Pneumonia – symptoms, treatment, complications [EXPLAINED]

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Pneumonia is a disease that, if left untreated, can lead to serious health consequences. It is especially dangerous for young children, the elderly and people with weakened immune systems. What is pneumonia? What are the symptoms of pneumonia? Find out all the information below.

Pneumonia – what is it?

Pneumonia is a form of acute respiratory infection that affects the lungs. The lungs are made of small sacs called alveoli that fill with air when a healthy person breathes. When a person has pneumonia, the alveoli in the lungs become filled with pus and fluid, making breathing painful and restricting oxygen intake.

Zapalenie płuc to największa zaraźliwa przyczyna zgonów dzieci na całym świecie. In 2017, pneumonia killed 808 children under the age of 694, accounting for 5% of all deaths in children under the age of five. Pneumonia affects children and families worldwide, but is most common in South Asia and sub-Saharan Africa.

Also check: Lipid responsible for pneumonia

Pneumonia – causes

Pneumonia is caused by a number of infectious agents, including viruses, bacteria and fungi. The most common are:

1. Streptococcus pneumoniae – the most common cause of bacterial pneumonia,
2. Haemophilus influenzae type b (Hib) – the second most common cause of bacterial pneumonia,
3. Respiratory syncytial virus is the most common viral cause of pneumonia;
4. in HIV-infected infants Pneumocystis jiroveci it is one of the most common causes of pneumonia, responsible for at least a quarter of all deaths from pneumonia in HIV-infected infants.

Some bacteria cause pneumonia with symptoms or characteristics other than ‘typical’ pneumonia. This infection is known as atypical pneumonia. For example Mycoplasma pneumoniae causes a mild form of pneumonia, often called ‘walking pneumonia’. Legionella pneumophila causes a severe type of pneumonia called Legionnaires’ disease. Bacterial pneumonia can either start on its own or develop after a cold or flu.

Viruses that infect the lungs and respiratory tract can cause pneumonia. Influenza (flu virus) and colds (rhinovirus) are usually the most common causes of viral pneumonia in adults. Respiratory syncytial virus (RSV) is the most common cause of viral pneumonia in young children.

Wiele innych wirusów może powodować zapalenie płuc, w tym SARS-CoV-2, wirus odpowiedzialny za COVID-19.

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Pneumonia – types

The types of pneumonia are classified according to the causative agent of the disease and the location of the inflammation in the lungs.

Classification of the types of pneumonia based on the factor that caused the disease:

1. fungal pneumonia,
2. atypical pneumonia,
3. viral pneumonia,
4. chemical pneumonia (includes aspiration pneumonia),
5. allergic pneumonia,
6. bacterial pneumonia.

Classification of the types of pneumonia by inflammation in the lungs:

1. lobar pneumonia – pneumonia caused by streptococcus (the disease covers one entire lobe of the lung and the pleura that covers a given lobe),
2. bronchopneumonia – caused by the entry of microorganisms into the bronchi, through the walls damaged by inflammation,
3. segmental pneumonia – the disease affects specific segments of the lungs.

FOR THE LUNGS – herbal tea that can be drunk as an aid in the treatment of infections, as well as prophylactically to strengthen the immune system, has a positive effect on the respiratory system.

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Pneumonia – How Do You Get It?

Pneumonia can spread in many ways. Viruses and bacteria that are common in the nose or throat can infect the lungs if inhaled. They can also spread through airborne droplets when you cough or sneeze. In addition, pneumonia can spread through the blood, especially during and shortly after birth.

Pneumonia can also be caused by mycoplasmosis bacteria. To find out about this, it is worth performing a mail-order mycoplasmosis test available on Medonet Market at an attractive price.

Ile trwa zapalenie płuc?

Pneumonia can persist for about two weeks or even longer in young children, the elderly, and people with a weak immune system or an ongoing disease such as chronic obstructive pulmonary disease or asthma. Even healthy people may feel tired or weak for a month or more after their lungs are cleared.

