Pneumonia - Common, Yet Misunderstood Respiratory Disease.

There have been 1.7 million google searches every single month about Pneumonia - Yes, that many people want to know about it. 

So, I, Dr. Rashesh Shah,  thought of creating a perfect Guide to that disease, which can help people to learn and bust their myths. 

So, Let’s learn…

Pneumonia Meaning: - 

• It is a term derived from Greek word - Pneumon meaning Lung. IA or ITIS means inflammation of something. Ex - Sinusitis meaning inflammation of sinus. So, the word Pneumonia means inflammation of Lungs. 

Pneumonia Definition: - 

• An acute Inflammation of the alveoli due to infection. 

Believe me it’s English,But medical one! 

Let me simplify it for you….

• Acute means of short duration - Most of Pneumonia will get cured in 2 weeks.

Now turn for the second word of definition….

• There are air sacs in lungs that inflate when we breathe in and deflate when we breathe out, which are called Alveoli. 

• Microorganisms - Bacteria, Virus or Fungi can get into it and cause infection. 

• So, there will be inflammatory response there - Natural response to fight any infection that will result in dilatation of local blood vessels and flow of more Defense cells towards that body part. 

• More blood flow will cause its boundaries to swell as some plasma - fluid part of the blood will come out of the blood around Alveoli due to osmotic gradient. 

Now, you got it. ..

• Due to infection in air sacs of lungs, fluid from blood will get collected around it ;so, the patient cannot breathe in fully. In other words, he will have troublesome breathing.

Pneumonia Vs Bronchitis: - 

• Lot of misconceptions are out there, when it comes to these two terms. 

Let me simplify it for you …

• There are divisions of windpipe in the lungs. Inflammation of that is called Bronchitis. 

• Those divisions will ultimately end up in the air filled sac - Alveoli. Inflammation of it is called Pneumonia. 

• If the bronchitis remains untreated, it will progress to Pneumonia. 

Now it should be clear, I guess….!

Pneumonia Classification: - 

• Community Acquired Pneumonia -

The disease acquired from community, other than medical setup.

• Hospital Acquired pneumonia -

When the person is in hospital, he will get infected by that disease. There have been several instances found of it being Antibiotic Resistant.

So, it is the most dangerous type of the disease. 

• Ventilator Acquired Pneumonia -

Those patients who cannot breath on their own, they are put on the ventilator machine that will help them breath mechanically. Pneumonia acquired via that machine is called VAP. 

• Aspiration Pneumonia -

It generally affects people of old age and Alcoholics.

When people aspire any microorganism because they are sedated or they lose their natural response to stop that bacteria from entering their body, they fall victim to aspiration Pneumonia. 

----> Pneumonia - Aspiration type is also caused by a large amount of material entering into lungs from the stomach or oral cavity. 

Pneumonia Stages: - 

• Bronchopneumonia:

It affects both the lungs. Only alveoli parts around the bronchial tubes are affected. 

• Lobar pneumonia:

It affects particular lobes of the lung. Yes! Right lung has 3 lobes and Left has 2. 

Pneumonia Symptoms: -  

• Shortness of Breath -

As there is fluid deposition around Alveoli, its volume will be less that means less space for filling of air.

Due to this, the person cannot breath fully. He needs to take a short breath and then exhale it before he can breath in again. 

• Chest Pain -

Due to Fluid in the Lungs; upon breathing , the fluid around alveoli will compress structures around. It will result in pain. 

• Fever -

It is one of the signs of Inflammation. Any infection in the body will result in overwork that will raise the temperature. 

• Productive Cough-

The fluid around Alveoli, when gets mixed with dead Defence cells - WBCs of the body along with infected tissues and dead bacteria, it is called pus.

That pus will come out in Pneumonia cough. And because it is coming from the lower respiratory tract, it is called phlegm. 

• Tiredness -

Due to shallow breathing, the body cannot get proper oxygen. So, body tissues cannot generate energy and work optimally. This will result in Fatigue. 

• Loss of Appetite

• Nausea

• Vomiting

• Headache

Is Pneumonia Contagious?

----> Yes. 

• As it is caused by Microorganisms, they will spread via cough or sneeze of infected person. However, fungus cannot spread via that route. 

• So, if your immunity is low, you can get Pneumonia ;not only from an infected person, but also from the environment as microorganisms are also present in the environment. 

• Hence, to protect yourself from any communicable disease, you need to boost your immunity.

Walking Pneumonia: - 

• When you have Pneumonia, the symptoms of it are so mild that you do not realize even that you have disease. Because your immune system is powerful to tackle it. 

• Doctors call it walking Pneumonia.

Cause of Pneumonia: - 

----> The disease could be caused by any microorganisms.

