Vaughn Roy L.

Chua

Pneumonia
Definition:

is a serious infection or inflammation of one or both lungs.

Description: is caused by the inhalation of infected microorganisms (tiny, single-celled living organisms, such as bacteria, viruses, fungi or protozoa) spread through contact with an infected person. The microorganisms enter the body through the mouth, nose and eyes. If the body's resistance is down, the natural process of fighting off diseases is weakened and the microorganisms are free to spread into the lungs and the lungs' air sacs. The air sacs become filled with fluid and pus from the infectious agent, making it more difficult for the body to get the oxygen it needs, and the person may become sick. Potential complications of pneumonia include pleural effusion (fluid around the lung), empyema (pus in the pleural cavity), hyponatremia (low blood sodium) and rarely, an abscess in the lung.

Causes of Pneumonia: Bacterial pneumonia: Pneumonia-causing bacteria is present in many throats, but when the body's defenses are weakened (for example, by illness, old age, malnutrition or impaired immunity) the bacteria can multiply, working its way into the lungs, inflaming the air sacs and filling the lungs with liquid and pus. The bacteria that cause bacterial pneumonia are streptococcus pneumonia (resulting in lobar pneumonia), hemophilus influenza (resulting in bronchopneumonia), legionella pneumophilia (resulting in Legionnaires' disease) and staphylococcus aureus. Viral pneumonia: Half of all pneumonias are believed to be caused by viruses, such as influenza (flu), adenovirus, coxsackievirus, chickenpox, measles, cytomegalovirus and respiratory syncytial virus. These viruses invade the lungs and multiply. Mycoplasmal pneumonia (also called "walking pneumonia"): Similar to bacterial pneumonia, the mycoplasmas multiply and spread, causing infection. Some of the other pneumonia-related disorders are aspiration pneumonia, chlamydial pneumonia, Loffler's syndrome, pneumocystis carinii pneumonia, pediatric pneumonia and necrotizing pneumonia.

Symptoms of Pneumonia: Symptoms vary, depending on the type of pneumonia and the individual.

Vaughn Roy L. Chua

With bacterial pneumonia, the person may experience: Shaking, chills, chattering teeth, severe chest pain, cough that produces rustcolored or greenish mucus, very high fever, sweating, rapid breathing, rapid pulse rate

With viral pneumonia, the person may experience: Fever, dry cough, headache, muscle pain and weakness, These flu-like symptoms may be followed within one or two days by: increasing breathlessness, dry cough becomes worse and produces a small amount of mucus, higher fever, bluish color to the lips

With mycoplasma pneumonia, the person may experience: violent coughing attacks, chills, fever, nausea, vomiting, slow heartbeat, breathlessness, bluish color to lips and nailbeds, diarrhea, rash, muscle aches,

Regardless of the type of pneumonia, the person may also experience the following symptoms: a loss in appetite, feeling ill, clammy skin, nasal flaring, fatigue, mental confusion, joint and muscle stiffness, anxiety, stress and tension, abdominal pain

Diagnosis of Pneumonia: To diagnose pneumonia, the doctor begins with a medical history and physical examination. By placing a stethoscope on the chest, the doctor may be able to hear crackling sounds, coarse breathing, wheezing and/or the breathing may be faint in a particular area of the chest. Additionally, the doctor may order a chest x-ray, a sputum gram stain and a blood test. The chest x-ray may show a blotchywhite area, where fluid and pus has accumulated in the lung's air sacs. The sputum grain stain and the blood test may determine the cause and severity of the condition. If these tests are inconclusive, the doctor may perform a procedure called a bronchoscopy. In this procedure, a flexible, thin and lit viewing tube is inserted into the nose or mouth after a local anesthetic is administered. The breathing passages can then be directly examined by the doctor and specimens from the infected part of the lung can be obtained.

Vaughn Roy L. Chua

Treatment of Pneumonia: Treatment depends on the severity of symptoms and the type of organism causing the infection. Bacterial pneumonia (caused by the streptococcus pneumonia bacteria) is often treated with penicillin, ampicillin-clavulanate (Augmentin) and erythromycin. Bacterial pneumonia (caused by the hemophilus influenza bacteria) is treated with antibiotics, such as cefuroxime (Ceftin), ampicillin-clavulanate (Augmentin), ofloxacin (Floxin), and trimethoprim-sulfanethoxazole (Bactrim and Septra). Bacterial pneumonia (caused by legionella pneumophilia and staphylococcus aureus bacteria) are treated with antibiotics, such as erythromycin. Viral pneumonia does not respond to antibiotic treatment. This type of pneumonia usually resolves over time. If the lungs become infected with a secondary bacterial infection, the doctor will prescribe an appropriate antibiotic to eliminate the bacterial infection. Mycoplasma pneumonia is often treated with antibiotics, such as erythromycin, clarithromycin (Biaxin), tetracycline or azithromycin (Zithromax). In addition to the pharmaceutical intervention, the doctor will also recommend bedrest, plenty of fluids, therapeutic coughing, breathing exercises, proper diet, cough suppressants, pain relievers and fever reducers, such as aspirin (not for children) or acetaminophen. In severe cases, oxygen therapy and artificial ventilation may be required. The course of pneumonia varies. Recovery time depends upon the organism involved, the general health of the person and how promptly medical attention was obtained. A majority of sufferers recover completely within a few weeks, with residual coughing persisting between six and eight weeks after the infection has gone.

Pathophysiology of Pneumonia: The invading organism causes symptoms, in part, by provoking an overly exuberant immune response in the lungs. The small blood vessels in the lungs (capillaries) become leaky, and protein-rich fluid seeps into the alveoli. This results in a less functional area for oxygen-carbon dioxide exchange. The patient becomes relatively oxygen deprived, while retaining potentially damaging carbon dioxide. The patient breathes faster and faster, in an effort to bring in more oxygen and blow off more carbon dioxide. Mucus production is increased, and the leaky capillaries may tinge the mucus with blood. Mucus plugs actually further decrease the efficiency of gas exchange

Vaughn Roy L. Chua

in the lung. The alveoli fill further with fluid and debris from the large number of white blood cells being produced to fight the infection. Consolidation, a feature of bacterial pneumonias, occurs when the alveoli, which are normally hollow air spaces within the lung, instead become solid, due to quantities of fluid and debris. Viral pneumonias, and mycoplasma pneumonias, do not result in consolidation. These types of pneumonia primarily infect the walls of the alveoli and the parenchyma of the lung.