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Pneumonia

Pneumonia

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Published by: Nader Smadi on Feb 07, 2009
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02/24/2013

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 Pneumonia
Definition
Every year, more than 60,000 Americans die of pneumonia — an inflammation of thelungs that's usually caused by infection with bacteria, viruses, fungi or other organisms. Pneumonia is a particular concern for older adults and people with chronicillnesses or impaired immune systems, but it can also strike young, healthy people.Worldwide, it's a leading cause of death in children.There are many kinds of pneumonia ranging in seriousness from mild to life-threatening. Pneumonia acquired while in the hospital can be particularly virulent anddeadly. Although signs and symptoms vary, many cases of pneumonia developsuddenly, with chest pain, fever, chills, cough and shortness of breath. Infection oftenfollows a cold or the flu, but it can also be associated with other illnesses or occur onits own.Although antibiotics can treat some of the most common forms of bacterial pneumonias, antibiotic-resistant strains are a growing problem. For that reason, and because the disease can be very serious, it's best to try to prevent infection in the first place.
Symptoms
Pneumonia can be difficult to spot. It often mimics a cold or the flu, beginning with acough and a fever, so you may not realize you have a more serious condition. Chest pain is a common symptom of many types of pneumonia. Pneumonia symptoms canvary greatly, depending on any underlying conditions you may have and the type of organism causing the infection:
 
Bacteria.
Many types of bacteria can cause pneumonia. Bacterial pneumoniacan occur on its own, at the same time as viral pneumonia, or you maydevelop it after you've had a viral upper respiratory infection such asinfluenza. Signs and symptoms, which are likely to come on suddenly, includeshaking chills, a high fever, sweating, shortness of breath, chest pain, and acough that produces thick, greenish or yellow phlegm.Ironically, high-risk groups such as older adults and people with a chronicillness or compromised immune system may have fewer or milder symptomsthan less vulnerable people do. And instead of the high fever that oftencharacterizes pneumonia, older adults may even have a lower than normaltemperature.Bacterial pneumonia is often confined to just one area (lobe) of the lung. Thisis called lobar pneumonia.
 
 
Viruses.
About half of pneumonias are caused by viruses. Viral pneumoniatends to begin with flu-like signs and symptoms. It usually starts with a dry(nonproductive) cough, headache, fever, muscle pain and fatigue. As thedisease progresses, you may become breathless and develop a cough that produces just small quantities of phlegm that may be clear or white. When youhave viral pneumonia, you run the risk of also developing a secondary bacterial pneumonia.
 
Mycoplasma.
This tiny organism causes signs and symptoms similar to thoseof other bacterial and viral infections, although symptoms appear moregradually and are often mild and flu-like. You may not be sick enough to stayin bed or to seek medical care and may never even know you've had pneumonia. That's why this type of pneumonia is often called
walkingpneumonia
.Mycoplasma pneumonia spreads easily in situations where people congregateand is common among schoolchildren and young adults. Mycoplasma pneumonia responds well to treatment with the appropriate antibiotics,although you may continue to have a dry, nagging cough and continue to feelweak during your convalescence.
 
Fungi.
Certain types of fungus also can cause pneumonia, although thesetypes of pneumonia are much less common. Most people experience few if any symptoms after inhaling these fungi, but some develop symptoms of acute pneumonia, and still others may develop a chronic pneumonia that persists for months.
 
Pneumocystis carinii.
Pneumonia caused by P. carinii is an opportunisticinfection that affects people living with AIDS. People whose immune systemsare compromised by organ transplants, chemotherapy, or treatment withcorticosteroids or other immune-suppressing drugs such as tumor necrosisfactor (TNF) inhibitors also are at risk. The signs and symptoms of Pneumocystis carinii pneumonia include a cough that doesn't go away, fever and shortness of breath.
Causes
 
Your lungs are two spongy organs surrounded by a moist membrane (the pleura).Each lung is divided into lobes — three on the right and two on the left. When youinhale, air is carried through the windpipe (trachea) to your lungs. Inside your lungs,there are major airways called bronchi. The bronchi repeatedly subdivide into manysmaller airways (bronchioles), which finally end in clusters of tiny air sacs calledalveoli.Your body has mechanisms to protect your lungs from infection. In fact, you'refrequently exposed to bacteria and viruses that can cause pneumonia, but your bodynormally prevents most of these organisms from invading and overwhelming your airways. For example, the nasal cilia screen out a lot of organisms but can't stop allfrom getting into your airways. Sometimes — for reasons that aren't always wellunderstood — these microorganisms can get past your body's defenses, finally findingtheir way into your lungs' air sacs.There, white blood cells (leukocytes), a key part of your immune system, begin toattack the invading organisms. The accumulating pathogens, white cells and immune proteins cause the air sacs to become inflamed and filled with fluid, leading to thedifficult breathing that characterizes many types of pneumonia. If both lungs areinvolved, it's called
double pneumonia
.
Classifications of pneumonia
 Pneumonia is sometimes classified according to the cause of pneumonia:
 
Community-acquired pneumonia.
This refers to pneumonia you acquire in the course of  your daily life — at school, work or the gym, for instance.
 
Hospital-acquired (nosocomial) pneumonia.
If you're hospitalized, you're ata higher risk of pneumonia, especially if you are on a mechanical ventilator,are in the intensive care unit or have a compromised immune system. Thistype of pneumonia can be extremely serious, especially for older adults, youngchildren and people with chronic obstructive pulmonary diseases (COPD) or HIV/AIDS.A common predisposing factor for this type of pneumonia is gastroesophagealreflux. This occurs when some of the contents of your stomach back up intothe upper esophagus. From there, the gastroesophageal contents can beaspirated into the trachea and then into your airways. Even very small amountsof gastroesophageal reflux can lead to pneumonia in people who arehospitalized.
 
Aspiration pneumonia.
This type of pneumonia occurs when foreign matter is inhaled (aspirated) into your lungs — most often when the contents of your stomach enter your lungs after you vomit. This commonly happens when a brain injury or other condition affects your normal gag reflex.Another common cause of aspiration pneumonia is consuming too muchalcohol. This happens when the inebriated person passes out, and then vomitsdue to the effects of alcohol on the stomach. If someone's unconscious, it's possible to aspirate the liquid contents and possibly solid food from thestomach into the lungs, causing aspiration pneumonia.

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