Pneumonia is an infection of the lungs that causes inflammation and accumulation of fluid and pus in the air sacs (alveoli). It can be caused by bacteria, viruses, or fungi. Bacterial pneumonia is the most common type in adults.
Common symptoms of pneumonia include cough with phlegm or pus, fever, chills, difficulty breathing, and chest pain with breathing or coughing. Diagnosis is usually made by hearing crackles on lung exam and seeing an infiltrate on chest X-ray.
Bacterial pneumonia often follows an upper respiratory viral infection. Risk factors include smoking, asthma, COPD, immunosuppression, and swallowing disorders. The elderly are at highest risk. Bacteria enter the lungs and multiply in the alveoli and interstitium leading to inflammation.
Viral pneumonia typically causes milder symptoms and often resolves on its own. Fungal pneumonia is rare but more serious in immunocompromised individuals. Hospitalization may be required for oxygen, IV antibiotics, fluids and supportive care.
Treatment for bacterial pneumonia involves appropriate antibiotic therapy. Viral pneumonia is managed with rest, fluids and symptom relief. Most types of pneumonia can be effectively treated, but complications like lung abscess or respiratory failure can occur. Preventive measures include vaccination, lifestyle changes and managing chronic conditions.
2. What is pneumonia?
Pneumonia is an infection that inflames the air sacs in one or both lungs. The air
sacs may fill with fluid or pus (purulent material), causing cough with phlegm or
pus, fever, chills, and difficulty breathing. Pneumonia can be life-threatening,
especially for certain risk groups.
3. Causes
Pneumonia can be caused by a variety of organisms, including:
1. Bacteria: Streptococcus pneumoniae is the most common cause of bacterial
pneumonia.
2. Viruses: Including influenza (flu), and SARS-CoV-2 (causes COVID-19).
3. Fungi: More common in people with chronic health problems or weakened
immune systems.
4. Symptoms
Key symptoms of pneumonia can include:
- Cough, often producing mucus or phlegm.
- Fever, sweating, and shaking chills.
- Shortness of breath.
- Chest pain that worsens with breathing or coughing.
- Fatigue and muscle weakness.
- Nausea, vomiting, or diarrhoea.
5. Risk factors
You are at greater risk for pneumonia if you:
- Are over 65 years old or below 2 years old.
- Have a weakened immune system due to
disease (like HIV/AIDS) or medical
treatment (like chemotherapy).
- Have a chronic illness like asthma, COPD,
diabetes, or heart disease.
- Smoke, or have a history of heavy drinking.
- Have recently had surgery or been
hospitalised.
- Have difficulty swallowing, due to neurological
conditions or other conditions that might cause
aspiration.
6. Types
Pneumonia types can be classified in several ways, including:
- By cause: bacterial, viral, fungal.
- By where the infection was acquired: community-acquired, hospital-acquired,
aspiration pneumonia.
- By location in the lung: lobar pneumonia (affects one part or "lobe" of the
lung),
bronchopneumonia (scattered throughout both lungs).
8. Steps for treatment
Treatment for pneumonia usually varies depending on the type and severity of pneumonia, the person's
overall health status, and the specific causative organism. Below are general steps for treating
pneumonia, but each patient needs to be individually evaluated by a healthcare professional.
● Medical evaluation :f you exhibit symptoms of pneumonia, such as fever, cough, and difficulty
breathing. A physical examination and tests may be required, including blood tests, a chest X-ray or
CT scan, and possibly a sputum test to identify the specific type of pneumonia.
● Medication as per the diagnosis (next slide)
● Rest and hydration is important
● Oxygen therapy: In severe cases, hospitalisation may be required, where oxygen therapy or
breathing treatments can be administered.
● Follow ups: it is important to have regular follow ups to ensure that the pneumonia has fully cleared.
A repeated chest x-ray is often performed
9. Treatment
The specific treatment for pneumonia depends on the type of pneumonia,
the severity of symptoms, and the patient's overall health. Antibiotics,
antivirals, or antifungals are usually used.
For bacterial pneumonia, antibiotics such as amoxicillin-clavulanate (typical
adult dosage: 500 mg three times a day for 7-10 days) or azithromycin
(typical adult dosage: 500 mg on the first day, then 250 mg daily for 4 more
days) can be used in community-acquired pneumonia. Hospital-acquired
pneumonia may require different antibiotics and more aggressive
treatment.
For viral pneumonia, antiviral medications like oseltamivir (Tamiflu: typical
adult dosage for treatment of influenza is 75 mg twice daily for 5 days; for
prevention 75 mg once daily) might be used, particularly if influenza is the
cause.
For fungal pneumonia, antifungal medications are used,
such as fluconazole or itraconazole.
A 10-day treatment plan will depend on the specific
causative organism, the patient's response to treatment,
and their overall health. For example, bacterial pneumonia
might be treated with amoxicillin-clavulanate, 500 mg three
times a day for 10 days. Supportive care to alleviate
symptoms like cough and fever, and to maintain hydration
and nutrition, is also important.
10. Prevention
Vaccines can prevent some types of pneumonia, such as pneumococcal
pneumonia and influenza. Good hygiene can also prevent respiratory infections
that sometimes lead to pneumonia. Lastly, managing and preventing chronic
illnesses and quitting smoking can also lower the risk of getting pneumonia.
