Pneumonia

Pneumonia is an infection caused by viruses, bacteria, or fungi. It results in inflammation in the air sacs (alveoli) of one or both lungs, causing them to fill with fluid or pus, which makes breathing difficult. Both viral and bacterial pneumonia are contagious and can spread from person to person through inhalation of airborne droplets from a cough or sneeze. These types of pneumonia can also be contracted by touching surfaces or objects contaminated with the bacteria or viruses that cause them. In contrast, fungal pneumonia is acquired from the environment and does not spread from person to person.

What are some misconceptions associated with pneumonia?

Pneumonia is not caused by cold weather or using air conditioning. However, air conditioners with poor filters may harbour some organisms that may cause chest infections, not the temperature.

What are the types of pneumonia?

Pneumonia is categorised based on where or how it is acquired:

• Hospital-acquired pneumonia (HAP): This form of bacterial pneumonia is contracted during a hospital stay. It can be especially severe due to potential antibiotic resistance in the bacteria causing it.
• Community-acquired pneumonia (CAP) Refers to pneumonia acquired outside of a medical or institutional setting, typically in the community.
• Ventilator-associated pneumonia (VAP): Occurs in individuals using a ventilator to assist with breathing. When pneumonia develops in these cases, it is referred to as VAP.
• Aspiration pneumonia occurs when bacteria from food, drink, or saliva are inhaled into the lungs. It is more likely to happen in individuals with swallowing difficulties or those who are heavily sedated due to medications, alcohol, or other drugs.

What are the symptoms of pneumonia?

Pneumonia symptoms can range from mild to life-threatening. Common symptoms include:

• Coughing: Often producing phlegm or mucus
• Fever
• Sweating or chills
• Shortness of breath: Occurring during everyday activities or even at rest
• Chest pain: Particularly worsened by breathing or coughing
• Fatigue: Feelings of tiredness or general weakness
• Loss of appetite
• Nausea or vomiting
• Headaches

Symptoms can vary depending on age and overall health:

• Infants: May show minimal symptoms but could exhibit vomiting, lack of energy, or difficulty feeding.
• Children under five years old Might experience rapid breathing or wheezing.
• Older adults: Symptoms tend to be milder, but confusion and chills can also occur.

What causes pneumonia?

Pneumonia occurs when infectious agents invade the lungs, triggering an immune response that leads to inflammation of the air sacs (alveoli). This inflammation causes the air sacs to fill with pus and fluid, resulting in pneumonia symptoms. Several types of infectious agents can cause pneumonia:

• Bacteria: Common bacterial causes include Streptococcus pneumoniae and Haemophilus influenzae.
• Viruses: Viral causes can include rhinoviruses (which cause the common cold), influenza viruses, measles, and coronavirus infections.
• Fungi: Fungal pneumonia can be caused by organisms such as Pneumocystis jirovecii, Cryptococcus species, and various species of Histoplasma.

These pathogens can enter the lungs through inhalation of airborne droplets or by spreading from infections in other parts of the body.

What are some risk factors for getting pneumonia?

Certain groups are at higher risk of developing pneumonia. These include:

• Infants: Particularly those from birth to 2 years old, whose immune systems are still developing.
• Elderly: Adults aged 65 and older whose immune systems may be weaker due to age.
• Individuals with weakened immune systems: This includes people who are pregnant, living with HIV, or using medications that suppress the immune system (such as steroids or certain cancer drugs).
• People with chronic medical conditions, Such as asthma, cystic fibrosis, diabetes, chronic obstructive pulmonary disease (COPD), heart failure, sickle cell disease, liver disease, or kidney disease, which can compromise lung function and immunity.
• Hospitalised patients, Particularly those who are or have been on a ventilator, who are more exposed to hospital-acquired infections.
• Individuals with neurological conditions, Such as stroke, head injury, dementia, or Parkinson’s disease, can impair swallowing or cough reflexes, increasing the risk of aspiration pneumonia.
• People exposed to lung irritants, including air pollution, toxic fumes (especially in occupational settings), or environmental factors that can damage the lungs.
• Residents of crowded living environments, Such as prisons or nursing homes, where close quarters can facilitate the spread of infections.
• Smokers: Smoking weakens the lungs’ ability to clear mucus and fight infections, increasing susceptibility to pneumonia.
• Individuals who use drugs or alcohol: Heavy alcohol use or drug use can weaken the immune system and impair reflexes, leading to an increased risk of aspiration pneumonia.