Also check: Asthma or COPD?

Viral pneumonia – characteristics

In children under 5 years of age, viruses are a direct or indirect cause of pneumonia in 85% of cases. Due to the damage to the lung defenses, they facilitate the penetration of bacteria, changing the properties of the normal secretion and destroying the respiratory epithelium. Among the viruses, the RS virus plays the most important role, although it can also be adenoviruses, parainfluenza virus, enteroviruses and others.

The greatest incidence of viral pneumonia occurs in the autumn-winter period. Infection occurs via droplets. Inflammation is usually preceded by a runny nose and cough for several days, and a slightly elevated temperature.

Viral pneumonia can be mild or very severe. The child’s general condition suddenly deteriorates, usually within a few hours, there is paroxysmal whooping cough and rapidly increasing dyspnoea. There is significant weakness, pallor, cyanosis and great anxiety of the child appear. There may be apnea. Most children then require immediate hospital treatment due to increasing symptoms of respiratory failure.

Although most cases of pneumonia in children are caused by viruses, the use of antibiotics is justified in cases of bacterial superinfections, because – as mentioned earlier – the virus, by impairing local defense apparatus, “paves” the way for bacterial superinfection.

Bacterial pneumonia – characteristics

Bacterial pneumonia may be primary or secondary to viral infection. It is susceptible to diseases in which there is stagnation of secretions in the bronchial tree (asthma, cystic fibrosis), congenital defects of the respiratory system and heart, immunological deficiencies, or aspiration of a foreign body or food to the respiratory tract.

Like some viruses, certain types of bacteria are especially responsible for certain clinical forms of the disease. The most frequently isolated pathogen is Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus.

Symptoms depend on the severity of inflammatory changes, and these largely depend on the child’s age and the maturity of the respiratory system and the immune system. Pneumonia in newborns and young infants increases very quickly, most often as part of a systemic infection.

Usually, there is a runny nose making it difficult to suck, anxiety and loss of appetite first. Very quickly, sometimes after a few hours, there is rapid breathing and shortness of breath, the child turns gray when screaming and grunts. The cough may be poorly expressed, and instead of an elevated body temperature, there is a normal or even lowered body temperature. Younger children may experience abdominal pain and distension, and vomiting as an expression of the toxic effect of microorganisms.

In addition to breathing disorders, the child’s low mobility and reluctance to suckle are noteworthy. In older children, the symptoms of pneumonia are more common. Rapid breathing, shortness of breath, fever and cough appear – initially dry, tiring, then changing into a moist one. The child cannot cough up secretions, swallows it more often, which provokes vomiting. Occasionally, in pneumonia, there is diffuse abdominal pain, sometimes more severe on the side of the inflammation in the lungs.

Treatment of pneumonia, depending on the severity of disease symptoms, is performed at home or in a hospital setting. Home symptomatic treatment and care are similar to bronchitis.

Mycoplasmic pneumonia – characteristics

Mycoplasmas are among the smallest microorganisms that can grow outside the host cells. In humans – as a causative element of infection – it is detected in the respiratory system, urinary system and joint cavities. Most often it is Mycoplasma pneumoniaewhich is responsible for 30% of pneumonia in preschool children and about 60% in school age.

Infection with pneumonia occurs through droplets, especially in children who are in close contact (school, kindergarten). Some infections are asymptomatic, sometimes there is inflammation of the throat, nose, paranasal sinuses or otitis.

The process of mycoplasma pneumonia is usually quite mild, but complications such as exudative pleurisy, lung abscesses, and even respiratory failure are becoming more common. This mainly affects the elderly.

In children, mycoplasma pneumonia usually manifests itself:

1. coughing
2. pharyngitis
3. headaches.
4. Occasionally there may be enlargement of the lymph nodes in the neck, skin rash, vomiting or joint pain.

