cough

Initially it is dry and non-productive but later it produce sputum

• Shortness of breath
• Difficult breathing
• Breath sounds

Breath sounds may be diminished in pneumonic patients but rales or rhonic may be heard. These are low pitched sounds.

Non-Respiratory Symptoms:

• Fatigue
• Sweats
• Headache
• Fever
• Leukocytosis (It is the above normal  range  of  white blood cells)
• Leukopenia (It is the  deficiency  of  white blood  cells)
• Chest pain
• Patchy consolidation in both lungs
• Abnormalities  in  liver  enzymes
• Hyponatremia  (It  is  the   low  level  of  sodium  in blood)
• Decrease in oxygen saturation
• Inappropriate ADH hormone secretion
• Mental status change

Causes

The development of pneumonia requires a pathogen that reaches the alveoli. The next step is based on the interaction between the invading bacteria and alveolar macrophages. Bacteria may overcome the alveolar macrophages and multiply in alveolar space. Then in response to the uncontrolled multiplication, alveolar macrophages will produce cytokines that is an inflammatory response. The endogenous sources of microorganisms are nasal carriers,sinusitis,gastric or tracheal colonization and hematogenous spread. Pneumonia is caused by infectious agents like viruses, fungi and bacteria. Streptococcus pneumoniae is the most common infectious agent causing bacterial pneumoniae.  Haemophilus pneumonia causes viral pneumoniae. The most common causative organism is the bacteria and it includes following bacteria,

• Streptococcus pneumonia
• Haemophilus influenzae
• Moraxella catarrhalis
• P.aeruginosa
• Staphylococcus aureus
• Klebsiella pneumonia
• Mycoplasma pneumonia
• Chlamydophila pneumonia
• Logionenella pneumophila
• Coxiella burnetii
• Chlamydia psittaci
• Escherichia coli
• Streptococci viridans

Other causative organisms are viruses which includes the following,

• Influenza virus
• Adenovirus
• Cytomegalovirus

Fungi include fungi pneumocystis jiroveci and pneumocystis Carini.

Treatment

The main aim of treatment is to monitor safety and efficacy of medicines and increase patient compliance. Macrolides, erythromycin, azithromycin and clarithromycin are preferred choices for the treatment of pneumonia. Macrolides have a dose dependent effect. They have bacteriostatic effect at low concentration and bactericidal effect at high concentration. Antibacterial spectrum is like penicillins that can be given to patients who are allergic to penicillins. In penicillins we prefer methicillin and amoxicillin because they are useful against mycoplasma and chlamydia pneumonia. They shorten the duration of atypical pneumonia and community acquired pneumonia. Fluoroquinolones are preferred in non-intensive care patients and include ciprofloxacin, levofloxacin, moxifloxacin, gemifloxacin and gatifloxacin. Levofloxacin, ciprofloxacin and moxifloxacin are used against streptococcus pneumoniae. They are used against multi drug resistant organisms such as in nosocomial and community acquired pneumonia. Extended-spectrum cephalosporins such as cefotaxime, ceftriaxone and cefepime are also effective for the treatment of pneumonia. Vaccinations are also effective and they enhance immunity. Vaccines cannot prevent all cases of infections but a person who is vaccinated has a milder case of infection. Pneumonia doesn’t last long and fever and serious complications don’t occur then those who are not vaccinated. The vaccines used are polysaccharide vaccine, conjugated vaccine, influenza vaccine and haemophilus influenza type b vaccine.

Frequently Asked Questions

What is a productive cough?

In a productive cough, blood stained or rust colored sputum is produced. If no sputum or mucus is produced then it is called a non-productive cough.

What are the risk factors of pneumonia?

Smoking is the major risk factor for pneumonia and it damages your body defense mechanism against viruses and bacteria.

What are the factors of patients that are responsible for the development of pneumonia?

Malnutrition, advanced age, altered consciousness and underlying pulmonary and systemic disease are the patient factors that increases the chance of getting the disease.