Pneumonia

What is pneumonia?

Pneumonia refers to inflammation of the lungs caused by infection. Pathogens like viruses, fungi, bacteria, and parasites can cause infection of air-sacs of the lungs, resulting in pneumonia. Among these pathogens, bacteria are the most frequent cause of pneumonia in adults and Streptococcus pneumoniae infection is known to be the most common cause of pneumonia. Although pneumonia can affect people of all ages, it severely affects elderly and people with a weak immune system. In some cases, pneumonia can be a complication of some other medical condition (like influenza).

What are the symptoms?

Pneumonia may present flu-like symptoms including fever and cough. The progression and extent of pneumonia symptoms may vary from one person to other, depending on overall health, age and immune system. Common symptoms of pneumonia may include the following:

  • Changes in body temperature – low body temperature in elderly or fever in others.
  • Coughing.
  • Breathlessness.
  • Sweating.
  • Chills.
  • Headache.
  • Chest pain upon breathing.
  • Slow heart beat.
  • Muscle pain.
  • Tiredness.

What causes pneumonia?

Different pathogens can cause different types of pneumonia, some of which are listed below:

  • Community-acquired pneumonia, mostly caused by S. pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Chlamydia pneumoniae, and some species of Legionella.
  • Hospital-acquired pneumonia, mostly caused by Staphylococcus aureus.
  • Nursing home–acquired pneumonia, mostly caused by S. aureus, S. pneumoniae, H. influenzae, influenza viruses, and anaerobic pathogens.
  • Pneumonia in immunocompromised patients, mostly caused by unusual pathogens.

However, in many cases, specific pathogens causing pneumonia cannot be found. Sometimes food and fluid enter the airways and reach as far as the lungs where it causes damage. This is known as aspiration pneumonia.

How is pneumonia treated?

Treatment of pneumonia varies, depending on the causative pathogen. Treatment options include use of antibiotics, antivirals or broad-spectrum antimicrobial therapy, along with supportive measures. Viral pneumonias, however, may resolve on their own without needing any treatment. Aspirin, naproxen, ibuprofen, or acetaminophen are given to control fever. Rest of the treatment may include the following:

  • Treating community-acquired pneumonia:
    – Ribavirin is recommended for children with pneumonia.
    – Oseltamivir or zanamivir can decrease the duration and manage the symptoms in patients with influenza infection.
    – Acyclovir may be given to treat varicella lung infections.
  • Treating hospital-acquired pneumonia:
    – Drugs called carbapenem (like imipenem, cilastatin, meropenem) or monobactam (like aztreonam, piperacillin or tazobactam) are recommended to the patients with hospital-acquired pneumonia.
    – Alternatively, ceftazidime or cefepime may be given to the patients either alone or in combination with vancomycin.
    – For chest infections caused by resistant bacteria, linezolid may be used.
  • Treating nursing home–acquired pneumonia:
    – An antibiotic dose works well against H. influenza and S. pneumonia.
    – Drugs called quinolone (like levofloxacin or moxifloxacin) to the patients in such settings.
    – Alternatively, ertapenem, ceftriaxone, and ampicillin or sulbactam may be given to treat nursing home-acquired pneumonia.
  • Treating immune-compromised patients:
    – Treatment regimen for such patients is decided based on the severity of the condition.
    – Broad-spectrum medicines are usually sufficient to kill many bacteria like S. aureus and other anaerobic pathogens.
    – If patients do not show improvement with antibiotic therapy, antifungal drugs are also added to the treatment regime.

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