They occur during and after respiratory symptoms disappear. Particularly dangerous are neurological complications (encephalomyelitis and meningitis, myelitis, phrenic nerve inflammation and others), cardiological (myocarditis and pericarditis) and hematological (thrombocytopenia, haemolytic anemia) complications.

Other complications include arthritis, pancreatitis, inflammation of the liver, gastroenteritis, and skin rashes. After mycoplasmal pneumonia, there may be paroxysmal cough for a long period (even several months), similar in nature to whooping cough.

The doctor diagnoses mycoplasmal pneumonia based on symptoms, radiographs and serological tests. Treatment with: antibiotic therapy, symptomatic treatment.

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Opportunistic pneumonia – characteristics

A common feature of opportunistic infections is that they are caused by microorganisms that may remain in the body for many years in a latent form, without affecting the healthy system. Only when immunity decreases do they cause disease symptoms.

Opportunistic pneumonia can be caused by:

1. protozoa (Pneumocystis jiroveci, Toxoplasma gondii),
2. mushrooms (Candida albicans, Aspergillus fumigatus) causing inflammation of a very severe course,
3. wirusy (cytomegalii i Epsteina-Barr), głównie u chorych po przeszczepach narządów,
4. gram-negative bacteria (Escherichia coli, Klebsiella, Pseudomonas),
5. atypical mycobacteria of tuberculosis.

The symptoms of opportunistic pneumonia are non-specific. They can be common to all pneumonia.

See: Tuberculosis of the urinary system – what is this disease?

Aspiration pneumonia – characteristics

Aspiration pneumonia is also known as Mendelson’s syndrome. It is characterized by the release of gastric contents into the bronchi or lungs, regardless of age, although children under five are more likely to be affected. In the course of the disease, inflammation covers the lung parenchyma, which causes inflammation in them, and in the alveoli – exudate.

The causes of aspiration pneumonia are numerous predisposing factors that promote the penetration of bacteria from the gastrointestinal tract into the bronchial tree and lung tissue.

Belong to them:

1. gastroesophageal reflux, caused by periodic relaxation of the lower esophageal sphincter,
2. neurological diseases that cause, among others impaired cough reflex and tendency to convulsions,
3. children fed through a gastric tube, intubated e.g. during general anesthesia and with congenital or acquired tracheo-esophageal malformations, esophageal achalasia, duodenal atresia have a high risk of developing aspiration pneumonia,
4. lying down, alcohol, other stimulants and some medications also contribute to the regurgitation of food into the esophagus and respiratory tract,
5. newborns are prone to aspiration of amniotic fluid and meconium, which may result in infection Streptococcus agalactiaethat colonizes the mother’s birth paths.

Among symptoms of aspiration pneumonia the following should be mentioned:

1. cough,
2. fever,
3. weakness,
4. poty,
5. pain in the chest,
6. ropną wydzielinę z dróg oddechowych,
7. rapid breathing,
8. general weakness
9. high fever,
10. chills.

Treatment of aspiration pneumonia requires antibiotic therapy with drugs such as:

1. penicillins with lactamase inhibitors,
2. clindamycyna,
3. crystal penicillin with metronidazole.

If the infection was caused by a bacterium in the family Enterobacteriaceae or Pseudomonas aeruginosa it is necessary to administer an aminoglycoside antibiotic or a XNUMXth generation cephalospotin. Saphylococcus aureus infection will require different treatment.

In this case, cloxacillin should be ordered, and if it is a methicillin, vancomycin or linezolid resistant strain. Aspiration pneumonia takes 1-3 weeks to heal, unfortunately it tends to recur.

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Śródmiąższowe zapalenie płuc — charakterystyka

Interstitial pneumonia is a disease that damages the structure of the alveoli in the lungs and causes damage to the connective tissue. The ailment most often affects adults, less often it is observed in children. The disease makes ventilation and gas exchange difficult, which in turn forces the use of mechanical ventilation.

