Video:Pneumonia

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Definition

Pneumonia is an inflammatory condition of the lung, where the small air sacs, known as alveoli, fill with fluid. It is most often caused by infection with bacteria.[1][2]

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Onset of illness

Symptoms for pneumonia typically include, cough, fatigue, chills, and shortness of breath. Each of the symptoms occurs with different frequencies.[3]

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Symptoms

Cough and fatigue are the most common symptoms, and seen in up to 9 out of 10 cases. Fever and shortness of breath, are present in roughly 3 out of 4 people. Productive sputum is present in 65 percent of cases, and chest pain occurs in roughly one-half of people.[4]

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Elderly

In the elderly, confusion may be the most prominent sign,[3] and fever is less likely to be present.

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Children Early Symptoms

In children under the age of five, fever, cough, and fast or difficult breathing are the most common symptoms.[5]

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Children Severe Pneumonia

More severe symptoms in children may include, blue-tinged skin, unwillingness to drink, convulsions, ongoing vomiting, extremes of temperature, or a decreased level of consciousness.[5][6]

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Causes

Pneumonia fills the lung's alveoli with fluid, limiting how much oxygen can be absorbed. The alveolus on the left is normal, whereas the one on the right is full of fluid from pneumonia.

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Bacterial Pneumonia

Pneumonia is usually caused by infection from bacteria or viruses. It is less commonly caused by other microorganisms, certain medications, and conditions, such as autoimmune diseases.[1][7]

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Risk factors

Risk factors for pneumonia, include smoking, a poor ability to cough, (such as after a stroke or surgery), and other lung diseases such as cystic fibrosis, COPD, and asthma.[8]

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Diagnosis

Diagnosis, is often based on symptoms and physical examination alone.[9]

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Diagnosis - Other Methods

Chest X-ray, blood tests, and culture of the sputum, may help confirm the diagnosis.[9]

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Classification

Where (and how) a pneumonia was acquired, can have a profound impact on survival. Examples are community-acquired, or hospital-acquired pneumonia. [10]

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Prevention

Because most pneumonias, are acquired from someone else that is infected, handwashing, and wearing surgical masks around the sick, are the most important preventative steps[11].

Vaccine

Vaccines to prevent certain types of pneumonia are available.[12]

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Other Methods

Other methods of prevention, include smoking cessation, and treating underlying illnesses (such as diabetes and HIV) properly.[12]

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Treatment

Antibiotics by mouth, rest, and simple analgesics and fluids, are usually enough to treat uncomplicated pneumonia.[13]

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Children

In children, those with respiratory distress, or oxygen saturations of less than 90%, should be hospitalized.[14]

Prognosis

With treatment, most types of bacterial pneumonia, will stabilize in 3–6 days.[15] It often takes a few weeks before most symptoms resolve.[15].

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Severe pneumonia

If the pneumonia is severe, the affected person is generally hospitalized, [16] and oxygen therapy may be necessary.[17]

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Epidemiology

Pneumonia is a common illness, affecting approximately 450 million people a year, and occurring in all parts of the world.[18] It is a major cause of death among all age groups, resulting in 7% of the world's total death yearly.[18][19]

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Death rates, are greatest in children less than five, and adults older than 75 years.[18]

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History

In the 19th century, William Osler called pneumonia "the captain of the men of death".[20]

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Survival rates

With the introduction of antibiotics and vaccines in the 20th century, survival has improved.[18]

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Developing countries

Nevertheless, in developing countries, and among the very old, young, and chronically ill, pneumonia remains a leading cause of death.[18][21]

US Navy 050112-N-6074Y-145 An Indonesian woman tends to her pneumonia-ridden child in the cabin of a U.S. Navy MH-60S Knighthawk helicopter.jpg

