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- 1. Pneumonia (Case Study) Company Name: Home Of Dissertations Website: https://www.dissertationhomework.com Contact Number: +44 7842798340 CONNECT NOW
- 2. Pneumonia
- 3. Introduction • Pneumonia is referred to infection which inflames air sacs present in the right and left lungs. The organisms which affect individuals to develop pneumonia include virus, fungi, bacteria and others (Jain et al. 2015). • In this presentation, an overview regarding the causes, risk factors, complications and symptoms related to cellular as well as physiological changes seen in pneumonia is to be discussed. • The current treatment opportunity available for Pneumonia is also to be explained to aware individuals regarding the way to cope with the disease.
- 4. Rationale for choosing Pneumonia • Pneumonia is one of the common pulmonary diseases that affects many individuals in the UK as well as the world and is regarded as one of the key reason for deaths among the population (NICE, 2016). • In 2012, as per the last published reports, nearly 28,952 deaths occurred in the UK due to pneumonia and it was 5.1% of all the deaths along with 25.3% of the deaths occurred in the country from pulmonary disease in the UK (NICE, 2016).
- 5. Contd.. • The current statistics revealed in 2016 informs that nearly 0.5-1% of adults in the UK are affected by community-acquired pneumonia.
- 6. Causes of Pneumonia • The common cause of pneumonia is bacteria and viruses that are borne through the air and are inhaled by the individuals causing infection in the lungs. • The Streptococcus pneumoniae is one of the common bacteria which are responsible for causing pneumonia. The S. pneumoniae may enter the body through cold or flu and is able to infect one part of the lungs leading to the condition known as lobar pneumonia (Silva- Costa et al. 2018).
- 7. Contd.. • The fungi related diseases such as coccidioidomycosis is found to be one of the major causes of fungal pneumonia (Hagos and Esayas, 2015).
- 8. Contd.. • Health-acquired pneumonia • Hospital stay
- 9. Risk factors of Pneumonia • Contaminated hospital surroundings • Chronic obstructive pulmonary disorder • Tobacco smoke • People with weakened immune system having HIV/AIDS, etc
- 10. Symptoms of Pneumonia The symptoms of pneumonia include: • Increased chest pain during breathing and coughing • Coughing produces pus or phlegm • Feeling of fatigue • Fever, shaking and chills • Low body temperature • Diarrhoea, nausea and vomiting • Shortness of breath (van der Maaden et al. 2016)
- 11. Physiological and cellular changes in Pneumonia • In normal condition, it is seen that resident macrophages in the body act to protect the lungs from the impact of any foreign pathogen. • However, the inflammation in the lungs is triggered by the pathogens leading to the clinical findings seen in pneumonia.
- 12. Contd.. • During pneumonia, the alveoli or the air sacs are inflamed creating spaces that are filled with pus and fluids. • It change leads to coughing up of phlegm during pneumonia by the individuals and feeling of pain in the chest along with shortness of breath. • This is because the alveoli cannot properly work to transport oxygen to the blood leading individuals to face lack of oxygen for respiration (Quinton and Mizgerd, 2015).
- 13. Diagnosis of Pneumonia • Physical examination • Chest X-rays • CT scan • Blood cell count • Bronchoscopy Chest X-Ray Chest CT Scan
- 14. Treatments of Pneumonia The treatment and recovery of pneumonia include the following ways: • The individuals affected with the disease are provided aspirin to control their fever (lung.org, 2019) • The people with pneumonia are provided acetaminophen or non- steroidal anti-inflammatory drugs to control their chest pain and fever.
- 15. Contd.. • The antibiotic such as macrolide drugs is used as preferred treatment for pneumonia among children and adults. • The individuals affected by pneumonia are to maintain proper hygiene so as to avoid spread of the disease. Moreover, the individuals are to take increased amount of water in thinning the sputum to loosen their chest (lung.org, 2019).
- 16. Prevention of Pneumonia • The two common vaccines used to prevent and control the risk of developing pneumonia are Prevnar or pneumococcal conjugate vaccine and Pneumovax or pneumococcal polysaccharide vaccine (Bonten et al. 2015).
- 17. Conclusion • Pneumonia is mainly caused by airborne pathogen and the organisms responsible for the disease include different types of bacteria, fungi and viruses. • The pneumonia symptoms include coughing sputum, tightness of chest, breathlessness and others. • The diagnosis of the disease is done through physical examination, CT scan, bronchoscopy and others. • The treatment available for pneumonia includes vaccination, antibiotics administration, intake of increased amount of water and others.
