Pneumonia

By Kemboi Kibet

Pneumonia is an inflammation of one or both lungs caused by infection by microorganism like bacteria, fungi and viruses. It is the sixth leading cause of death in the United States. It can range from mild to fatal or life threatening. Pneumonia infections caused by bacteria or fungi can be treated by antibiotics but not those caused by viruses. Pneumonia can also result from accidental inhalation of a liquid or chemical. It is especially common in children and people 65 years or older.
CAUSES AND RISK FACTORS
Pneumonia is commonly caused by bacteria or virus in the environment. Your body’s immune system’s mechanism usually prevent these microorganisms from invading your lung to cause infection. However sometimes due to weakened immune system (due to a stroke, diabetes, heart disease), pre-existing conditions like cold or flu, age or some other reasons, these organism breech your body’s defense mechanism and invade your lungs. It should be noted that different types of microorganism are responsible for the different types of pneumonia. Also the microorganism that cause this disease in healthy people is different from those that cause it in people with weakened immune system.
TYPES
There are different types of pneumonia. These include;
COMMUNITY – ACQUIRED PNEUMONIA – This is usually caused by microbes we encounter in our everyday life. These are present in the environment that we live in. These cause the mild form of pneumonia which is easily treatable. Example of microorganism that cause community-acquired pneumonia are;
Bacteria like Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae and Klebsiella pneumoniae. The previously health-care-acquired pneumonia bacteria Methicillin-resistant Staphylococcus aureus (MRSA), an antibiotic-resistant bacterium now causes pneumonia and skin infections in community settings.
Bacteria – like organisms like Mycoplasma pneumoniae – causes walking pneumonia. Chlamydia and Legionella pneumoniae are also pneumonia causing organisms that are neither bacteria or viruses.
Viruses can also cause pneumonia although most cases of viral pneumonia are less severe. Viruses that cause colds and flu can also cause pneumonia and particularly pneumonia caused by the influenza virus can be fatal. Note that most viral pneumonia pave way for a secondary infection by a bacteria.
Fungi, parasites and germs that cause tuberculosis may also cause pneumonia although this is less common. This type is more prevalent among people living in developing countries or people who travel to such places.
HEALTH-CARE-AQUIRED PNEUMONIA – Most of the resistant strains of bacteria like Pseudomonas aeruginosa and MRSA are found in the hospitals. These bacteria cause severe and difficult to treat pneumonia because they are resistant to antibiotics. The main concern of health care professional in this type of setting is to identify the strain of bacteria and find a correct antibiotic that can treat it. It is also possible to find community – acquired strains like Streptococcus pneumoniae and Haemophilus influenzae. This type of infection occurs in hospitals, dialysis centers, outpatient infusion centers and nursing homes.
INHALATION OR ASPIRATION PNEUMONIA – This happens when people accidentally breathe foreign material into their lungs due to a medical condition like Parkinson’s or a stroke which makes swallowing difficult or vomiting while unconscious or sleeping.
OPPORTUNISTIC BACTERIA, FUNGAL AND VIRAL PNEUMONIA – People with weaken immune system are especially susceptible to this kind. These include people with AIDS, stroke and diabetes. People who have received an organ transplant and those who have taken medication (chemotherapy and corticosteroids) that suppress the immune system are also very much at risk of this kind of pneumonia
Generally the risk of getting this disease increases with age, with certain medical conditions like COPD and AIDS, smoking and exposure to certain pollutants and chemicals.
SYMPTOMS
Symptoms differ for each individual depending on the type you have, your age and your preexisting medical condition. However, there are some general symptoms which is very characteristic of pneumonia. These include ;

Fever
Shortness of breath
Chills
Coughing
Headache
Muscle ache
Fatigue
Chest pain
sneezing
sore throat

People with bacterial infection most of the time cough and produce a lot of sputum which is usually greenish or tinted with blood. This is the opposite of what happen for non-bacterial infections where individuals cough but produce less sputum.
The elderly and children experience very few symptoms when they get the disease. One sure sign or symptom for elderly pneumonia is confusion or a preexisting lung condition which seems to worsen.
In babies and infants symptoms of pneumonia include poor feeding, being lethargic, looking pale, grunting and fever.
Most children have the same symptoms as healthy adults will experience
TESTS AND DIAGNOSIS
First of all your doctor will ask you questions about your medical history. He will then perform a physical examination on you. He will listen to your lungs with a stethoscope to check for crackling sounds and rumblings which is an indication of the presence of a thick fluid. He will then do a chest X-ray to confirm the diagnosis. Chest X-rays however do not always confirm pneumonia, especially when it is done too early. There are other test available that the doctor can perform to confirm diagnosis. These include ;
Blood tests – This is done to measure your white blood count. This often checks the severity of the pneumonia and also to identify the kind of microbe (bacteria or virus ) causing the pneumonia.
Sputum tests – This will also help to identify the kind of microbe causing the pneumonia by doing a gram stain and sputum culture.
Rapid urine test – This test is also done to identify the kind of microorganism causing the bacteria. It may also be used as a treatment guide
TREATMENT
Treatment of pneumonia depends on age and over all health of patient, type of pneumonia and severity.
Medications needed to treat pneumonia include
Antibiotics It is mostly used to treat bacterial pneumonia. Choosing a particular antibiotic for your pneumonia may involve trial and error in which your doctor may prescribe one antibiotic and change it to another if it doesn’t work. Your doctor will do this until he gets an antibiotics that is suitable to you and treats your bacterial pneumonia. Be sure to take the whole dose of the antibiotics if even you start to feel better.
Antiviral medications are effective against viral pneumonia. Antibiotics don’t work well with viral pneumonia.
Aspirin, ibuprofen, naproxen or acetaminophen are used to reduce fever
Cough medicine to relieve cough symptoms. It is however important to talk to your doctor before taking cough medication.
Hospital admission may be crucial if patient is a child or adult over 60, if patients needs help breathing, if blood pressure drops and patient is confused.
PREVENTION
Vaccination It lowers your risk of getting pneumonia
Seasonal flu shot lowers your risk of getting viral and bacterial pneumonia. This is because influenza can cause both of these types of pneumonia.
Pneumonia vaccine This vaccine is recommended for people at high risk of getting pneumonia. It is also recommended for adults age 65 and older and people of any age who live in nursing home and elderly centers. It is a one time shot against streptococcus pneumoniae bacteria (pneumococcus)
Childhood vaccine. Children should receive their yearly flu vaccine. It is also important for children under age 2 to get the pneumococcal conjugate vaccine especially those at high risk for pneumonia
Hib vaccine Haemophilus influenzae type b (Hib) is a type of bacteria that can cause pneumonia. The vaccine is recommended for all children below age 5 and should be given after 2 months of age. The vaccine helps prevent pneumonia infections.
Other ways to prevent pneumonia include

washing hands frequently with warm water and soup or using alcohol based sanitizer
don’t not smoke
eat healthy foods
get enough rest
engage in exercising to keep strong and healthy

COMPLICATION

Bacteria can enter the blood stream causing septic shock
Pneumonia involving both lungs can cause respiratory distress making breathing difficult
Pneumonia can cause fluid accumulation and infection of the lungs

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