Pneumonia: Are There Multiple Types?
What is pneumonia?
Pneumonia is an acute lung infection that causes inflammation of the air sacs in either one or both lungs. The air sacs get filled with fluid or pus, making it difficult for the affected person to properly breathe. Individuals who have contracted the infection usually cough and expel phlegm or mucus, have fever, and have breathing problems. There are a lot of factors that can cause pneumonia. They include bacteria, viruses, fungi, etc. Pneumonia can be mild or fatal. It is mostly serious in infants, small children, older adults, and people with underlying health issues or those who have a weak immune system.
What are the symptoms of pneumonia?
The signs and symptoms of pneumonia will depend on the severity of the infection, the type of pneumonia, and the age and overall health status of the affected person. The mild symptoms of pneumonia are very similar to that of a cold or flu, but they will remain for a longer period of time.
The common signs and symptoms of pneumonia are:
- Pain in the chest while breathing or coughing
- Confusion and certain changes in mental awareness (common in older adults)
- Coughing up mucus or phlegm
- Tiredness
- Fever
- Chills
- Low body temperature (in the case of older adults above 65 years and patients with a weak immune system)
- Nausea
- Vomiting
- Diarrhea
- Difficulty in breathing
In infants, at times, there may be no visible signs and symptoms, so pneumonia becomes very difficult to diagnose in the early stages. Some of the signs and symptoms that infants may have are:
- Vomiting
- Fever
- Cough
- Restlessness
- Low energy levels
- Fatigue
- Breathing problems
- Lack of appetite
When should you consult a doctor?
It would be best if pneumonia is diagnosed during its early stage so that the infection can be promptly treated. One must consult the doctor if he or she is having a difficulty in breathing or shortness of breath, chest pain, a continuous fever of 102 degrees Fahrenheit or more, and continuous coughing, particularly, if one's cough is accompanied by phlegm.
Moreover, it is essential for people who are at a higher risk of contracting the infection to seek medical attention. The individuals who are more prone to acquiring pneumonia are:
- Older adults above 65 years
- Babies below 2 years old
- People with underlying health problems or those who have a weak immune system
- Patients who are undergoing chemotherapy or some specific treatments that can significantly weaken the immune system
Pneumonia can become fatal in very young children, older adults, individuals with heart problems, and those who have chronic lung disorders.
What causes pneumonia?
Pneumonia can be caused by germs, the most common being bacteria and viruses that are present in the air we inhale. In most cases, the body will produce white blood cells (WBCs) to fight off these germs, inhibiting them to cause any infection to the lungs. However, there are times when the germs overpower the body's immune system, which can also happen to healthy individuals.
What are the types of pneumonia?
1) By the location where the infection was acquired
There are two types of pneumonia according to the location where it was acquired:
- Hospital-acquired pneumonia (HAP) - develops about 48 hours after being admitted to the hospital. The most common causes of HAP include Streptococcus pneumoniae, gram-negative bacilli, and Staphylococcus aureus. Since this type of infection is acquired in the hospital, the antibiotic-resistant organisms are an important factor to be kept in mind. Patients may develop pneumonia as a complication or a secondary disease, thereby making the prognosis often poor.
- Community-acquired pneumonia (CAP) - this type of acquired pneumonia develops on people with little or no hospital exposure at all. The most common causative organisms responsible for this type of pneumonia are Streptococcus pneumoniae, Legionella pneumophila, Haemophilus influenzae, Mycoplasma pneumoniae, and Chlamydia pneumoniae. Community-acquired pneumonia is a type of primary pneumonia often affecting the healthy population. Therefore, it has a better prognosis. However, it can still be fatal in young babies and children, as well as the elderly and sickly patients.
2) Classification based on the area of lung affected
Based on morphological grounds, two patterns of pneumonia are recognized. They are:
- Lobar pneumonia - this type of pneumonia affects a large confluent area of the lung and sometimes the entire lobe. However, the bronchi are not involved.
- Bronchopneumonia - In bronchopneumonia, the bronchi (air tubes) are involved. This type of pneumonia gives a patchy involvement of the lung.
3) Classification based on the cause of pneumonia
Based on the cause of pneumonia, there are six major types:
- Viral pneumonia
- Bacterial pneumonia
- Fungal pneumonia
- Mycoplasma pneumonia
- Pneumonia in immunocompromised people
- Aspiration pneumonia
Out of all of the above causes of pneumonia, bacterial pneumonia is the most common cause of pneumonia in adults above the age of 30. In all age groups, Streptococcus pneumoniae is the usual causative organism.
4) Classification based on the duration of the illness
Pneumonia can be classified into acute and chronic depending on the duration of the illness.
- Acute pneumonia - happens when the infection only lasts for less than three weeks.
- Chronic pneumonia - is when the illness persists for more than three weeks.
Acute pneumonia can be further classified into acute bronchopneumonia, atypical pneumonia, and aspiration pneumonia.
What are the risk factors?
Pneumonia is a lung infection that can affect anybody of any age, whether they are healthy or unhealthy. However, there are two particular age groups who are more susceptible to pneumonia. They include:
- Babies who are below two years old
- Older adults who are above 65 years
Some of the other risk factors are:
- Hospitalization: A person is more at risk of getting infected if he or she is in a hospital, especially in the intensive care unit and using a ventilator as a breathing aid.
- Chronic diseases: People who have chronic ailments such as asthma and heart or lung problems are at an increased risk of contracting the infection.
- Smoking: Due to smoking, the natural defenses of the body get damaged, and are not able to function properly.
- Weak immune system: People who have HIV and AIDS, those who have had an organ transplant, those undergoing chemotherapy or radiation, and those who are taking steroids for a prolonged period of time tend to have a weak immune system, making them even more susceptible to pneumonia.
How is pneumonia diagnosed?
In your doctor's appointment, the doctor will take your medical history and perform a physical examination. The doctor will listen to the sound of your lungs using a stethoscope to check if there are any unusual bubbling sounds, which could indicate pneumonia.
If the doctor suspects that you are suffering from pneumonia, the following tests may be requested:
- Blood test: This is useful to confirm if there is an infection going on and also to determine the specific type of organism that is causing the infection.
- Chest X-ray: This will help the doctor know the severity and the exact location of the lung infection.
- Pulse oximetry: To check the oxygen levels in the blood.
- Sputum test or culture: Needs a sample of your sputum for laboratory testing, and is usually requested for a more specific detection of the organism responsible for the infection.
The doctor may recommend additional tests for patients who are above 65 years old, those who are hospitalized, or those who have some serious health problems.
What are the treatment options?
Patients who are suffering from community-acquired pneumonia can be treated at home with rest and medications prescribed by the doctor. The symptoms are usually reduced in a couple of days or weeks. However, weakness can remain for almost a month.
Based on the type and the severity of pneumonia, specific treatment options can be recommended. The treatment plan will also depend on the age and the overall health status of the patient. Some of the treatment options are as follows:
- Antibiotics: These are medicine prescribed for treating bacterial pneumonia. The identification of the type of bacteria that is causing the infection may take some time. Hence, the doctor will initially prescribe an antibiotic, and if there is no improvement in the symptoms, the doctor will suggest switching to another type of antibiotic.
- Cough Medicine: Patients can be given cough medicine to relieve them from too much coughing and to help them take some rest. Coughing is good for losing and moving the fluids in the lungs. Therefore, coughing should not be completely eliminated.
- Fever reducers and painkillers: A patient can take these medications as needed depending on the severity of the infection. Doctors usually prescribe these medications alongside with antibiotics.