- 18. References • Bonten, M.J., Huijts, S.M., Bolkenbaas, M., Webber, C., Patterson, S., Gault, S., van Werkhoven, C.H., van Deursen, A.M., Sanders, E.A., Verheij, T.J. and Patton, M., 2015. Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults. New England Journal of Medicine, 372(12), pp.1114-1125. • Borges, I.C., Andrade, D.C., Cardoso, M.R.A., Meinke, A., Barral, A., Käyhty, H., Ruuskanen, O. and Nascimento-Carvalho, C.M., 2017. Seasonal patterns and association of meteorological factors with infection caused by Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis in childhood community-acquired pneumonia in a tropical region. Infectious Diseases, 49(2), pp.147-150. • Bourcier, J.E., Braga, S. and Garnier, D., 2016. Lung ultrasound will soon replace chest radiography in the diagnosis of acute community-acquired pneumonia. Current infectious disease reports, 18(12), p.43. • Chien, Y.F., Chen, C.Y., Hsu, C.L., Chen, K.Y. and Yu, C.J., 2015. Decreased serum level of lipoprotein cholesterol is a poor prognostic factor for patients with severe community-acquired pneumonia that required intensive care unit admission. Journal of critical care, 30(3), pp.506-510. • Cilloniz, C., Martin-Loeches, I., Garcia-Vidal, C., San Jose, A. and Torres, A., 2016. Microbial etiology of pneumonia: epidemiology, diagnosis and resistance patterns. International journal of molecular sciences, 17(12), p.2120. • Davis, T.R., Evans, H.R., Murtas, J., Weisman, A., Francis, J.L. and Khan, A., 2017. Utility of blood cultures in children admitted to hospital with community‐acquired pneumonia. Journal of paediatrics and child health, 53(3), pp.232-236. • Dieu, T.N.T., Nhat, A.P., Craig, T.J. and Duong-Quy, S., 2017. Clinical characteristics and cytokine changes in children with pneumonia requiring mechanical ventilation. The Journal of International Medical Research, 45(6), p.1805. • Hagos, G. and Esayas, R., 2015. Pulmonary coccidiodomycosis presenting as a mass, an uncommon disease entity in Ethiopia. Ethiop. Med. J, 53(1), pp.35-7. • Hemilä, H., 2018. Effect of β-Carotene Supplementation on the Risk of Pneumonia Is Heterogeneous in Males: Effect Modification by Cigarette Smoking. Journal of nutritional science and vitaminology, 64(5), pp.374-378. • Izumikawa, K., 2016. Clinical features of severe or fatal Mycoplasma pneumoniae pneumonia. Frontiers in microbiology, 7, p.800. • Jain, S., Self, W.H., Wunderink, R.G., Fakhran, S., Balk, R., Bramley, A.M., Reed, C., Grijalva, C.G., Anderson, E.J., Courtney, D.M. and Chappell, J.D., 2015. Community-acquired pneumonia requiring hospitalization among US adults. New England Journal of Medicine, 373(5), pp.415-427. • jun Li, Y., zhi Pan, C., quan Fang, C., xiang Zhao, Z., ling Chen, H., hao Guo, P. and wen Zhao, Z., 2017. Pneumonia caused by extensive drug-resistant Acinetobacter baumannii among hospitalized patients: genetic relationships, risk factors and mortality. BMC infectious diseases, 17(1), p.371. • Kumar, S.T., Yassin, A., Bhowmick, T. and Dixit, D., 2017. Recommendations from the 2016 guidelines for the management of adults with hospital-acquired or ventilator-associated pneumonia. Pharmacy and Therapeutics, 42(12), p.767. • Lazzerini, M., Seward, N., Lufesi, N., Banda, R., Sinyeka, S., Masache, G., Nambiar, B., Makwenda, C., Costello, A., McCollum, E.D. and Colbourn, T., 2016. Mortality and its risk factors in Malawian children admitted to hospital with clinical pneumonia, 2001–12: a retrospective observational study. The Lancet Global health, 4(1), pp.e57-e68. • lung.org 2019, Pneumonia Treatment and Recovery, Available at: https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/pneumonia/treatment-and-recovery.html [Accessed on: 13 December 2019] • Postma, D.F., Van Werkhoven, C.H., Van Elden, L.J., Thijsen, S.F., Hoepelman, A.I., Kluytmans, J.A., Boersma, W.G., Compaijen, C.J., Van Der Wall, E., Prins, J.M. and Oosterheert, J.J., 2015. Antibiotic treatment strategies for community-acquired pneumonia in adults. New England Journal of Medicine, 372(14), pp.1312-1323. • Quinton, L.J. and Mizgerd, J.P., 2015. Dynamics of lung defense in pneumonia: resistance, resilience, and remodeling. Annual review of physiology, 77, pp.407-430. • Shorr, A.F., Zilberberg, M.D., Micek, S.T. and Kollef, M.H., 2017. Viruses are prevalent in non-ventilated hospital-acquired pneumonia. Respiratory medicine, 122, pp.76-80. • Silva-Costa, C., Brito, M.J., Pinho, M.D., Friães, A., Aguiar, S.I., Ramirez, M., Melo-Cristino, J. and Portuguese Group for the Study of Streptococcal Infections, 2018. Pediatric complicated pneumonia