Only adequately fast diagnosis and treatment allow for recovery. Interstitial pneumonia can leave a memento of lung cavities or fibrosis.

Types of interstitial pneumonia:

1. lymphocytic interstitial pneumonia,
2. ordinary interstitial pneumonia,
3. nonspecific interstitial pneumonia,
4. acute interstitial pneumonia,
5. kryptogenne organizujące zapalenie płuc.

The most common causes of interstitial pneumonia are:

1. the use of drugs that reduce immunity,
2. HIV virus,
3. bone diseases (e.g. RA),
4. heavy smoking,
5. bacterial infections,
6. choroby ziarniniakowe,
7. systemic vasculitis,
8. viral infections,
9. contact with toxic substances.

Symptoms of St.The types of interstitial pneumonia are:

1. dyspnoea,
2. cough (usually dry and tiring)
3. lack of appetite
4. changes in the lungs audible during a stethoscope examination,
5. fluid in the lungs
6. wheezing
7. rapid breathing,
8. weakening of the body.

Często niemożliwe jest ustalenie przyczyny śródmiąższowego zapalenia płuc, mówimy wówczas o idiopatycznym śródmiąższowym zapaleniu płuc.

In the treatment of interstitial pneumonia, drugs in the form of e.g. glucocorticosteroids are introduced. An antibiotic is given when the patient is at risk of a bacterial infection. Symptomatic treatment, on the other hand, includes oxygen therapy and breathing exercises. Idiopathic interstitial pneumonia is treated with pirfenidone and nintedanib. Both drugs act to inhibit the growth of impaired tissues.

Asymptomatic pneumonia – characteristics

In some people, pneumonia has less specific symptoms and may not be noticed at all. We are talking then about asymptomatic pneumonia.

Niekiedy w ogóle nie obserwuje się kaszlu czy wysokiej temperatury, a oprócz tego lekarz nie słyszy żadnych niepokojących zmian w płucach. W takich sytuacjach objawem choroby jest zwykle senność i ogólne osłabienie organizmu. Do tego mogą dołączyć zlewne poty oraz duszność.

Pneumonia in newborns

Pneumonia, if it occurs several hours after your baby is born, can lead to dangerous sepsis, an inflammatory reaction to an infection. It is a very serious condition that requires very professional medical care as septic shock and even death can occur.

Wystąpienie zapalenia płuc po siedmiu dniach od urodzenia (lub później), może mieć związek z długotrwałą intubacją maluszka, która jest konieczna w przypadku niektórych schorzeń płuc. Bakterie wywołujące chorobę przedostają się zazwyczaj do dziecka w trakcie porodu (z dróg rodnych kobiety) lub na skutek zakażenia szpitalnego. Do grupy ryzyka zalicza się wcześniaki, dzieci z niewydolnością oddechową, intubowane oraz leczone antybiotykami.

The first step in treating neonatal pneumonia is testing for sepsis. In addition, broad-spectrum antibiotics are given that not only treat sepsis but also pneumonia.

See: Nastolatki częściej rodzą wcześniaki

Pneumonia in an infant

The cause of pneumonia in an infant can be both a bacterial and a viral infection. The very course of the disease depends on the triggering factor and the child’s immunity. It is worth mentioning that the respiratory tract in infants is shorter, and its system is not fully functional yet. Thus, even the most common rhinitis can very quickly lead to bronchitis and even pneumonia.

Pneumonia in an infant depends on his age, immunity and the cause of the disease (bacteria, viruses). However, the most common occurrence is:

1. shortness of breath
2. runny nose,
3. cough
4. lack of appetite (reluctance to eat and drink),
5. high temperature or fever.

With pneumonia in an infant, antibiotic therapy is necessary. Often the disease ends in a hospital stay where an antibiotic is administered intravenously. Pneumonia caused by bacteria such as meningococcus and pneumococcus is especially dangerous. In the youngest babies, due to the underdeveloped immunity, pneumonia may end in sepsis, pneumococcal or meningococcal disease.

