CONDITIONS
Pneumonia
Pneumonia
Pneumonia is an infection (usually bacteria but viruses may also be responsibel) inflaming the air sacs in one or both lungs. This infection results in fluid or pus filling in the air sacs of the lungs making it difficult for a person to breathe. Anyone can be affected with pneumonia but children under 2 years old and adults over 65 are commonly affected owing to their weak immune system.
India is the highest contributor of death due to pneumonia and is also contributor of around 20% of global mortality among under five children. Pneumonia can mild to life-threatening, with severe cases seen among children.
What are the symptoms of pneumonia?
Depending on the type of infection-causing germ, the age and overall immunity, the signs and symptoms of pneumonia vary from mild to severe as follows:
Common pneumonia symptoms include:
- Cough – maybe dry or mucous or phlegm producing
- Breathing difficulties – shortness of breath
- Extreme tiredness and not feeling hungry
- Chest pain while coughing and even breathing
- Fever, sweat, and chills
- Nausea, vomiting, and diarrhea
- In older adults (above 65) – Confusion, Mental awareness changes, lower than normal body temperature
There maybe no sign or symptoms of an infection in a new born baby.
What are the causes of pneumonia?
Pneumonia is caused most commonly by the bacteria and viruses in the air inhaled by us. Common causes include flu viruses, cold viruses, RSV(respiratory syncytial virus) – the top cause of pneumonia in babies age 1 or younger, bacteria called Streptococcus pneumoniae and Mycoplasma pneumoniae. Depending on the germs causing infection and the place where infection occurred, pneumonia is classified as: –
- Community-acquired pneumonia: Most common type of pneumonia occurring outside hospitals or other health care facilities. Includes infection caused by viruses, bacteria and fungi.
- Bacterial – the most common cause of bacterial pneumonia is Streptococcus pneumoniae, can occur post cold or flu. A part of lung maybe be affected known as lobar pneumonia.
- Bacteria-like organisms (Mycoplasma pneumoniae) may cause pneumonia with milder symptoms, so much so, that it often known as Walking pneumonia, a type of pneumonia which typically isn’t severe enough to require bed rest.
- Fungi – May be caused by the fungi found in soil or bird droppings and vary depending upon geographic location.
- Viruses, including COVID-19: Most common cause of pneumonia in children younger than 5 years, although they are mostly mild. However, some may turn serious; Coronavirus 2019 (COVID-19) may cause pneumonia, which can become severe.
- Hospital-acquired pneumonia (HAP): People who get infected with pneumonia during a hospital stay for another illness. May be serious since people are already sick and the bacteria may be antibiotic resistant.
- Health care-acquired pneumonia: May occur in people living in permanent care facilities or receiving care in outpatient clinics, like kidney dialysis centers.
- Aspiration pneumonia: Accidental inhalation of food, drink, vomit or saliva in the lungs.
How is Pneumonia diagnosed?
Owing to common symptoms with other conditions, such as the common cold, bronchitis and asthma, pneumonia is often difficult to diagnose. The doctor may be ask certain questions and conduct physical exams. Following tests could be advised:
- Blood tests to assess bacterial infection presence
- A chest X-ray to check for infection in lung and its spread
- Pulse oximetry – measuring oxygen levels in blood
- A sputum test to assess the cause of infection by checking the fluid in lungs.
HAP related pneumonia or if symptoms are initially seen in hospital, doctor may advise following additional tests:
- An arterial blood gas test
- Bronchoscopy – for airways for blockages by a small camera
- A CT scan to get a more detailed image of lungs
- A pleural fluid culture – tests the fluid around lung tissues to look for pneumonia-causing bacteria
How is pneumonia treated?
Mild pneumonia is usually be treated at home by:
- Antibiotics
- Taking plenty of rest
- Drinking lot of fluids
In case of viral pneumonia, antibiotics won’t work and only resting and taking fluids is advised. Cough medicine is advised in some cases to calm the cough to help patients rest. Fever reducers/pain relievers may be prescribed to reduce fever and discomfort.
Hospitalization may be required if symptoms are severe and if a person is more prone to serious illness. Antibiotics and fluids are given intravenously through a drip, and in some cases, oxygen may be required to help breathing.
The road to recovery is long and a person may require lots of rest. A person may still feel tired for a month.
How can Pneumonia be prevented?
Most cases of pneumonia are bacterial and not contagious.
However, maintaining good standards of hygiene will help prevent germs from spreading. These practices are:
- Proper handwashing regularly or using an alcohol-based hand sanitizer.
- Covering mouth and nose while coughing or sneezing
- Discarding used tissues immediately and properly to avoid germs to spread
Getting vaccinated: Ask the doctors advise on vaccination. Recent recommendation by scientific bodies in India is to begin with vaccine PCV13 followed by PPSV23 after a specific time interval.
Make sure children get vaccinated: There are different pneumonia vaccine for children younger than age 2 and for children ages 2 to 5 years who are at particular risk of pneumococcal disease.
Not smoking: Smoking damages the lungs’ natural defenses against respiratory infections.
Keeping the immune system strong: By regular and enough sleep, exercising regularly and eating a healthy diet.
References
- Pneumonia. Mayo Clinic. January 2024. https://www.mayoclinic.org/diseases-conditions/pneumonia/symptoms-causes/syc-20354204
- Sharma BB, Singh V. Indian pneumonia guidelines. Lung India. 2012 Oct;29(4):307-8.
- Pneumonia. NHS Inform. January 2024. https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/pneumonia/
- Ghia CJ, Rambhad G. Pneumococcal Vaccine Recommendations for Old-Age Home Indian Residents: A Literature Review. Gerontol Geriatr Med. 2022 Sep 1;8:23337214221118237.