References

  1. 1.0 1.1 McLuckie, A., ed. (2009). Respiratory disease and its management. New York: Springer. p. 51. ISBN 978-1-84882-094-4.
  2. Leach, Richard E. (2009). Acute and Critical Care Medicine at a Glance (2nd ed.). Wiley-Blackwell. ISBN 978-1-4051-6139-8.
  3. 3.0 3.1 Hoare Z, Lim WS (May 2006). "Pneumonia: update on diagnosis and management" (PDF). BMJ. 332 (7549): 1077–79. doi:10.1136/bmj.332.7549.1077. PMC 1458569. PMID 16675815.
  4. Tintinalli, Judith E. (2010). Emergency Medicine: A Comprehensive Study Guide (Emergency Medicine (Tintinalli)). New York: McGraw-Hill Companies. p. 480. ISBN 978-0-07-148480-0.
  5. 5.0 5.1 Singh V, Aneja S (March 2011). "Pneumonia – management in the developing world". Paediatric Respiratory Reviews. 12 (1): 52–59. doi:10.1016/j.prrv.2010.09.011. PMID 21172676.
  6. Nair GB, Niederman MS (November 2011). "Community-acquired pneumonia: an unfinished battle". The Medical Clinics of North America. 95 (6): 1143–61. doi:10.1016/j.mcna.2011.08.007. PMID 22032432.
  7. Jeffrey C. Pommerville (2010). Alcamo's Fundamentals of Microbiology (9th ed.). Sudbury MA: Jones & Bartlett. p. 323. ISBN 978-0-7637-6258-2.
  8. "Who Is at Risk for Pneumonia?". NHLBI. 1 March 2011. Archived from the original on 7 March 2016. Retrieved 3 March 2016.
  9. 9.0 9.1 "How Is Pneumonia Diagnosed?". NHLBI. 1 March 2011. Archived from the original on 7 March 2016. Retrieved 3 March 2016.
  10. "Types of Pneumonia". NHLBI. 1 March 2011. Archived from the original on 5 February 2016. Retrieved 2 March 2016.
  11. "Pneumonia (Fact sheet N°331)". World Health Organization. August 2012. Archived from the original on 30 August 2012.
  12. 12.0 12.1 "How Can Pneumonia Be Prevented?". NHLBI. 1 March 2011. Archived from the original on 7 March 2016. Retrieved 3 March 2016.
  13. Lim WS, Baudouin SV, George RC, Hill AT, Jamieson C, Le Jeune I, Macfarlane JT, Read RC, Roberts HJ, Levy ML, Wani M, Woodhead MA (October 2009). "BTS guidelines for the management of community acquired pneumonia in adults: update 2009". Thorax. 64 Suppl 3 (Suppl 3): iii–155. doi:10.1136/thx.2009.121434. PMID 19783532.
  14. Bradley JS, Byington CL, Shah SS, Alverson B, Carter ER, Harrison C, Kaplan SL, Mace SE, McCracken GH, Moore MR, St Peter SD, Stockwell JA, Swanson JT (October 2011). "The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America". Clinical Infectious Diseases. 53 (7): e25–76. doi:10.1093/cid/cir531. PMID 21880587.
  15. 15.0 15.1 Behera, D. (2010). Textbook of pulmonary medicine (2nd ed.). New Delhi: Jaypee Brothers Medical Pub. pp. 296–97. ISBN 978-81-8448-749-7.
  16. "What Is Pneumonia?". NHLBI. 1 March 2011. Archived from the original on 29 February 2016. Retrieved 2 March 2016.
  17. "How Is Pneumonia Treated?". NHLBI. 1 March 2011. Archived from the original on 6 March 2016. Retrieved 3 March 2016.
  18. 18.0 18.1 18.2 18.3 18.4 Ruuskanen O, Lahti E, Jennings LC, Murdoch DR (April 2011). "Viral pneumonia". Lancet. 377 (9773): 1264–75. doi:10.1016/S0140-6736(10)61459-6. PMID 21435708.
  19. Lodha R, Kabra SK, Pandey RM (June 2013). "Antibiotics for community-acquired pneumonia in children". The Cochrane Database of Systematic Reviews. 6 (6): CD004874. doi:10.1002/14651858.CD004874.pub4. PMID 23733365.
  20. Osler, William (1901). Principles and Practice of Medicine, 4th Edition. New York: D. Appleton and Company. p. 108. Archived from the original on 2007-07-08.
  21. George, Ronald B. (2005). Chest medicine : essentials of pulmonary and critical care medicine (5th ed.). Philadelphia: Lippincott Williams & Wilkins. p. 353. ISBN 978-0-7817-5273-2.