These factors contribute to a higher susceptibility to pneumonia by compromising the body’s defences against infections or increasing exposure to infectious agents.

Can pneumonia be prevented?

Preventing pneumonia is possible through several measures:

• Vaccination: Getting vaccinated is the primary preventive measure against pneumonia. Vaccines such as the pneumococcal conjugate vaccine (PCV13) and the pneumococcal polysaccharide vaccine (PPSV23) effectively prevent pneumococcal pneumonia. The influenza (flu) vaccine can also help prevent viral infections that can lead to pneumonia.
• Smoking cessation: If you smoke, quitting is crucial as smoking weakens the lungs and makes you more susceptible to respiratory infections, including pneumonia.
• Hygiene: Regularly washing your hands with soap and water for at least 20 seconds helps prevent the spread of germs that can cause pneumonia.
• Respiratory hygiene: When you cough or sneeze, cover your mouth and nose with a tissue or your elbow to prevent respiratory droplets from spreading, which can carry infectious agents.
• Healthy lifestyle: Maintaining a healthy lifestyle strengthens your immune system, making it more capable of fighting infections. This includes getting enough rest, eating a balanced diet of fruits and vegetables, and exercising regularly.

How is pneumonia treated?

Treatment for pneumonia typically varies based on the type of pneumonia, its severity, and the individual’s overall health condition. Here are some common approaches to treatment:

Prescription Medications:

• Antibiotics: If bacteria cause your pneumonia, your doctor will prescribe antibiotics. The specific antibiotic will depend on the type of bacteria causing the infection. Completing the entire course of antibiotics as prescribed is crucial, even if you start feeling better sooner. This ensures that all bacteria are eradicated and reduces the risk of antibiotic resistance.
• Antivirals: Antiviral medications may be prescribed for viral pneumonia. These medications can help reduce the severity and duration of viral infections.
• Other Medications: Depending on your underlying health conditions, such as heart failure or diabetes, your doctor may prescribe medications to manage these conditions and support overall recovery.

Supportive Care:

• Pain Relievers and Fever Reducers: Over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help relieve pain and reduce pneumonia-associated fever.
• Cough Medications: Depending on the severity of your cough, your doctor may recommend cough suppressants or expectorants to help manage symptoms.
• Oxygen Therapy: In severe cases of pneumonia, where breathing is difficult, supplemental oxygen may be necessary to ensure adequate blood oxygenation.

Hospitalisation:

• Intravenous Antibiotics: If pneumonia is severe or if there are complications, hospitalisation may be required for intravenous administration of antibiotics or other medications.
• Monitoring: Hospitalization allows close monitoring of vital signs, oxygen levels, and overall response to treatment.

Additional Therapies:

• Respiratory Therapy: In cases of severe pneumonia or respiratory distress, respiratory therapists may assist with breathing exercises or the use of respiratory devices to improve lung function.
• Fluids: Maintaining adequate hydration is essential, especially during illness. Intravenous fluids may be administered if necessary.

Follow-up Care:

• Monitoring: After initial treatment, follow-up appointments with your doctor may be necessary to monitor recovery and ensure complete resolution of the infection.
• Reevaluation: If symptoms persist or worsen despite treatment, further evaluation may be needed to assess for complications or underlying conditions.

Treatment for pneumonia is tailored to each individual’s specific circumstances. It’s important to follow your doctor’s instructions closely, complete prescribed medications, and seek medical attention promptly if symptoms worsen or new symptoms develop.