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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.

 Signs and symptoms:

They vary from mild to severe, depending on factors such as the type of germ causing the infection, and the age and overall health.

Mild signs and symptoms often are similar to those of a cold or flu, but they last longer, they may include:

  • Chest pain when you breathe
  • Confusion or changes in mental awareness (in adults age 65 and older)
  • Cough, which may produce phlegm
  • Fatigue, fever, sweating and shaking chills Lower than normal body temperature (in adults older than age 65 and people with weak immune systems), also nausea, vomiting or diarrhea & shortness of breath.
  • Newborns and infants may not show any sign of the infection. Or they may vomit, have a fever and cough, appear restless or tired and without energy, or have difficulty breathing and eating.

Causes:

Many germs can cause pneumonia. The most common are bacteria and viruses in the air we breathe.

The immunity system of the body usually prevents these germs from infecting the lungs. But sometimes these germs can overpower your immune system, even if the health is generally good.

Pneumonia is classified according to the types of germs that cause it and where patient got the infection:

Community-acquired pneumonia:

  • Community-acquired pneumonia is the most common type of pneumonia.
  • It occurs outside of hospitals or other health care facilities.
  • It may be caused by: Bacteria, Bacteria-like organisms, fungi, or Viruses, including COVID-19. As Some of the viruses that cause colds and the flu can cause pneumonia.
  • Viruses are the most common cause of pneumonia in children younger than 5 years.
  • Viral pneumonia is usually mild. But in some cases it can become very serious.
  • Coronavirus 2019 (COVID-19) may cause pneumonia, which can become severe.

Health care-acquired pneumonia:

  • It is a bacterial infection that occurs in people who live in long-term care facilities or who receive care in outpatient clinics, including kidney dialysis centers.
  • Like hospital-acquired pneumonia, health care-acquired pneumonia can be caused by bacteria that are more resistant to antibiotics.

Aspiration pneumonia:

  • It occurs when you inhale food, drink, vomit or saliva into your lungs.
  • Aspiration is more likely if something disturbs your normal gag reflex, such as a brain injury or swallowing problem, or excessive use of alcohol or drugs.

Who are at risk?

  • Smokers, as smoking damages your body's natural defenses against the bacteria and viruses that cause pneumonia.
  • Weakened or suppressed immune system; People who have HIV/AIDS, who've had an organ transplant, or who receive chemotherapy or long-term steroids are at risk.

Even with treatment, some people with pneumonia, especially those in high-risk groups, may experience complications,

Complications:

Bacteria in the bloodstream (bacteremia). Bacteria that enter the bloodstream from your lungs can spread the infection to other organs, potentially causing organ failure.

To help prevent pneumonia:

• Get vaccinated. Vaccines are available to prevent some types of pneumonia and the flu. Talk with the doctor about getting these shots. Make sure children get vaccinated. Doctors recommend a different pneumonia vaccine for children younger than age 2 and for children ages 2 to 5 years who are at particular risk of pneumococcal disease.

• Practice good hygiene. To protect yourself against respiratory infections that sometimes lead to pneumonia, wash your hands regularly or use an alcohol-based hand sanitizer.

• Don't smoke. Smoking damages your lungs' natural defenses against respiratory infections.

• Keep your immune system strong. Get enough sleep, exercise regularly and eat a healthy diet.

Pneumonia can be Diagnosed via:

Chest X-ray: This helps your doctor diagnose pneumonia and determine the extent and location of the infection, but it can't tell your doctor what kind of germ is causing the pneumonia. Doctors will ask about the medical history and doing a physical exam, including listening to your lungs with a stethoscope to check for abnormal bubbling or crackling sounds that suggest pneumonia. If pneumonia is suspected, your doctor may recommend the following tests:

Blood Tests are used to confirm an infection and to try to identify the type of organism causing the infection. However, precise identification isn't always possible. Pulse Oximetry: This measures the oxygen level in your blood. Pneumonia can prevent your lungs from moving enough oxygen into your bloodstream.

Sputum Test: A sample of fluid from your lungs (sputum) is taken after a deep cough and analyzed to help pinpoint the cause of the infection. Your doctor might order additional tests if you're older than age 65, are in the hospital, or have serious symptoms or health conditions. These may include:

CT Scan: If pneumonia isn't clearing as quickly as expected, your doctor may recommend a chest CT scan to obtain a more detailed image of your lungs.

Pleural Fluid Culture: A fluid sample is taken by putting a needle between your ribs from the pleural area and analyzed to help determine the type of infection.


Treatment:

It involves curing the infection and preventing complications.

People who have community-acquired pneumonia usually can be treated at home with medication.

Although most symptoms ease in a few days or weeks, the feeling of tiredness can persist for a month or more.

Specific treatments depend on the type and severity of your pneumonia, patient’s age and overall health. The options include:

Antibiotics: These medicines are used to treat bacterial pneumonia. It may take time to identify the type of bacteria causing your pneumonia and to choose the best antibiotic to treat it. If your symptoms don't improve, your doctor may recommend a different antibiotic.

Cough Medicine: This medicine may be used to calm your cough so that you can rest. Because coughing helps loosen and move fluid from your lungs, it's a good idea not to eliminate your cough completely. In addition, you should know that very few studies have looked at whether over-the-counter cough medicines lessen coughing caused by pneumonia. If you want to try a cough suppressant, use the lowest dose that helps you rest.

Fever reducers/pain relievers: You may take these as needed for fever and discomfort. These include drugs such as aspirin, ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others).

Hospitalization

Patient may need to be hospitalized if older than age 65, reached to a point when they are confused about time, people or places, kidney function has declined the systolic blood pressure is below 90 millimeters of mercury (mm Hg) or the diastolic blood pressure is 60 mm Hg or below, or/ & if breathing is rapid (30 breaths or more a minute) as patient will need breathing assistance & when/if temperature is below normal, heart rate is below 50 or above 100 You may be admitted to the intensive care unit if you need to be placed on a breathing machine (ventilator) or if your symptoms are severe.

These tips can help you recover more quickly and decrease your risk of complications:

  • Get plenty of rest. Don't go back to school or work until after your temperature returns to normal and you stop coughing up mucus.
  • Even when you start to feel better, be careful not to overdo it. Because pneumonia can recur, it's better not to jump back into your routine until you are fully recovered. Ask your doctor if not sure.
  • Stay hydrated. Drink plenty of fluids, especially water, to help loosen mucus in your lungs.
  • Take your medicine as prescribed. Take the entire course of any medications your doctor prescribed for you. If you stop taking medication too soon, your lungs may continue to harbor bacteria that can multiply and cause your pneumonia to recur.

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