kathi

Pneumonia

What is pneumonia? How do people "catch pneumonia?" What are the
symptoms of pneumonia? How is pneumonia diagnosed? What are some of
the organisms that cause pneumonia and how are they treated?
Conclusions Pneumonia At A Glance

What is pneumonia?

Pneumonia is an infection of one or both lungs which is usually caused
by a bacteria, virus, or fungus. Prior to the discovery of antibiotics,
one third of all people who developed pneumonia subsequently died from
the infection. Currently, over 3 million people develop pneumonia each
year in the United States. Over a half a million of these people are
admitted to a hospital for treatment. Although most of these people
recover, approximately five percent will die from pneumonia. Pneumonia
is the sixth leading cause of death in the United States.

How do people "catch pneumonia?"

Most cases of pneumonia are contracted by breathing in small droplets
that contain the bacteria or virus that can cause pneumonia. These
droplets get into the air when a person infected with these germs coughs
or sneezes. In other cases, pneumonia is caused when bacteria or viruses
that are normally present in the mouth, throat, or nose inadvertently
enter the lung. During sleep it is quite common for people to aspirate
secretions from the mouth, throat, or nose. Normally, the body's reflex
response (coughing back up the secretions) and immune system will
prevent a pneumonia from starting. However, if a person is in a weakened
condition from another illness, a severe pneumonia can develop. People
with emphysema, heart disease, and swallowing problems, as well as
alcoholics, drug users and those who have suffered a stroke or seizure
are at higher risk for developing pneumonia.

Once the bacteria, virus or fungus enter the lungs, they usually settle
in the air sacs of the lung where they rapidly grow in number. This area
of the lung then becomes filled with fluid and pus as the body attempts
to fight off the infection.

What are the symptoms of pneumonia?

Most people who develop pneumonia initially have symptoms of a cold
which is then followed by a high fever (sometimes as high as 104
degrees), shaking chills, and a cough with sputum production. The sputum
is often bloody. Chest pain may develop on one side and the patient may
become short of breath. In other cases of pneumonia, there can be a slow
onset of symptoms. A worsening cough, headaches, and muscle aches may be
the only symptoms. At times, the individual's skin color may change and
become dusky or purplish due to their blood being poorly oxygenated.

Children and babies often do not have any specific signs of a chest
infection, but develop a fever, appear quite ill, and can become
lethargic. Elderly people may also have few symptoms with pneumonia.

How is pneumonia diagnosed?

Pneumonia may be suspected when the doctor examines the patient and
hears coarse breathing or crackling sounds when listening to a portion
of the chest with a stethoscope. There may be wheezing or the sounds of
breathing may be faint in a particular area of the chest. A chest x-ray
is usually ordered to confirm the diagnosis of pneumonia. Sputum samples
can be collected and examined under the microscope. If the pneumonia is
caused by a bacteria, it can often be detected by this examination. A
sample of the sputum can be grown in special incubators and the
offending bacteria can be subsequently identified. A blood test can be
performed (called a CBC) and the white blood cell count of this test can
often give a hint as to the severity of the pneumonia and whether it is
caused by a bacteria or a virus.

Bronchoscopy is a procedure in which a thin, flexible lighted viewing
tube is inserted into the nose or mouth after a local anesthetic is
administered. The breathing passages can then be directly examined by
the doctor and specimens from the infected part of the lung can be
obtained. Sometimes, fluid collects around the lung as a result of the
inflammation from pneumonia. This fluid is called a pleural effusion. If
the amount of this fluid that develops is large enough, it can be
removed by inserting a needle into the chest cavity and withdrawing the
fluid with a syringe. This procedure is called a thoracentesis.

What are some of the organisms that cause pneumonia and how are they
treated?

The most common cause of a bacterial pneumonia is Streptococcus
pneumoniae. There is usually an abrupt onset of the illness with shaking
chills, fever and a rust-colored sputum. The infection spreads into the
blood in 20-30% of cases and if this occurs 20-30% of these patients
die. A vaccine (Pneumovax) is available and is recommended for people
who have diabetes, steroid-dependent asthma, alcoholism, cigarette abuse
and in those persons who have had their spleen removed.

Antibiotics often used in the treatment of this pneumonia include
penicillin, ampicillin-clavulanate
(Augmentin), and erythromycin. Hemophilus influenza is a bacteria that
often causes pneumonia in people suffering from emphysema or alcoholism.
Useful antibiotics are cefuroxime (Ceftin), ampicillin-clavulanate
(Augmentin), ofloxacin (Floxin), and trimethoprim-sulfamethoxazole
(Bactrim, Septra).

Mycoplasma pneumonia is often a slowly developing infection. Symptoms
include fever, chills, muscle aches, diarrhea, and rash. This bacteria
is the principal cause of many pneumonias in the summer and fall months
and is often referred to as "atypical pneumonia." Erythromycin,
clarithromycin (Biaxin), and azithromycin (Zithromax) are antibiotics
commonly prescribed for mycoplasma pneumonia.

Legionnaire's disease is caused by the bacteria Legionella pneumoniae
and is most often found in contaminated water supplies and air
conditioners. It is a potentially fatal infection if not accurately
diagnosed. Pneumonia is part of the overall infection and symptoms
include high fever, a relatively slow heart rate, diarrhea, nausea,
vomiting, and chest pain. Older men, smokers, and persons whose immune
systems are suppressed are at higher risk to develop Legionnaire's
disease. Erythromycin and other similar antibiotics are the treatment of
choice in this infection.

Viral pneumonias do not typically respond to antibiotic treatment. These
pneumonias usually resolve over time with the body's immune system
fighting off the infection. It is important to make sure that a
bacterial pneumonia does not secondarily develop. If it does, then the
bacterial pneumonia is treated with appropriate antibiotics.

Fungal pneumonias that can occur include actinomycosis, nocardiosis,
histoplasmosis, coccidiomycosis, blastomycosis, aspergillosis, and
cryptococcosis. These are responsible for a relatively small percentage
of pneumonias in the United States. Each has specific antibiotic
treatments among which are amphotericin B, fluconazole (DIFLUCAN),
penicillin, and sulfonamides.

Conclusions

Pneumonia can be a serious and life-threatening infection. This is true
especially in the elderly, children and those that have other serious
medical problems such as emphysema, heart disease, diabetes, and certain
cancers. Fortunately, with the discovery of many potent antibiotics,
most pneumonias are successfully treated. In fact, most pneumonias can
be treated with oral antibiotics and without the need for
hospitalization.

Pneumonia At A Glance

Pneumonia is a lung infection that can be caused by different types of
microorganisms. Symptoms of pneumonia include cough with sputum
production, fever, and chest pain when breathing in. Diagnosis of
pneumonia is suspected when a doctor hears abnormal sounds in the chest
and confirmed by a chest x-ray. Bacteria causing pneumonia can be
identified in sputum by culturing. A pleural effusion is a fluid
collection around the inflamed lung. Bacterial and fungal (but not
viral) pneumonia can be treated with antibiotics.

http://www.medicinenet.com/Pneumonia/article.htm