Read: Pneumococcus – a deadly threat

Pneumonia in a child

While most healthy children can fight infection using their natural defenses, children with a compromised immune system are at a higher risk of developing pneumonia. A baby’s immune system can be weakened by malnutrition or malnutrition, especially in non-breastfed infants.

Pre-existing illnesses, such as symptomatic HIV infection and measles, also increase a child’s risk of developing pneumonia.

The following environmental factors also make a child more susceptible to pneumonia:

1. zanieczyszczenie powietrza w pomieszczeniach spowodowane gotowaniem i ogrzewaniem paliwami z biomasy,
2. living in crowded houses
3. smoking by parents.

Pneumonia in children – prevention

Prevention of pneumonia in children is an essential part of a strategy to reduce child mortality. Vaccination against Hib, pneumococcus, measles and whooping cough (whooping cough) is the most effective way to prevent pneumonia.

Adequate nutrition is key to improving babies’ natural defenses, starting with exclusive breastfeeding through the first 6 months of life. In addition to effectively preventing pneumonia, it also helps to reduce the duration of the disease if a child becomes ill.

Addressing environmental factors such as indoor air pollution (for example by providing inexpensive, clean indoor stoves) and encouraging hygiene in crowded homes also reduces the number of children who get pneumonia.

In HIV-infected children, the antibiotic co-trimoxazole is given daily to reduce the risk of pneumonia.

Pneumonia – what are the indications for hospitalization?

O tym czy musimy zostać w szpitalu czy leczyć się w domu, w każdym przypadku decyduje lekarz na podstawie badań oraz radiogramu klatki piersiowej. Pacjent kierowany jest do szpitala w przypadku:

1. low blood pressure
2. lung abscess,
3. pleural empyema,
4. inflammatory changes affecting both sides of the lungs,
5. breathing problems (failure) which usually occur with widespread pneumonia
6. liver or kidney failure
7. disturbance of consciousness.

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Pneumonia – diagnosis

Pneumonia is diagnosed by a doctor based on the interview, clinical symptoms and the results of physical examination and changes found on the chest radiograph. The doctor may use the following tests to confirm the diagnosis:

1. Chest X-ray – the basic examination to diagnose pneumonia, assess its extent and the presence of certain complications is a chest radiograph,
2. badania krwi (morfologia, CRP)– wykonywane są w celu sprawdzenia, czy infekcja jest obecna i czy rozprzestrzeniła się do krwiobiegu. Gazometria krwi tętniczej sprawdza ilość tlenu we krwi,
3. blood culture – is a laboratory test to determine whether the bacteria causing the infection are colonizing the patient’s bloodstream. The purpose of the test is to confirm the infectious etiology, identify the etiological factor, and target antibiotic therapy,
4. bacteriological examination of sputum – this is a test aimed at detecting and demonstrating the presence of bacteria or fungi that cause lung and respiratory infections. Sputum is a thick fluid produced in the lungs and airways that
5. bronchoscopy – used for severe forms of pneumonia. It involves inserting a bronchoscope tube with a light and small camera through the nose or mouth, down the throat into the windpipe or windpipe, and into the bronchi and bronchioles of the lungs. This procedure is used to find the cause of a lung problem. It can detect lumps, signs of infection, excess mucus in the airways, bleeding or blockages in the lungs. It may also allow your doctor to take mucus or tissue samples for other laboratory tests.
6. Chest Computed Tomography – This imaging procedure uses a combination of X-rays and computer technology to produce sharp, detailed horizontal or axial images (often called slices) of the body. Computed tomography shows detailed images of any part of the body, including bones, muscles, fat, and organs. CT scans are more detailed than regular X-rays.

Compare the prices of such a study in selected locations on the clinic.pl website.

