Pneumonia

"Older people or those who consume alcohol are more at risk in this pathology".

DR. ANA BELÉN ALCAIDE OCAÑA
SPECIALIST. PNEUMOLOGY DEPARTMENT

Pneumonia is a lung infection that can be caused by multiple microorganisms (bacteria, viruses and fungi).

Pneumonias are classified according to whether they are acquired in a person's day-to-day life (community-acquired pneumonia) or in a healthcare facility (hospital-acquired pneumonia).

Anyone can suffer from pneumonia, and there are many factors that make a person more susceptible to infection by some microorganisms or others. For example, in healthy people, the most common pneumonia is caused by a bacterium called pneumococcus (Streptococcus Pneumoniae). On the other hand, in people admitted to hospital centers, other bacteria that are not very common in the community are more frequent.

In developed countries it is the sixth cause of death. There are approximately 7 to 15 cases per 1,000 people per year.

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What are the symptoms of pneumonia?

The symptoms of pneumonias are variable, without always being related to the type of germ causing the pneumonia. Some cases present with what is called a "typical pneumonia", which consists of the appearance in several hours or 2-3 days of cough with purulent or rusty expectoration, sometimes with blood, chest pain and fever with chills.

Other pneumonias, called "atypical" produce more gradual symptoms with tenths of a fever, general malaise, muscle and joint aches, tiredness and headache. The cough is dry, without expectoration, and the chest pain is less intense. Some patients may have mild digestive symptoms such as nausea, vomiting and diarrhea.

If the pneumonia is extensive or there is previous lung or heart disease, respiratory distress may occur. In addition, if the germs pass into the bloodstream they produce a bacteremia that can lead to "septic shock.

In elderly people the presentation may have less noticeable initial symptoms with low or absent fever, low cough and behavioral disturbance.

The most common symptoms are:

  • Cough with purulent expectoration.
  • Chest pain.
  • Fever with chills.

Do you have any of these symptoms?

You may have pneumonia

What are the causes of pneumonia?

Pneumonias occur when an infectious germ invades the lung tissue.

The most frequent mechanism is the aspiration of microorganisms from the upper respiratory tract. The body's defenses can be weakened by certain circumstances such as smoking, chronic lung disease, alcoholism, malnutrition, etc. and thus facilitate that these germs reach the lung and produce infections.

Other microorganisms reach the lung from the inspired air, as occurs in pneumonias caused by Mycoplasma pneumoniae, Chlamydia pneumoniae, Chlamydia psitacii , Coxiella burnetti (Q fever), Legionella pneumophila or virus.

Finally, some germs can come from another region of the body (bile ducts, urinary system, heart valves, etc.) and reach the lung through the blood circulation.

Pneumonias acquired in hospitals, also called intrahospital or nosocomial, are usually more severe and have different characteristics.

How can it be prevented?

There are few measures to prevent the onset of pneumonia. Since many of them start after a viral or flu-like process, annual flu vaccination is recommended for all those at greatest risk (over 65 years old, chronic bronchial or pulmonary diseases, chronic renal, cardiac or liver diseases).

Likewise, vaccination with anti-pneumococcal vaccine prevents the appearance of pneumonias with bacteremia caused by pneumococcus. Its use is recommended in persons over 65 years of age or over 2 years of age with chronic cardiovascular or pulmonary disease, alcoholism, chronic liver disease, absence of spleen due to surgery or trauma, or loss of cerebrospinal fluid, as well as persons with immunodeficiencies, generalized cancer, chronic renal failure or those who have received a transplant.

People who suffer from asthma, chronic bronchitis or bronchiectasis should start antibiotic treatment early when symptoms of respiratory infection appear, as prescribed by a physician.

How is pneumonia diagnosed?

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The diagnosis of pneumonia usually requires a chest x-ray. A physical examination is also necessary, and once the diagnosis is established, other tests are usually needed to see the type of germs and the type of severity.

After the diagnosis, treatment should be started as soon as possible.

In the mildest cases, hospital admission is not necessary, but in more severe cases, either because of the condition of the patient who has it or the severity of the pneumonia or even the social situation, hospital admission may be necessary.

How is pneumonia treated?

The treatment of bacterial pneumonias is based on antibiotic drugs. There is a very important diversity of antibiotics and the decision of the type of antibiotic depends on the suspected germ, the severity of the pneumonia and the characteristics of the patient.

In most cases, it is not necessary to look for the germ that causes it, unless it is a serious pneumonia or it does not respond to treatment. In these cases, it may be necessary to perform diagnostic techniques such as respiratory or blood culture, bronchoscopy, serology or lung puncture.

If there are serious factors, you should be admitted to the hospital and begin intravenous treatment with antibiotics and other medications that may be required.

The severity of a pneumonia depends on the extent of the lung that is affected, the type of germ that causes it and the age and diseases that are already present.

Most pneumonias in healthy people if not extensive are cured with oral antibiotic treatment, without the need for hospital admission. Thus, in this group only 3 to 10% require admission.

However, if there are other diseases added, pleural effusion, is extensive or has not responded to a correct initial treatment requires admission to a hospital for treatment.

Severe cases may require intubation and connection to a ventilator and admission to an intensive care unit.

Where do we treat it?

IN NAVARRA AND MADRID

The Department of Pneumology
of the Clínica Universidad de Navarra

Specializing in smoking and tobacco-related diseases, the Department has over 15 years of experience in smoking cessation and lung cancer early detection programs.

The department's specialists have received training at leading centers around the world, including centers in the United States, and have extensive experience in the diagnosis and treatment of all respiratory diseases, both common and rare.

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