Pneumonia
Authored by Dr.Aashish A Kadakia
Introduction
Pneumonia is an infection of one or both lungs by fungi, viruses or bacteria causing inflammation of the air sacs known as alveoli. When these sacs are filled with fluids, it leads to the onset of symptoms. The term Pneumonia was coined by the founder of modern medicine, Dr. William Osler, who studied the disease throughout his career. Owing to the huge toll of the disease on humanity, the term Pneumonia was devoted to the disease as it denotes “the captain of the men of death�. Severity of Pneumonia varies according to the causative agent, age and general conditions of the patient. Causes Pneumonia can be divided into several types, based on the cause. Bacteria and viruses are the most common causes responsible for half and one-third of the total cases respectively. Fungi and parasites are also responsible for causing the disease in some cases.
Symptoms Pneumonia patients have a productive cough, fever, chest pain, and shortness of breath accompanied by an increased breathing rate, chills, muscular pain nausea and vomiting. In severe conditions, skin may turn bluish due to lack of oxygen and blood may be found in sputum. Furthermore, temperature may also reach extreme with rapid heart rate and confusion.
Diagnosis Symptoms of Pneumonia are similar to that of the flu; as a result certain tests are performed to diagnose the disease. A physician may feel coarse breathing, crackling sound and wheezing from a patient’s lungs through stethoscope. Although chest X-ray is an integral part of the diagnosis procedure indicating the presence of fluid in a lung, it cannot provide sufficient information on the progress of disease and the causative agent; hence further tests can be used to assist in the diagnosis such as CT-scan for obtaining a detailed view of the lungs, sputum test to determine type of the disease, and culture test to know if infection have been spread to blood. Other tests may include pulse oximetry, bronchoscopy and culture of the pleural fluid. Who are at Risk People who have had stroke, or are bedridden can easily suffer from the disease. Elderly patients above 65 years of age and children below two years are also at risk. Steroids and anti-cancer medications may weaken the immune system and increases risk of infections. The other factors which may contribute to the development of Pneumonia are excessive alcohol consumption, smoking and diseases such as asthma, diabetes, cystic fibrosis and heart failure.
Treatment Prior to the antibiotic discovery, one third of all patients suffered from Pneumonia died. Treatment depends on the cause of infection. Bacterial infections are treated by antibiotics, whereas viral infections can be cured by anti-viral drugs. There are no specific anti-virals for the treatment, but drugs such as amantadine, rimantadine can be used for influenza A virus and osletamivir, zanamivir or peramivir for influenza A or B. Antibiotics commonly used in bacterial infection are Macrolides such as azithromycin, clarithromycin and erythromycin. Levofloxacin, ceftriaxone and doxycycline can also be used depending on the conditions. Acetaminophen or Aspirin can be considered for patients with fever and analgesics can be prescribed for relieving pain. Cough medicines may help in excretion of mucus from the lungs. Oxygen supplementation may also be provided in severe cases of Pneumonia. Lifestyle modifications: • Undergo an X-ray test to ensure eradication of fluid from the lungs completely. • Take up to 3 weeks of rest before getting back to daily routine. • Drink plenty of water to dilute the mucus for its easy excretion from the lungs. • Do not miss a single dose and follow the treatment as directed by the physician to avoid re-infection. • Addition of colorful vegetables in your diet can help your body in fighting the infection. • Brushing your teeth/cleaning your mouth after every meal may prevent bacterial growth in the mouth, which can aggravate the symptoms if passed into lungs. • During the day, sit upright as much as possible instead of lying down. • Do deep breathing exercises frequently. Complications: Pneumonia, if untreated, may lead to severe complications such as pleurisy (fluid accumulation), blood poisoning and lung abscess Prevention The first step that you can take to prevent Pneumonia is to get a flu shot as it is a major cause of the disease. You can also get yourself vaccinated against Pneumococcal pneumonia if you are at an increased risk for it. Other measures which can help in prevention are:
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Wash your hands frequently to avoid contamination. Quit smoking as it may lower your lung’s ability to fight infections. Follow a healthy diet with adequate sleep and regular exercise. Maintain distance with people suffering from infections.