caused by Streptococcus pneumoniae serotype 3 in 13-valent pneumococcal conjugate vaccinees, Portugal, 2010–2015. Emerging infectious diseases, 24(7), p.1307. • Tomassetti, S., Wells, A.U., Costabel, U., Cavazza, A., Colby, T.V., Rossi, G., Sverzellati, N., Carloni, A., Carretta, E., Buccioli, M. and Tantalocco, P., 2016. Bronchoscopic lung cryobiopsy increases diagnostic confidence in the multidisciplinary diagnosis of idiopathic pulmonary fibrosis. American journal of respiratory and critical care medicine, 193(7), pp.745- 752. • van der Maaden, T., de Vet, H.C., Achterberg, W.P., Boersma, F., Schols, J.M., Mehr, D.R., Galindo-Garre, F., Hertogh, C.M., Koopmans, R.T. and van der Steen, J.T., 2016. Improving comfort in people with dementia and pneumonia: a cluster randomized trial. BMC medicine, 14(1), p.116. • Vardakas, K.Z., Trigkidis, K.K. and Falagas, M.E., 2017. Fluoroquinolones or macrolides in combination with β-lactams in adult patients hospitalized with community acquired pneumonia: a systematic review and meta-analysis. Clinical Microbiology and Infection, 23(4), pp.234-241. • Walters, J.A., Tang, J.N.Q., Poole, P. and Wood‐Baker, R., 2017. Pneumococcal vaccines for preventing pneumonia in chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, (1). pp.23-45. • Williams, D.J., Hall, M., Auger, K.A., Tieder, J.S., Jerardi, K., Queen, M.A., Statile, A., Myers, A. and Shah, S.S., 2015. Association of white blood cell count and C-reactive protein with outcomes in children hospitalized with community-acquired pneumonia. The Pediatric infectious disease journal, 34(7), p.792. • NICE 2016, Pneumonia in adults, Available at: https://www.nice.org.uk/guidance/qs110/resources/pneumonia-in-adults-pdf-75545291391685 [Accessed on: 13th December 2019] • lung.org 2019, Pneumonia Treatment and Recovery, Available at: https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/pneumonia/treatment-and-recovery.html [Accessed on: 13 December 2019]
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Editor's Notes
- Pneumonia is one of the common pulmonary diseases that affects many individuals in the UK as well as the world and is regarded as one of the key reason for deaths among the population (NICE, 2016). In 2012, as per the last published reports, nearly 28,952 deaths occurred in the UK due to pneumonia and it was 5.1% of all the deaths along with 25.3% of the deaths occurred in the country from pulmonary disease in the UK (NICE, 2016). This indicates many people in the UK die as a result of pneumonia and effective awareness regarding the disease is to be created by informing the causes, risk factors and treatment related to the disease so that people can be protected from major health condition and deaths as a result of the disease.
- The current statistics revealed in 2016 informs that nearly 0.5-1% of adults in the UK are affected by community-acquired pneumonia. According to reports, 5-12% people who are diagnosed with lower respiratory infection presented before the GPs and 22-42% of them when admitted to the hospital show that they have mortality rate between 5-12% due to pneumonia. In the UK, more than half of the pneumonia-related deaths which occurs are seen among people who are above 84 years (statistics.blf.org.uk, 2019). This indicates that pneumonia is an essential health issue to be discussed so that by understanding the causes, effective intervention and treatment can be applied to lower the death and control better well-being of the individuals.
- The Streptococcus pneumoniae is seen to release hydrogen peroxide in the lungs which damage DNA and leads to apoptosis in the lungs which leads the alveoli to get damaged. The damaged alveoli are unable to perform proper function to exchange gases in the lungs leading to the development of pus or phlegm making individuals show symptoms of pneumonia (Borges et al. 2017). The Mycoplasm pneumonia is another bacteria-like organism which causes milder symptoms of pneumonia (Izumikawa, 2016).
- The fungal pneumonia is common among individuals who have chronic health condition as their immune system which is key defence system of the body is weakened. This creates opportunity for the body to get easily affected by spores released in the air by fungi as the defence mechanism to control its impact is not properly maintained (Hagos and Esayas, 2015). The viruses which cause flu and cold are able to cause pneumonia. The viral pneumonia is mostly seen among children below the age of 5 years and though it is mild but in some cases, it may create fatal consequences (Shorr et al. 2017).