Pneumonia – prevention

Pneumonia can be very serious and even life-threatening. Vaccines can help prevent some types of pneumonia. Good hygiene (frequent hand washing), quitting smoking, and keeping your immune system strong by exercising regularly and eating healthy are other ways to reduce your risk of getting pneumonia.

A greater risk of lung disease occurs with AAT protein deficiency. You can order alpha1-antitrypsin level test from Medonet Market’s offer now.

Vaccinations – vaccines can help prevent pneumonia caused by pneumococcal bacteria or the flu virus. However, vaccines cannot prevent all cases of pneumonia. Compared to people who do not get vaccinated, people who are vaccinated and still get pneumonia tend to have:

1. mniej poważnych komplikacji,
2. milder infections,
3. pneumonia that is not long-term.

Vaccines against pneumococci – Two vaccines are available to prevent infections caused by pneumococcus, the most common type of bacteria that causes pneumonia. Pneumococcal vaccines are especially important for people at high risk of pneumonia, including:

1. adults aged 65 or older
2. dzieci do 2 lat,
3. people with chronic (ongoing) illnesses, serious long-term health problems or a weak immune system. This can include people with cancer, HIV, asthma, a damaged or removed spleen,
4. smokers.

Vaccine – annual flu vaccine can help to prevent pneumonia caused by flu. The flu vaccine is usually given from September to October, before the flu season starts.

Szczepionka przeciw Hib — Haemophilus influenzae type b (Hib) is a type of bacteria that can cause pneumonia and meningitis. The vaccine is often given to infants from 2 months of age.

Other ways to prevent pneumonia:

1. wash your hands frequently with soap and water and use alcohol-based disinfectants to kill germs.
2. do not smoke – smoking prevents the lungs from filtering out properly and defends the body against germs,
3. build your immunity – take care of your health and try to build your immunity. Take up physical activity, avoid stimulants, take care of your diet.

Read: How to build the body’s immunity in a child?

Pneumonia – complications

Zapalenie płuc jest chorobą, którą można skutecznie leczyć. Thanks to the prompt introduction of treatment, the disease does not progress and there are no serious health consequences.

Complications from pneumonia are more common in children, the elderly, and people with other serious medical conditions. May appear:

1. acute respiratory distress (ARDS) and respiratory failure are common complications of severe pneumonia,
2. uszkodzenie nerek, wątroby i serca , które ma miejsce, gdy narządy te nie otrzymują wystarczającej ilości tlenu do prawidłowego działania lub gdy układ odpornościowy reaguje negatywnie na infekcję,
3. necrotizing pneumonia, a condition that develops when the infection causes the lung tissue to die and the formation of lung abscesses (pockets of tissue filled with pus). It also makes it difficult to treat pneumonia. Surgery or drainage with a needle is used to remove pus,
4. zaburzenia opłucnej, czyli tkanki pokrywające zewnętrzną część płuc mogą ulec zapaleniu, a jama klatki piersiowej wokół płuc może zostać wypełniona płynem i ropą,
5. Sepsis, which occurs when bacteria from the lungs enter the bloodstream and cause inflammation throughout the body.

Read also: Sepsis in children – causes, symptoms, treatment

Pneumonia – treatment

Pneumonia is most often treated with an antibiotic, and what type it will be depends on the doctor. Antibiotics are usually taken by mouth (for home treatment), please inform your doctor about any drug allergies or side effects of antibiotic treatment before you are discharged. When it comes to hospital treatment, intravenous antibiotics are often required depending on the patient’s condition.

The antibiotic should be taken for about a week, in severe cases it may be up to 14 or 21 days (in case of infection with other bacteria or microorganisms).

Whether the antibiotic for pneumonia should be taken on an empty stomach or after a meal depends on the information provided in this leaflet.

As in any antibiotic therapy, also during pneumonia it is important to take preparations containing bacteria that complement the natural intestinal flora. As is well known, antibiotics destroy it. Here are some examples of preparations:

1. Laccid,
2. Proactive,
3. Linex,
4. Trilac.

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