What is Pneumonia?
Pneumonia is lung inflammation caused by bacterial, fungal, or viral infection. Pneumonia causes the lung tissue to swell (inflammation) and causes pus or fluid in the lungs. Pneumonia can affect one or both lungs. If it affects both the lungs it is called bilateral or double pneumonia.
Difference Between Bacterial and Viral Pneumonia
While pneumonia is caused by an infection in the lungs, one can experience different symptoms depending on whether the root cause is fungi, bacteria, or viruses. Bacterial pneumonia is not only more common than viral pneumonia. While bacterial pneumonia is treated with antibiotics, viral pneumonia is more likely to resolve independently.
Types of Pneumonia
Pneumonia can be categorised into types based on what caused it and whether one acquires it-hospital acquired community-acquired or ventilator-associated pneumonia.
1. Community-Acquired Pneumonia (CAP)
When an individual acquires pneumonia outside a healthcare facility, it’s referred to as community-acquired pneumonia.
Bacteria: Infection caused by Streptococcus pneumoniae bacteria is called pneumococcal disease. It is the most common cause of community-acquired pneumonia.
Bacteria-like organisms: Mycoplasma pneumoniae can also be a causative factor of pneumonia. The symptoms are milder than other types of pneumonia.
Viruses: Viruses that cause COVID-19, the flu (influenza), the common cold, and respiratory syncytial virus (RSV) can also lead to pneumonia. Virus is the most common cause of pneumonia in children younger than the age of five.
Fungi: Fungi such as Coccidioides, Pneumocystis jirovecii, and Cryptococcus are some of the lesser-known causes of pneumonia. People with compromised immunity are at a greater risk of pneumonia from fungus.
Protozoa: In rare cases, protozoa like toxoplasma can also cause pneumonia.
2. Hospital Acquired Pneumonia (HAP)
An individual can get hospital-acquired pneumonia when treated in a healthcare facility or a hospital for illness. Hospital-acquired pneumonia is usually more serious than community-acquired pneumonia and is most commonly caused by antibiotic-resistant bacteria.
3. Ventilator-Associated Pneumonia (VAP)
If an individual is on a breathing machine or respirator (often used in intensive care units), they are at risk of ventilator associated pneumonia.
Pneumonia Causes
Pneumonia develops when the body’s immune system attacks an infection in the small sacs (alveoli) of the lungs. This causes inflammation and leakage of fluids in the lungs. Bacteria are the most common cause of pneumonia in adults and viruses are the most common causes of pneumonia in school-going children.
1. Viral Pneumonia Causes
Common cold (rhinovirus)
The flu (influenza virus)
COVID-19
Human metapneumovirus (HMPV)
Human parainfluenza virus (HPIV)
Respiratory syncytial virus (RSV)
Measles virus
Adenovirus
The whooping cough virus
2. Bacterial Pneumonia Causes
3. Fungal Pneumonia Causes
Pneumonia Symptoms
Pneumonia symptoms vary from mild to severe. How an individual responds to pneumonia depends on the causes, age, and overall health.
1. Bacterial Pneumonia Symptoms
Cough (green, yellow, or bloody mucus)
Fever, heavy sweating, and chills
Shortness of breath
Rapid breathing
Sharp chest pain
Loss of appetite
Fatigue or extreme tiredness
Nausea and vomiting (more common in children)
2. Viral Pneumonia Symptoms
Headache
Muscle pain
Worsening of cough
Weakness
Shortness of breath
Pneumonia Diagnosis
Diagnosis of pneumonia is usually based on recent health history (such as travel exposures, a cold, or surgery) and the extent of the illness. The following tests may be used to confirm the pneumonia diagnosis:
1. Chest X-ray
This X-ray takes pictures of internal tissues, organs including the lungs and bones.
2. Chest CT scan
This scan uses computer technology and X-rays to produce detailed axial or horizontal images of the body.
3. Blood tests
This test detects if the infection is present and if it has spread into the bloodstream.
4. Bronchoscopy
This is a direct examination of the bronchi (main airways of the lungs) using a flexible tube called a bronchoscope.
5. Pleural fluid culture
In this test, a fluid sample is taken from the pleural space (the space between the chest wall and the lungs). It is then tested for pneumonia-causing bacteria.
Management & Pneumonia Treatment
Pneumonia treatment depends on its cause- viral, bacterial, or fungal and the severity of the case. Treatment options for pneumonia include:
1. Supportive treatment with:
Antipyretics
Anti Allergens
Bronchodilator
IV fluids
Oxygen therapy
2. Antibiotics: Antibiotics treat bacterial pneumonia.
3. Antivirals: Viral pneumonia usually goes away on its own. If not, a doctor may prescribe antiviral medications to lessen the severity and shorten the duration of the illness.
4. Antifungals: Antifungal medication can treat pneumonia caused by a fungal infection.
Pneumonia Risk Factors
Pneumonia can affect people of all ages. However, two age groups that are at a greater risk of pneumonia are:
Other risk factors include:
1. Being hospitalised
An individual is at a greater risk of pneumonia if they are in a hospital intensive care unit, especially a respirator or a ventilator.
2. Chronic diseases
An individual is more likely to get pneumonia if they have heart disease, asthma, or obstructive pulmonary disease (COPD).
3. Smoking
Smoking damages the body’s immunity and defence against viruses and bacteria that cause pneumonia.
4. Suppressed or weakened immune system
People with a weakened immune system such as those with HIV/AIDS, those who have previously undergone an organ transplant or are on chemotherapy or long-term steroids are at a greater risk.
Also read: Long-term Effects of Pneumonia on Children's Lungs
Complications of Pneumonia
A majority of people with pneumonia respond well to treatment. However, complications are likely to occur in case of an older adult, a very young child, or if an individual has a suppressed immune system, or a serious medical issue like diabetes. The complications may include:
Acute respiratory distress syndrome (ARDS): A severe form of respiratory failure.
Lung abscesses: Pockets of pus that form in or around the lung.
Sepsis: A condition when the infection spreads into the blood, leading to organ failure.
Who Should Get Vaccinated?
People who are more prone to respiratory tract infections must consider influenza vaccine on a yearly basis and in case of immunocompromised individuals, pneumococcal vaccines must be considered.
When to See a Doctor?
If you think you or your child has symptoms of pneumonia, seek medical care at the best pneumonia treatment hospital in Gurgaon before the symptoms worsen. See a doctor immediately, if you experience difficulty breathing, develop a bluish colour in the fingertips or lips, have a high fever, chest pain, or have a severe cough with mucus.
FAQs
1. What are the stages of pneumonia?
The stages of pneumonia are congestion, red hepatisation, grey hepatisation, and resolution.
2. What are the most common symptoms of pneumonia?
Some of the typical symptoms of pneumonia include:
Cough with mucus
Shortness of breath
High fever or chills
Rapid breathing
Chest pain
3. How serious is pneumonia?
Pneumonia can range from mild to life-threatening. Complications for pneumonia include lung abscess, sepsis, and respiratory failure.
4. How long does pneumonia last?
The time it takes to recover from pneumonia depends on the type of pneumonia and an individual’s overall health. Some people can return to their normal routine in one to two weeks. For some others, it may take a month or longer.
Article By Dr. Seema Dhir
Sr. Consultant, Internal Medicine
Artemis Hospitals