CHEST INFECTION SPECIALIST MANCHESTER

Pneumonia is an infection that inflames the air sacs (alveoli) in one or both lungs. Lungs may fill with fluid or pus (purulent material), causing a number of symptoms like cough with phlegm or pus, fever, chills, and difficulty breathing. A large variety of microorganisms (bacteria, viruses and fungi) and chemicals (like oil) can cause pneumonia.

Pneumonia can range in seriousness from mild to life-threatening. It is most serious for infants and young children, people older than age 65, and people with health problems or weakened immune systems.

What are the symptoms of pneumonia?

Symptoms may range from being mild to severe. This depends on the nature of the type of organisms involved, the age and overall well-being of the individual. Mild pneumonia often mimics a cold or flu, but the symptoms tends to last longer.

Usual symptoms of pneumonia may include:

• Chest pain with breathing or coughing
• Fever, sweating and shaking chills
• Cough, which may be dry to start with or may produce phlegm (sputum)
• Shortness of breath
• Loss of appetite
• Fatigue and irritability or restlessness
• Nausea, vomiting or diarrhoea
• Newborns and infants may show only non-specific signs and high degree of suspicion is needed

What causes pneumonia?

A number of microorganisms can cause pneumonia and they most commonly found in the air that we breathe. Human body is usually effective in killing these germs but on occasions the immune system may be overpowered by a powerful (virulent) germ or if the immune system is weakened.

Pneumonia is mainly of 3 types and that depends on how the microorganism gets into the lungs.

Community-acquired pneumonia

Community-acquired pneumonia is the most common type of pneumonia and it occurs outside of hospitals. This is usually caused by a bacteria (most commonly streptococcus pneumoniae also known as pneumococcus) and may follow a trivial flue like illness. This usually results a large section of the lung being involved (lobr pneumonia) and the infection may spill out to the sac placed outside the lungs (also known as pleural effusion or empyema). Other organisms like mycoplasma may cause a milder pneumonia (atypical pneumonia). Fungi may also infect lungs especially in those who have chronic health problems or with weak immune system. In younger kids viruses may cause pneumonia and the seriousness of illness can range from being mild to life threatening.

Hospital-acquired pneumonia

Children may catch pneumonia from the hospital settings during their hospital stay for unrelated reasons (like being admitted for elective surgery). This can be serious as the bacteria causing it may be more resistant to antibiotics and because the children who get it are already sick. Children in intensive care units and those who are on breathing machines (ventilators) are at higher risk of this type of pneumonia.

Health care-acquired pneumonia

Health care-acquired pneumonia is a bacterial infection that occurs in children who live in long-term care facilities or who receive care in outpatient clinics (like kidney dialysis). The worry about this type of pneumonia is about the bugs that cause it may be more resistant to antibiotics.

Aspiration pneumonia

Accidental inhalation of food, drink, vomit or saliva into the lungs results in aspiration pneumonia. Aspiration is more likely if the normal gag reflex is disturbed (as in head injury or neurological problems affecting swallowing).

Are there any risk factors for pneumonia?

Pneumonia can affect anyone but is more common in extremes of age (under 2 years and over 65 years). Other risk factors may include smoking (or exposure to smoke), asthma, co-existing heart disease and those who are in the hospital environment (and ventilated). It may also happen to those who have a weak immune system (HIV, cancer chemotherapy, chronic steroids and transplanted) or have chronic disease (like diabetes).

What are the complications of pneumonia?

Fortunately, with modern antibiotics and supportive management, even serious pneumonias can be treated efficiently. However, complications do occur. The bacteria may spread from the lungs into the blood stream (sepsis) and can infect other organs leading to organ failure. Extreme difficulty in breathing may require the use of breathing machines (ventilators) and oxygen therapy. With the collection of pus around the lungs (empyema) a chest drain (or further surgery to remove the pus) may be required. Very rarely an abscess (large collection of pus within the lungs) can form and more complicated surgery may be needed. Fortunately, death from pneumonia is extremely rare in developed countries but is still a major problem globally.

Can pneumoniae be prevented?

Not for all, but certainly good hygienic practices and refraining from exposure to tobacco smoke can help. However, some types of pneumoniae can be prevented by vaccination (flu vaccine and pneumococcal vaccination). A healthy lifestyle that includes a good balanced diet, plenty of sleep and regular exercise is also helpful.

More Information Link

Mayo Clinic

British Lung Foundation

NHS Choices