All You Should Know About Pneumonia

Dr.Pravin Valsalan
Consultant Pulmonology
Aster Medcity, Kochi

Pneumonia is a form of acute respiratory infection that affects the lungs..It is a preventable and treatable disease. but sadly it is the single largest infectious cause of death both among adults and children, worldwide. Pneumonia accounts for 16% of all deaths of children under 5 years old.

When an individual has pneumonia, infection that is present, inflames the air sacs in one or both lungs. The alveoli are filled with pus and fluid, which makes breathing painful and limits oxygen intake.

It is most serious for infants and young children, people older than age 65, and people with health problems or weakened immune systems. It is also more common among diabetics, or those with underlying lung disease like Chronic obstructive pulmonary disease or those with chronic heart disease or kidney disease and transplant patients. Hospital acquired pneumonia happens in those patients who have been staying in the hospital/ICU or more importantly if they are on a ventilator for a while

Causes

Pneumonia is caused by a number of infectious agents, including viruses, bacteria and fungi. The most common

organisms include streptococcus pneumonia, atypical organisms like haemophilus influenza and respiratory syncytial virus among children. Hospital acquired infection could be caused by a variety of bugs and many of them will be drug resistant bugs too.

Transmission
Pneumonia can be spread in a number of ways. It could be droplet spread, through cough or sneeze ie from person to person spread. The germs can migrate from an upper airway infection to the lower lungs and can cause pneumonia. In addition, pneumonia may spread to the lungs from a blood stream infection.

Presenting features

The signs and symptoms of pneumonia vary from mild to severe, depending on factors such as the type of bug causing the infection, and your age and overall health. Mild signs and symptoms often are similar to those of a cold or flu.

Commonest signs and symptoms of pneumonia may include:

• Chest pain when you breathe or cough

• Confusion or changes in mental awareness (in adults age 65 and older)

• Cough, with or without phlegm

• Fatigue

• Fever, sweating and shaking chills

• Lower than normal body temperature (in adults older than age 65 and people with weak immune systems)

• Nausea, vomiting or diarrhea

• Shortness of breath

Risk Factors :

Pneumonia can affect anyone. But It is more common among young and people above 65yrs of age. Other risk factors include recent hospitalization or being in the hospital or in ICU or on ventilator (for hospital acquired pneumonia), chronic diseases like bronchial asthma, COPD, chronic heart and kidney disease. Smoking and indoor and outdoor pollution is an extremely important modifiable risk factor. Another important risk factor is a weakened immune system due to diabetic mellitus, people with HIV/AIDS or those who are immunosuppressive medications like organ transplant patients or those on steroid therapy.

Treatment

Pneumonia should be treated with antibiotics. Mild cases may not require admission. Moderate to severe cases will require admission and management. Admission may also be required for those patients with underlying significant risk factors or those with hemodynamic instability or confusion.

Prevention

Preventing pneumonia is an essential component of a strategy to reduce mortality. 

Vaccination – both for children as well as adults is probably the best proven way to prevent pneumonia. Adult Vaccination includes both flu as well as pneumococcal vaccination.

Preventing modifiable risk factors include smoking cessation, reducing pollution – both indoor as well as outdoor. Having a good personal hygiene including washing the hands regularly or using a hand sanitizer do help to reduce the transmission of infection.

Controlling diabetic and Keeping your immune system strong by Getting enough sleep, exercise regularly and eat a healthy diet.