pneumonia

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Community acquired pneumonias depends on the clinical presentation and are divided into two major types: chronic and acute.

Streptococcus pneumonia is the major cause of community acquired pneumonias.

Hospital acquired pneumonias (HAPs) on the other hand are caused by different microorganisms and encompasses pneumonias that are contracted by patients in an hospital approximately 48–72 hours after being admitted.

Ventilator-associated pneumonia (VAP) is a sub-type of (HAPs) which occurs in patients’ who are receiving mechanical ventilations.

Healthcare-associated pneumonia is a condition affecting people who come from the community but have frequent visits to healthcare environment.

Etiology on the Categories of Pneumonia

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Microorganisms such as bacteria or viruses enter the lower respiratory tract.

During sleep time, 45% of individuals aspirate oropharyngeal secretions to the lower respiratory tract but pneumonia does not develop due pulmonary system defense mechanisms.

The commonest routes of infection leading to pneumonia are aspiration and inhalation.

If bacteria are the causative agent, the first symptom is the outpouring of edema fluid which is rapidly followed by the appearance of polymorphonuclear leukocytes which are actively engaged in active phagocytosis of the bacteria after which fibrin is deposited in the inflamed region.

If the causative agent is viral on the other hand, the virus first localizes in the respiratory epithelial cells causing destruction of the mucosal surface and cilia hence leading to the loss of the muco-ciliary function.

Pathophysiology

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Chest pain during breathing or coughing

Cough, which may produce phlegm

Sweating, fever and shaking chills

Nausea, vomiting or diarrhea

Shortness of breath

Changes in mental awareness or confusion - in adults age 65 and older.

Lower than normal body temperature - in adults age 65 and older.

Symptoms of Pneumonia

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Being hospitalized

Smoking

Suppressed or weakened immune systems

Having chronic diseases such as; chronic obstructive pulmonary disease (COPD), asthma or heart disease.

Children who are younger than 2 years

Individuals who are age 65 or older

Risk Factors

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To diagnose pneumonia, a doctor;

Reviews a patient’s medical history

Performs a physical exam

Orders relevant diagnostic tests

A chest X-ray is the commonest test for detecting pneumonia.

Diagnostic Tests

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Prevention encompasses:

Getting vaccinated.

Practicing good hygiene to prevent against respiratory diseases.

Maintaining a healthy immune system by getting enough sleep and exercising regularly.

Treatment entails:

Administering drug whereby the antibiotic therapy is pathogen specific.

Administering supportive therapies such as percussion, postural drainage as well as assisted coughing techniques.

Prevention and Treatment

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Breitling, L. P., Saum, K. U., Schöttker, B., Holleczek, B., Herth, F. J., & Brenner, H. (2016). Pneumonia in the Noninstitutionalized Older Population: A prospective Observational Study Over 11 years. Deutsches Ärzteblatt International, 113(37), 607.

Hillegass, E. (2016). Essentials of Cardiopulmonary Physical Therapy. Elsevier Health Sciences.

Wang, Q., Mi, G., Hickey, D., Li, Y., Tu, J., Webster, T. J., & Shen, Y. (2018). Azithromycin-loaded Respirable Microparticles For Targeted Pulmonary Delivery For The Treatment Of Pneumonia. Biomaterials, 160, 107-123.

References

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