- The hospital stay is one of the major causes of increased pneumonia among older individuals. This is because in the hospital the older people are contaminated by antibiotic-resistance bacteria and viruses from the droplets released by other patients through coughing and sneezing. This leads older people to become very sick. The people under ventilation in intensive care unit are prone to get affected by hospital-acquired pneumonia (Jun Li et al. 2017). The health-acquired pneumonia is the bacterial infection which causes the disease among people who are in long-term care facilities and receiving care at the outpatients’ clinics such as kidney dialysis centres and others (Kumar et al. 2017).
- The treatment of the patients in hospital surroundings where proper hygiene is not maintained creates risk for people to develop pneumonia (Lazzerini et al. 2016). The presence of chronic diseases such as chronic obstructive pulmonary disorder or heart diseases creates risks for people to develop pneumonia. This is because in this condition the cells and tissues within the lungs that is responsible in managing the fluids and respiration are damaged leading the infection-causing agents to easily attack the respiratory system to make the patients develop pneumonia (Walters et al. 2017). The people who smoke are prone to develop pneumonia because the harmful agents in the tobacco smoke damage the cells and tissues within the lungs making them weakened to fight against pathogens. Thus, the lack of proper defence from the body creates favourable environment for the growth of infection-causing bacteria and viruses to cause pneumonia among individuals (Hemilä, 2018). The people with weakened immune system having HIV/AIDS, individuals who have undergone organ transplant or chemotherapy are at risk of developing pneumonia as their immune system is not working properly to protect their body from infection (Chien et al. 2015).
- There is an intricate balance maintained between organisms which are residing in the lower part of the respiratory tract and at the local as well as at systematic defence mechanism. When this balance is disturbed, the inflammation of the lung parenchyma occurs leading to the development of pneumonia. In normal condition, it is seen that resident macrophages in the body act to protect the lungs from the impact of any foreign pathogen. However, the inflammation in the lungs is triggered by the pathogens leading to the clinical findings seen in pneumonia. During infection, the macrophage which is intended to protect the body engulfs the foreign pneumonia-causing pathogen and this triggers signalling or cytokinesis such as IL-8, TNF-α and IL-1 which recruits the inflammatory cells to the infection site. They are also seen to serve the antigens to the T cells which trigger both humoral and cellular defence mechanism creating activation of complement and form antibodies against the organisms. This leads towards the inflammation of the parenchyma of the lungs making the lining of capillaries leaky creating exudative congestion which underlines the pathogenesis of pneumonia (Dieu et al. 2017).
- Pneumonia is initially suspected in individuals through physical examination executed by the general physicians. The presence of wheezing, cracking, decreased breathing with sounds is indicative the person may be suffering from pneumonia (Cilloniz et al. 2016). The Chest X-rays are done for confirming areas in the lungs being affected by pneumonia. A CT scan of the chest is done to get detailed description of the damage caused to the alveoli in the lungs as a result of pneumonia (Bourcier et al. 2016). The blood cell count is done to measure the number of white blood cells in the body. This is because white blood cells which are mainly involved in ensuring immunity to the body in lower amount indicates that the person is intensely affected by pneumonia and requires immediate action to control the impact of the disease to avoid further worsening of the individual’s health (Williams et al. 2015). A blood culture is done to identify the nature of organisms which has caused pneumonia so that proper antibiotics can be administered to help the patient cope with the disease (Davis et al. 2017). A bronchoscopy is executed for diagnosis of pneumonia and in this process, a thin and flexible tube that is fitted with a light is inserted into the lungs of the person affected by the disease. This is done to direct check the infected parts of the lungs and airways (Tomassetti et al. 2016).
- However, in recent conditions, it is seen that Mycoplasma pneumoniae have become resistant to the drug creating issues for the physicians to control pneumonia caused by the pathogen (Postma et al. 2015). The medications such as fluoroquinolones are found to widely used in the treatment of pneumonia among patients as it is found to be effective in resolving CAP caused by the H influenzae, H parainfluenzae, Klebsiella pneumoniae, M catarrhalis, C pneumoniae, Legionella pneumophila, S aureus, S pneumoniae and others. The medications are not fit to be provided to the children and to be used for adults only. In order to treat children, instead tetracycline drugs are to be used (Vardakas et al. 2017).
- The Prevnar is usually provided as a routine immunisation for the child and it is recommended to be provided to people between 2-65 years and over. The Pneumovax is also recommended for both adults and children. Moreover, it is recommended to be administered to people above 65 years of age, diabetic people, people with lung, heart or kidney disorder, people with spleen disorder and individuals who smoke (Bonten et al. 2015). The vaccines do not offer entire protection to the patient but it reduces the risk of development of pneumonia.