By Dr Madhu K, Pulmonologist
Pneumonia is a serious respiratory infection that requires prompt diagnosis and appropriate treatment. It is brought on by bacteria, viruses, or fungi that causes lung tissue to swell. These bacteria and viruses that we breathe in from the air may spread by coughing, sneezing, contaminated surfaces, and other means. An individual breathes these into their lungs’ alveoli. The lungs may fill with fluid or pus as a result of this infection. It is crucial to comprehend the causes, symptoms, and risk factors in order to prevent problems and effectively treat existing ones.
Pneumonia can be classified as Community Acquired and Hospital Acquired. Community Acquired Pneumonia as the name suggests, is acquired from the community that is, outside the healthcare facilities. On the other hand, Hospital Acquired Pneumonia is infected when an individual is admitted in the hospital. The causative agents that include bacteria, viruses and fungi; for both these types vary accordingly. Majority of severe pneumonia is caused by bacteria, whereas viruses like influenza, COVID CAB can also cause severe pneumonia.
Symptoms and Presentations
The severity of pneumonia symptoms can range from being so mild that you hardly notice them to needing to be hospitalised. The type of bacteria causing the infection, your age, and your general health all affect how your body reacts to pneumonia.
Different factors, such as age, health status, type of germ, and so forth, can cause different symptoms. Additionally, this can change based on the severity of the illness.
Major and common symptoms include cough, fever with rigor and chills, sweating, shortness of breath and chest pain. In children, nausea, vomiting or no specific symptoms can occur for this infection.
Newborns and infants may not show any signs of the infection. They could also appear anxious, sick, or fatigued and distracted. They might also throw up, cough, and have a fever. Elderly people, people with major illnesses, and people with compromised immune systems may have less severe symptoms. Their body temperature can be lower than usual. Occasionally, sudden changes in mental awareness might be caused by pneumonia in elderly persons. The symptoms may worsen if a person already has a chronic pulmonary condition.
Diagnosis
Since the symptoms of pneumonia can vary so much and frequently resemble those of the common cold or influenza, it can occasionally be challenging to identify the illness.
Pneumonia is mainly diagnosed clinically from history and examination of the patient and from radiological findings using X-ray of the chest.
Blood test like blood counts C-reactive protein , and other test will help in assessing the severity of pneumonia.The causative organism of pneumonia is identified by blood culture , sputum culture or the newer methods of early diagnosis by using PCR technique.
In some patients, when pneumonia doesn’t respond to treatment, CT Thorax may be required. Bronchoscopy may be done in certain patients to get microbiology sample.
When patient develop complication like pleural effusion it has to be removed by aspiration or by surgical drainage
Treatment
Treatment of pneumonia is mainly based on the possible causes like the type of infection the patient acquires. If it is a community acquired pneumonia the first step will be made according to severity of the infection ie., whether the patient should be admitted or treated as an out patient. If the patient requires admission then decision will be taken whether to admit in ward or ICU depending on severity of the infection.
The choice of antibiotics and antiviral drugs mainly depends on the severity. Initially before identifying the cause the patient will be treated with antibiotics suitable for common organism and this is called as Empirical Antibiotics. When the organism is identified the antibiotics used may be changed.
Apart from antibiotics other treatments like oxygen therapy , non invasive or invasive ventilation and other supportive treatments may be required in certain patients. Patients are advised to take sufficient water and food and adequate rest.
There are two approved vaccine in preventing pneumonia both in children and adults, that is, Influenza Vaccine and Pneumococcal Vaccine. All patients above the age of 60 and less than 60 years with any respiratory illness also should take these vaccines.
Prevention
Pneumonia can be prevented if the advised immunisation is received. Maintaining proper hygiene is essential to preventing sickness. Thus, be careful to take care of your body and maintain proper hygiene by washing your hands before eating. Other ways to lower your risk of pneumonia include eating a healthy diet, stopping smoking, and exercising frequently to strengthen your immune system.
Therefore, developing good living habits at a young age can help avoid the onset of disease. Pneumonia is a disease that is carried via the air. One important factor influencing the spread of illness is the air we breathe. Regular testing and examinations can be used to diagnose the disorders. Vaccinating kids consistently in accordance with their birth chart is one of the most effective approaches to avoid pneumonia in children. Therefore, depending on severity, pneumonia is a curable infection with appropriate treatments and care.
