Pneumonia

Pneumonia is an inflammation of the lungs, making it difficult to breathe. As the lungs fill with fluid, oxygen has more and more trouble reaching your blood and a whole series of events may occur that can eventually kill.

Until 1936, according to the American Lung Association, pneumonia was the number 1 killer in the United States. Since then antibiotics have had a major impact, but the disease still takes its toll.

Causes

There isn't just one cause of pneumonia. In fact, it can have over 30 causes, according to the American Lung Association. (Read about "Microorganisms") There are five that result in the vast majority of the cases:

• Viruses
• Bacteria
• Mycoplasmas
• Other infectious organisms such as fungi
• Foreign bodies and/or chemical agents

Each cause has its own symptoms and onset characteristics.

Viruses

Fifty percent of pneumonia cases are the result of viral infections. Viral pneumonia tends to be less severe then other forms but it can still cause serious illness and death, especially if it is caused by the flu virus. (Read about "Influenza") The National Institute on Aging (NIA) says this is especially true for seniors. The first signs of a viral pneumonia are the same as for the flu. These include fever, a dry cough, headache, muscle pain and weakness. Within the next day or so there is increased difficulty breathing, the cough gets worse and there is some mucus production. A high fever and, as in many cases of pneumonia, a blueness of the lips from the lack of oxygen may develop. There are no specific treatments for viral infections, which usually clear up on their own. Treatment is usually what is called supportive. It includes supplemental oxygen for hypoxia (low levels of oxygen in the blood), intravenous fluids for dehydration (Read about "Dehydration") and nebulized bronchodilators to help open the passages in the lungs.

Bacteria

The second biggest cause is bacteria. The National Foundation for Infectious Diseases says this type of pneumonia can attack anyone of any age; however, the most susceptible are people who already have other health issues. Alcoholics, post operative patients, and people who already have respiratory disease or other infections stand the greatest risk. (Read about "Chronic Obstructive Pulmonary Disease" "Cystic Fibrosis") It's estimated by the U.S. Centers for Disease Control and Prevention that up to 40,000 people die each year from bacterial pneumonia.

The onset of bacterial pneumonia can be either sudden or gradual. In the most severe cases there are chills that result in shaking and chattering teeth. There can be a cough with green to rust colored mucus along with severe chest pain. A patient's temperature can rise to 105 degrees with sweating (Read about "Sweating"), rapid breathing and increasing pulse rate. Lips and nails can turn blue from the lack of oxygen, which can also make the person confused or delirious.

Pneumococcal pneumonia is caused by a bacterium called Streptococcus pneumoniae. This is the most common bacterium that causes pneumonia. The National Foundation for Infectious Diseases says the good news is that there is a vaccine available for it. People, whose immune system (Read about "The Immune System") has been compromised in any way, may want to talk with their doctor about getting the vaccine. One shot provides all the protection needed, though a booster shot is sometimes recommended for those over 65 who had the shot more than 5 years earlier, according to NIA. Children should be vaccinated in early childhood, according to the Centers for Disease Control and Prevention (CDC). As always, talk with your doctor about your particular situation and understand any of the possible side effects.

Another bacterium, Legionella pneumophila, causes legionellosis. The more severe form of this infection, which includes pneumonia, is Legionnaires' disease. Pontiac fever is a milder illness. (Read about "Legionnaires' Disease & Pontiac Fever") Legionnaires' disease acquired its name in 1976 when an outbreak of pneumonia occurred among persons attending a convention of the American Legion in Philadelphia. CDC says an estimated 8,000 to 18,000 people get Legionnaires' disease in the United States each year. Some people can be infected with the Legionella bacterium and have mild symptoms or no illness at all. When outbreaks do occur, they are usually recognized in the summer and early fall, but cases may occur year-round. About 5 to 30 percent of people who have Legionnaires' disease die.

Staphylococcus aureus or "staph" (Read about "Staph and MRSA") can also cause pneumonia. Most cases of pneumonia caused by staph occur in people who have compromised immune systems (Read about "The Immune System"), are or have been recently hospitalized, or are residents of nursing homes or other chronic care facilities.

Mycoplasma

Neither viral nor bacterial, mycoplasmas are something in between with characteristics of both. The American Lung Association says they can cause what is generally a mild and widespread case of pneumonia. They usually attack older children or young adults. This is also sometimes called "walking" pneumonia. The death rate is low even when left untreated.

The most prominent sign is a cough that comes in violent attacks but produces only a small amount of white mucus. Chills and a fever can be early symptoms and may be followed by nausea and vomiting. Antibiotics, such as erythromycin, azithromycin and clarithromycin (Read about "Antibiotics"), may be used to treat mycoplasma pneumonia.

Other infectious organisms

The first sign for many AIDS patients (Read about "HIV / AIDS") is pneumonia caused by the pneumocystis carinii organism. It is believed to be a fungus. Once again, it is people with weakened immune systems that are most at danger. Treatments also tend to address the other problems, not just the pneumonia.

Foreign bodies and other agents

Any blockage or damage to the lungs can result in pneumonitis, which by its definition, is an inflammation of the lungs. More and more cases are showing up, according to the American Lung Association as the result of environmental causes including chemicals. (Read about "Occupational Respiratory Disease")

Who's at risk

The American Lung Association says people who are at risk of pneumonia should ask their doctor about a vaccine. Among the conditions that put someone in a high risk category are:

• having chronic lung disease (Read about "Chronic Obstructive Pulmonary Disease")
• having heart disease (Read about "Coronary Heart Disease")
• being diabetic (Read about "Diabetes")
• having kidney disorders (Read about "Kidney Disease")
• being in a nursing home
• recovering from a serious illness
• being over the age of 65

Treatment

Pneumonia can be diagnosed by a physical exam and/or a chest x-ray. (Read about "X-rays") Pneumonia can be treated but the earlier treatment starts the better. Treatment depends on the cause of the pneumonia. If the cause is bacteria or mycoplasmas, antibiotics (Read about "Antibiotics") can be used. If it is viral, supportive therapies such as rest, fluids and oxygen may be used. Antifungal medication can be used if the cause is a fungus. Medications to reduce symptoms, such as cough or fever, may also be used. Relapses are far more serious than the initial attack. Some types of pneumonia can increase the risk of pneumothorax, a condition that can lead to collapsed lung. (Read about "Pneumothorax") Pneumonia can also lead to acute respiratory distress syndrome (ARDS), an inflammatory lung condition that can cause sudden respiratory failure. (Read about "Acute Respiratory Distress Syndrome") It's important to see your doctor if symptoms of respiratory problems last more then a few days. It's also important to follow your treatment plan exactly.

Related Information:

    Primary Immunodeficiency

    Respiratory System

    Medicine Safety

    Seniors and Flu

    Glossary of Respiratory Terms