Pneumonia causative agent: 

	Bacteria	Virus	Fungi
Most Common	Streptococcus Pneumoniae	Influenza (Flu)	Pneumocystis jiroveci
Others	Mycoplasma Pneumonie, Haemophilus Influenzae	Rhinovirus	Cryptococcus, Histoplasmosis

                             

-----> Pneumonia bacterial subtype - Streptococcus Pneumoniae is most common here in the United States. 

Risk factors for Pneumonia: - 

• Extreme age - People under 2 years of age and over 65. 

• Those with weak immune response - Taking immunosuppressant therapy due to organ transplant, cancer, chronic illness like Diabetes, Asthma

• Chronic Smokers

• People with swallowing issues due to Age or Brain Stroke.

• Hospitalized patients receiving mechanical ventilation for a long time. 

• Those chronically getting exposed to Lung Irritants - Polluted cities, Mine workers, Cotton Factory laborers

 Pneumonia vaccine: - 

• Vaccine is available against almost all the causative organisms - Bacteria and Virus. 

• Prevnar 13 and Pneumovax 23 - effective against Pneumonia bacteria - Pneumococcal. 

• Flu shots - effective against Influenza virus

• Hib VAccine - effective against Haemophilus influenzae type b. 

Other ways of protection from Pneumonia: -

• Quit Smoking -

Smoking will make you susceptible to respiratory infections because hair like structure in the beginning of the respiratory tract - Cilia will get destroyed due to it.

This will facilitate the entry of microorganisms in the respiratory tract. If you have issue in Giving up smoking, you can try this...

• Covering your sneeze and cough in a tissue and despising it immediately. 

• Maintaining personal hygiene. 

• Boost your immunity by taking enough rest, exercise and a healthy diet. More ways to boost immunity could be read by clicking here. 

Pneumonia in Children: - 

• It is a common childhood disease, with 120 million annual reported cases worldwide according to CDC - Centres for disease control and prevention . The causative organisms vary by age of the baby. 

• Till 5 years of age, Streptococcus Pneumonie and Haemophilus Influenzae are common and between 5 and 13, Mycoplasma Pneumonia is common. 

• Lack of appetite and energy along with troublesome breathing are the signs of baby Pneumonia. 

ICD - 10 code for Pneumonia: - 

----> J18.9 is a billable code used to specify a medical diagnosis of pneumonia, unspecified organism.

Pneumonia Diagnosis: - 

• When you go to your Doctor, he will first go for your physical examination and will ask about any relevant medical history like past lung surgery or regular medication.

• Also, symptoms that you feel will be noted in the Case history.  

• Cracking, bubbling or rumbling sound will be heard in Pneumonia during inhalation , when listened with the Stethoscope. 

Interesting: When I was in Med school, I used to remember crackling as a Pneumonia Breath Sound. 

----> Apart from that Doctor will prescribe few diagnostic tests to you --

• Chest X- ray - 

Pneumonia x-ray will show the extent of inflammation spread in the lungs. This will help doctors decide the line of treatment. 

• Blood C&S Test -

Pneumonia blood test will show the organism that caused the disease. This later on will help the Doctor to decide the medications.  

• Sputum Examination -

It will help the Doctor confirm lab findings of blood reports - Microorganism involved. . 

• Pleurocentesis -

Doctor will insert the needle between the ribs to take the pleural fluid out to test it to look for the infection causing organisms. 

• Pulse oximeter -

It will determine the level of Oxygen in the blood. 

• Bronchoscopy -

To check the minute details of Airway - Adhesion, Pus collection, Etc. 

Truth:

Pneumonia will decrease the lifespan of those close to death and will limit their suffering. Due to it, it is also called ‘Old Man’s Friend'.

Pneumonia Complications: - 

1. Bacteremia
2. Pleural effusion
3. ARDS - Acute Respiratory Distress Syndrome
4. Lung Abscess
5. Emphysema
6. Death

Pneumonia Treatment: - 

• Like every disease, there is a different Pneumonia care plan for everyone depending on their General Health, Age and The type of Disease. 

• Hospitalization -

If the disease is severe, a person needs to be given IV fluids for hydration and mechanical ventilation. 

• Antibiotics -

For bacterial disease. Even if you start feeling better after some time of starting medicine, you need to complete the full course.

As if you discontinue pneumonia antibiotics from between, it will be very hard to tackle the remaining organisms that will become resistant to Antibiotics. 

• Antiviral -

For viral Pneumonia, antiviral medicines are prescribed. 

• Antifungal -

Fungal disease will require this medication to cure it. Unlike bacterial and viral infection, the patient needs to take antifungal for weeks or months even. 

• Analgesics -

For pain relief, these medicines are prescribed depending upon the severity of the pain. 

• Antipyretics -

It will cure fever of the patient.

Conclusion: - 

----> Pneumonia is a very common disease, not in just developing, but also the developed world.

----> The best way to avoid it is to take vaccine and even if someone gets it, it is easily curable, most of the time. 

So, even after reading a detailed Pneumonia guide, you have any questions or want to know more, feel free to leave a comment below...