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Pneumonia

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Pneumonia

What is pneumonia?

Pneumonia is an infection or inflammation in the lung tissue. Despite all the advances in medicine, pneumonia is still a common disease in Ireland, accounting for approximately 5% of deaths in this country. The most 'at risk' groups of people from the disease are older people and young children.

It can be caused by a variety of different microorganisms such as bacteria, viruses, fungi, parasites or by corrosive chemicals breathed into the stomach or the inhalation of toxic gases.

How is it contracted?

Pneumonia is usually contracted by breathing in the microorganisms which cause the infection. In more rare cases, pneumonia can be caused by breathing in the contents of your stomach after vomiting. This causes chemical pneumonia and can result in the microorganisms passing into the lungs.

Sometimes pneumonia can occur as a result of infection in other parts of the body. Microorganisms from the infected site can be carried via the bloodstream and into the lungs where they remain and trigger off pneumonia. However, this method of contracting the infection remains relatively rare.

What are the symptoms?

Pneumonia has a number of very definite symptoms, none of which should be ignored, as it is very important to seek medical advice as soon as possible. The symptoms include:

  • Classic pneumonia starts off suddenly with shivering fits, fever, pains in the chest and coughing. These first signs may look like a bad cold or flu, but it is the rapid progression of the infection that distinguishes it from a cold or flu.
  • The cough which is present is dry at first, but within a day or two the patient begins to cough up phlegm which may be yellow, bloodstained or rust-coloured.
  • Breathing becomes very laboured and is usually fast and shallow. The patient may be gasping for air, and may turn bluish around the lips and nails as they try to breathe.
  • Older people may become acutely confused.
  • There may be pain when breathing deeply or when trying to cough. This may signify that the inflammation has spread to the membranes which cover the lungs (pleuritis or pleurisy).
  • As the infection begins to progress, there may be a serious outbreak of cold sores (herpes simplex) around the mouth. This signifies that the immune system is breaking down and is no longer able to defend the body against infection.

Who are in the 'at risk' categories?

As we have stated, the most 'at risk' categories for the development of pneumonia are older people and young children. However, there are other groups of people who fall into the 'at risk' category as well, and they include:

  • Smokers, particularly those who have developed chronic bronchitis or emphysema.
  • Those who have a weak immune system, eg. HIV infected patients.
  • Adults or children who are suffering from chronic illness, especially those with heart conditions, asthma or diabetes.
  • People who have had their spleen removed.
  • Alcoholics, whose immune system will have been weakened over the years as a result of the abuse of alcohol and poor nutrition.

How is it diagnosed?

If pneumonia is suspected, your GP will examine your chest using a stethoscope to listen for unusual sounds such as a harsh creaking noise when breathing. It may be necessary to have lung x-rays taken to ascertain the seriousness of the condition. If severe pneumonia is present, admission to hospital is almost certain.

How is pneumonia treated?

Depending on the strain of pneumonia identified, and the underlying cause for it, there are a number of treatments available. If the pneumonia is believed to be due to a bacterial infection, antibiotics will be given. It is important to take the antibiotics as prescribed, and always finish the course. Other treatments may be offered, depending on symptoms. If there is wheeze or shortness of breath, inhalers or tablets may be prescribed to treat the inflammation that is causing these symptoms. Paracetamol, taken regularly in the recommended doses, is helpful in treating the fever and the muscle pains and aches.

Can pneumonia be prevented?

The best approach to preventing lung diseases such as pneumonia is not to smoke cigarettes. If you don’t smoke, don’t start. If you already smoke, you should seriously think about stopping. Your GP or pharmacist can advise you about smoking cessation programmes.

There are no effective means of preventing pneumonia caused by many bacteria or viruses. However, there is a vaccination available for one common bacterial cause, the pneumococcal bacteria. All those who are in the 'at risk' category are advised to discuss this vaccination with their GP. This assists in the prevention of pneumonia and is well worth investigating. It can be given in conjunction with the flu vaccination.

It must be remembered that pneumonia is a serious and potentially life-threatening disease, and every step should be taken to prevent it if possible.

If pneumonia is suspected, seek medical advice as quickly as possible.

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