Disease Pneumonia

Pneumonia can affect people of all ages. However, infectious pneumonia is more common and may become more severe in children younger than two years old and adults aged 65 years or above.

Other groups at increased risk include:

๐ Patients receiving hospital treatment, particularly those in an intensive care unit

๐ People with chronic conditions such as diabetes, asthma, chronic obstructive pulmonary disease, or heart disease

๐ People with weakened immune systems, including those living with HIV, organ transplant recipients, cancer patients receiving chemotherapy, and people taking immunosuppressive medication for extended periods

๐ People who smoke regularly

Causes of Pneumonia

Pneumonia may result from infectious or non-infectious causes.

1. Infectious Causes

Infection is the most common cause. The microorganism involved may vary according to the patient’s age, occupation, underlying conditions, immune status, travel history, smoking habits, and environment.

Possible infectious causes include:

๐ Viruses: Respiratory Syncytial Virus, influenza viruses, and coronaviruses

๐ Bacteria: Streptococcus pneumoniae, Haemophilus influenzae, and atypical bacteria

๐ Fungi: Fungal pneumonia is less common and is more likely to affect people with weakened immune systems

2. Non-Infectious Causes

Inflammation of the lungs may also develop without infection. Possible causes include:

๐ Dust

๐ Smoke

๐ Irritating chemicals or fumes

๐ Certain chemotherapy medicines

๐ Some medicines used to control abnormal heart rhythms

Non-infectious inflammation of lung tissue may also be referred to as pneumonitis.

How Infection Reaches the Lungs

Pneumonia-causing microorganisms may enter or spread to the lungs in several ways.

Respiratory Droplets

The infection may spread when a person inhales droplets released through coughing, sneezing, talking, or close breathing contact.

Aspiration

Saliva, food, vomit, or digestive secretions may accidentally enter the lungs.

Aspiration pneumonia is more common among older adults and people with chronic diseases, swallowing difficulties, reduced consciousness, or neurological conditions.

Spread Through the Bloodstream

An infection elsewhere in the body may spread to the lungs through the bloodstream.

This may occur in patients who have long-term urinary catheters, central venous catheters, or bloodstream infections.

Spread from Nearby Organs

An infection in a nearby organ may extend into the lung. For example, a liver abscess may rupture and spread infection into surrounding tissues.

Healthcare-Associated Infection

Pneumonia may occasionally be associated with medical procedures or contaminated equipment, including:

๐ Bronchoscopy

๐ Airway suctioning

๐ Mechanical ventilation

๐ Lung-function testing equipment

๐ Nebulisers or humidifying devices

๐ Inadequate hand hygiene among healthcare personnel

Strict infection-control procedures help reduce these risks.

Symptoms of Pneumonia

The severity of symptoms varies according to the cause of the infection, the patient’s age, and their overall health.

Common symptoms include:

๐ Cough with phlegm

๐ Chest pain when breathing or coughing

๐ Rapid breathing

๐ Shortness of breath or difficulty breathing

๐ Fever

๐ Sweating and chills

๐ Nausea, vomiting, or diarrhoea

๐ Fatigue and weakness

Symptoms in Older Adults

Older adults may experience symptoms that are less typical, including:

๐ Drowsiness

๐ Confusion

๐ Reduced alertness

๐ A lower-than-normal body temperature

๐ General weakness without a high fever

Symptoms in Infants and Young Children

Infants and young children may experience:

๐ Abdominal bloating

๐ Vomiting

๐ Unusual drowsiness

๐ Poor feeding

๐ Refusal to breastfeed, drink, or eat

๐ Rapid or laboured breathing

Treatment for Pneumonia

Treatment aims to control the underlying infection, relieve symptoms, support breathing, and prevent complications.

Specific Treatment

Bacterial pneumonia requires prompt and appropriate antibiotic treatment.

The doctor will select an antibiotic based on factors such as:

๐ Age

๐ Underlying medical conditions

๐ Immune status

๐ Travel history

๐ Environmental exposure

๐ Previous antibiotic use within the past three months

๐ Risk factors for antibiotic-resistant bacteria

Antibiotics should be taken exactly as prescribed and should not be used unnecessarily because inappropriate use can contribute to antimicrobial resistance.

Supportive Treatment

Viral pneumonia and other types of pneumonia may require supportive care.

Treatment may include:

๐ Fever-reducing medication

๐ Bronchodilators when appropriate

๐ Medicine to help loosen phlegm

๐ Adequate fluid intake

๐ Intravenous fluids in severe cases

๐ Supplemental oxygen

๐ Chest physiotherapy in selected patients

Severely ill patients may require hospital admission, respiratory support, or treatment in an intensive care unit.

Treatment of Complications

One important complication occurs when bacteria spread from the lungs into the bloodstream, potentially causing infection in other organs.

Other possible complications include:

๐ Sepsis

๐ Lung abscess

๐ Fluid around the lungs

๐ Infected fluid in the pleural cavity

๐ Respiratory failure

Preventing Pneumonia

Vaccination

Vaccination may help reduce the risk and severity of certain infections that can lead to pneumonia.

Vaccination is particularly important for:

๐ Children younger than two years old

๐ Adults aged 65 years or above

๐ People with weakened immune systems

๐ People with certain chronic medical conditions

Recommended vaccines may include:

๐ Influenza vaccine: Helps reduce the risk of influenza and related complications

๐ Pneumococcal vaccine: Helps protect against diseases caused by Streptococcus pneumoniae, also known as pneumococcus

Pneumococcal vaccines include:

๐ Pneumococcal conjugate vaccines, such as PCV13

๐ Pneumococcal polysaccharide vaccine, such as PPSV23

The appropriate vaccine type, sequence, and interval depend on age, medical history, immune status, and previous vaccination. A doctor should determine the most suitable schedule for each individual.

Practical Ways to Reduce the Risk

Do Not Smoke

Smoking damages the lungs’ natural defence mechanisms and makes respiratory infections more likely.

Maintain Good Personal Hygiene

๐ Wash your hands regularly.

๐ Avoid touching your mouth, nose, and eyes with unwashed hands.

๐ Avoid close contact with people who have respiratory infections.

๐ Limit time in crowded or poorly ventilated places during outbreaks.

Avoid Respiratory Irritants

Reduce exposure to:

๐ Cigarette smoke

๐ Fire or cooking smoke

๐ Vehicle exhaust fumes

๐ Dust and air pollution

๐ Strong chemical vapours

Seek Care for Respiratory Infections

Do not ignore a cold or influenza that continues to worsen. Medical assessment is recommended when symptoms include persistent fever, chest pain, difficulty breathing, or severe weakness.

Support the Immune System

๐ Get enough sleep.

๐ Eat a balanced and nutritious diet.

๐ Exercise regularly according to your physical condition.

๐ Manage chronic illnesses consistently.

Avoid Excessive Alcohol Consumption

Heavy alcohol consumption may reduce alertness and increase the risk of saliva, food, or vomit entering the lungs.

When to Seek Immediate Medical Attention

Urgent medical care is required when pneumonia symptoms are accompanied by:

๐ Severe difficulty breathing

๐ Blue lips or fingertips

๐ Severe chest pain

๐ Confusion or reduced consciousness

๐ Very rapid breathing

๐ Persistent high fever

๐ Inability to eat or drink

๐ Rapidly worsening symptoms

Early diagnosis and appropriate treatment can reduce the risk of serious complications and improve recovery.

 

Reference:

Bangphai Hospital Pneumonia

ArokaGO Providers Bangphai Hospital