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Pneumonia is inflammation of the airspaces in the lungs, most commonly due to an infection.
fever,
chills,
cough,
shortness of breath,
fatigue.
Community-acquired pneumonia (CAP) is acquired outside of the health-care setting
Antibiotics treat pneumonia by controlling the bacterial or fungal infection. The initial
choice of antibiotic depends on the organism presumed to be causing the infection as well as
local patterns ofantibiotic resistance.
Pneumonia can be fatal in up to 30% of severe cases that are managed in the
intensive-care setting.
Influenza and respiratory syncytial virus (RSV) are the most common viral causes of
pneumonia.
Risk factors for pneumonia include age over 65 or under 2, having certain chronic
medical conditions (including underlying lung disease, cigarette smoking, alcoholism, and
neurological problems), or sustaining injuries that interfere with swallowing or coughing.
What is pneumonia?
Pneumonia is an inflammation of the airspaces in the lung most commonly caused by infections.
Bacteria, viruses, or fungi can cause the infection. There are also a few noninfectious types of
pneumonia that are caused by inhaling or aspirating foreign matter or toxic substances into the
lungs. Around 50,000 people die each year of pneumonia in the U.S. Although anyone of any age
can be affected, pneumonia is more common in elderly people and often occurs when the immune
system becomes weakened via a prior infection or another condition.
Pneumonia is generally more serious when it affects older adults, infants and young children, those
with chronic medical conditions, or those with weakened immune function.
Other classification systems for pneumonia describe the way the inflammatory cells infiltrate the lung
tissue or the appearance of the affected tissue (see the following examples).
Lobar pneumonia causes an inflammation of one lobe of a lung and typically involves all the
airspaces in a single lobe.
Lipoid pneumonia is characterized by the accumulation of fats within the airspaces. It can be
caused by aspiration of oils or associated with airway obstruction.
Sometimes, types of pneumonia are referred to by the type of organism that causes the
inflammation, such as bacterial pneumonia, viral pneumonia, or fungal pneumonia. The specific
organism name may also be used to describe the types of pneumonia, such as pneumococcal
(Streptococcus pneumoniae) pneumonia or Legionella pneumonia.
Other types of pneumonia that are commonly referenced include the following:
Aspiration pneumonia develops as a result of inhaling food or drink, saliva, or vomit into the
lungs. This occurs when the swallowing reflex is impaired, such as with brain injury or in an
intoxicated person.
pneumonia" and is referred to as atypical because its symptoms differ from those of other types
of bacterial pneumonia.
Pneumonia that arises from being on a ventilator for respiratory support in the intensive-care
setting is known as ventilator-associated pneumonia
having a chronic disease such as cystic fibrosis, COPD, sickle cellanemia, asthma, heart
disease, or diabetes;
swallowing or coughing problems, as may occur following stroke or other brain injury;
malnutrition;
cigarette smoking
Symptoms and signs of pneumonia may be mild or severe and depend upon someone's overall state
of health as well as the type of organism causing the pneumonia. Severe symptoms include
cough,
coughing up phlegm,
fever,
chills.
Nausea, vomiting, and diarrhea are other possible symptoms that can accompany the respiratory
symptoms.
Infants and newborns may not show specific symptoms of pneumonia. Instead, they may appear
restless or lethargic. They may have a fever or cough or vomit. Older adults or those who have weak
immune systems may also have fewer symptoms and a lower temperature. A change in mental
status, such as confusion, can develop in older adults with pneumonia.
A chest X-ray is able to illustrate whether or not pneumonia is present, but it does not
provide information about the organism responsible for the infection.
In some cases, a chest CT scan may be performed. This will reveal more detail than the
chest X-ray.
Pulse oximetry measures the amount of oxygen in the bloodstream. The test involves a
painless sensor attached to the finger or ear. Blood levels of oxygen may be reduced in
pneumonia.
Microbiology tests to identify the causative organism. Tests may be performed on blood or
sputum. Rapid urine tests are available to identify Streptococcus pneumoniae and Legionella
pneumophila. Cultures of blood or sputum not only identify the responsible organism but can
also be examined to determine which antibiotics are effective against a particular bacterial
strain.
Bronchoscopy is a procedure in which a thin, lighted tube is inserted into the trachea and
major airways. This allows the doctor to visualize the inside of the airways and take tissue
samples if needed. Bronchoscopy may be performed in patients with severe pneumonia or if
pneumonia worsens despite antibiotic treatment.
Antibiotic medications are the treatment of choice for pneumonia caused by bacterial and fungal
infections. The exact choice of medications depends on many factors, including the following:
About 80% of cases of CAP can be managed at home with the patient taking oral antibiotics. There
are numerous treatment regimens available. Initial treatment (before the causative organism has
been identified) is called empiric treatment and is based upon the organisms most likely to be
responsible for the illness. Once the exact organism has been identified in the laboratory and
susceptibility testing performed to determine which antibiotics are effective, the treatment regimen
can be further individualized. In around 20% of cases, CAP must be managed in the hospital,
typically with intravenous antibiotics initially. HAP is managed in the hospital, typically with
intravenous antibiotics.
Antibiotics are not effective against viral pneumonia. Depending upon the type of virus that causes
pneumonia, antiviral medications can provide benefit when started early in the course of the disease.
For example, the medications oseltamivir (Tamiflu) and zanamivir (Relenza) are used to treat
influenza virus infections. Antifungal agents are used to treat most fungal pneumonias.