Community Acquired Pneumonia


Written By Dr.Amol kumar Diwan

Introduction


Pneumonia is an inflammation of the lung tissue. It is usually due to infection. Pneumonia can be a serious life-threatening illness that needs medical attention. Pneumonia results from germs that cause an infection in the lungs. Many people with pneumonia are treated with prescription medication at home, but others require more intensive treatment and a hospital stay. You can help prevent pneumonia by receiving immunization and with frequent hand washing.

Anatomy


Your lungs are located in the rib cage inside of your chest. Your lungs expand and relax when you breathe. Your body has a natural defense system, your immune system, that protects your lungs from germs to keep them healthy and functioning optimally. Under illness or certain conditions, viral, bacterial, or fungal germs can infect the lungs, causing pneumonia.

Causes


Community-Acquired
  • Pneumococus(30-60%)
  • H.influenzae(10%)
  • Moraxella catarrhails
  • Staphylococcus aureus
  • Mycoplasma(10-30%)
  • Legionella(2-10%)
  • Chlamydophila(5-10%)
  • Gram negative bacteria
  • Viruses-influenzae,
  • HMPV, RSV, adenovirus
  • Unknown(40-50%)
Nosocomical
  • Gram -ve bacteria
  • Kiebsiella(4%)
  • Escherichia coli
  • Pseudomonas(5%)
  • MRSA
  • Polymicrobial(13%)
  • Unknown(33%)
Immunocompromised
  • Cytomegalovirus(CMV)
  • Pneumocystis jiroveci
  • Mycobacterium avium
  • Aspergillosis
  • Candidiasis
  • Others-listed elsewhere
Aspiration
  • Anaerobic oral flora-Bacteroides ,Prevotella,Fusobacterium, Peptostreptococcus
  • Aerobic-pneumococcus, staph, aureus,haemophilus influenzae, Pseudomonas aeruginosa
Viruses, bacteria, or fungi that infect the lungs cause pneumonia. The presence of these microorganisms creates a chain of events that result in an excess amount of fluid and inflammation in the lungs. The excess amount of fluid and inflammation makes it difficult to breathe.

Symptoms


Pneumonia can cause fever, coughing, sweating, and chills. It can cause shortness of breath, shallow breathing, fast breathing, and chest pain upon breathing. Other symptoms of pneumonia include headache, muscle ache, loss of appetite, and fatigue. You may cough up sputum that is green or yellow or contains blood. Infants with pneumonia may not cough but may make grunt-like noises.

Diagnosis


Your doctor can diagnose pneumonia by reviewing your medical history, conducting an exam, and evaluating test results. Your doctor will listen to your lungs with a stethoscope while you breathe. A chest X-ray is used to show the condition of the lungs. Blood tests and sputum cultures can help identify the cause of your pneumonia.

Treatment


Many people with pneumonia are treated with prescription medications at home. The type of medication that you receive depends on the cause of your pneumonia. For example, antibiotics are used to treat infections caused by bacteria, and antiviral medications are used for viral infections. People with severe symptoms, complications, or other medical illnesses may be hospitalized and treated with intravenous medications and oxygen.

Prevention


You should ask your doctor if you are a candidate for the pneumonia or flu vaccines that can help prevent certain strains of pneumonia. Wash your hands regularly with soap and water. Avoid touching your eyes and nose. Also, Cigarette smoke damages the lining of the airways and makes the lungs more prone to infection. So, stopping smoking will lessen your risk of developing lung infections.

Am I at Risk?


Adults over the age of 65 and very young children have an increased risk of pneumonia. Native Americans and Native Alaskans have an increased risk of pneumonia.

Other risk factors for pneumonia include:


  • Smoking and alcohol abuse
  • Certain diseases, such as heart disease, lung disease, diabetes, GERD, HIV/AIDS
  • Suppressed immune system from illness or immunosuppressant medications
  • Hospitalization, surgery, or traumatic injury
  • Exposure to toxic chemical fumes or pollution

Complications


Pneumonia can be a serious life-threatening condition that can lead to death. Complications of pneumonia include blood infection, fluid accumulation in the lungs, abscesses in the lung, and acute respiratory distress syndrome.

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