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Pneumonia Causes Diagnosis and Treatment

 Pneumonia Causes Diagnosis Symptoms and Treatment

Pneumonia refers to inflammation of the terminal airways, alveoli and interstitial lungs. It can be caused by disease microorganisms, physical and chemical factors, immune damage, allergies and drugs. Bacterial pneumonia is the most common pneumonia and one of the most common infectious diseases. 

The pneumonia mentioned in the daily life mainly refers to pneumonia caused by bacterial infections. This pneumonia is also the most common one. Before the application of antibiotics, bacterial pneumonia was a great threat to the health of children and the elderly. The emergence and development of antibiotics once caused The mortality rate of pneumonia has decreased significantly, but in recent years, despite the use of powerful antibiotics and effective vaccines, the overall mortality rate of pneumonia no longer decreases or even rises.
Elderly pneumonia often lacks obvious respiratory symptoms. 
The symptoms are often atypical, the disease progresses rapidly, and missed diagnosis and misdiagnosis are easy to occur. The first symptoms are shortness of breath and dyspnea, or conscious disturbance, lethargy, dehydration and loss of appetite.

English name:    Pneumonia



Visiting department:    Respiratory



Common disease:    Lungs



Expert interpretation:    Understanding pathogens, "seeing clearly" pneumonia

"Pneumonia" is the main killer of children and the elderly, and the most common infectious disease among young and middle-aged people.


Table of Content

    1. Causes

    2. Clinical Manifestations

    3. Inspection

    4. Diagnosis

    5. Treatment

Basic Information

What are the Common Causes of Pneumonia?

Gram-negative bacilli such as Escherichia coli, Klebsiella, Pseudomonas aeruginosa, influenza, etc . Bacteria, viruses, fungi, aerobic bacteria, anaerobic bacteria, etc.

What are the Common Symptoms of Pneumonia?

    Shortness of breath, dyspnea, lethargy, dehydration, decreased appetite; pulse rate, wet snoring, accompanied by diminished breathing sounds and bronchoalveolar breathing sounds, etc.

What are the Causes of Pneumonia?

Gram-negative bacilli infection
More common, mostly Escherichia coli, Klebsiella, Pseudomonas aeruginosa, influenza B and so on.

2. Respiratory tract infections

Due to reduced body resistance in the elderly, fungi and anaerobic bacteria often exist in the oropharynx, which can cause pneumonia.

3. Mixed infection

Due to the low immune function, the elderly often show mixed infections caused by multiple pathogens. Such as bacteria, viruses, fungi, aerobic bacteria, anaerobic bacteria and so on.

4. Increase in drug-resistant bacteria

Due to the large and widespread use of antibiotics, the genes of pathogenic microorganisms have changed to produce drug resistance, of which Gram-negative bacilli are the most prominent.

What is the Clinical Manifestation of Pneumonia?

Aged pneumonia has the following clinical features.

1. Symptoms

Most have typical symptoms such as fever, sputum, and a few are symptomatic or asymptomatic. The first symptoms are shortness of breath and dyspnea, or conscious disturbance, lethargy, dehydration, and loss of appetite.

2. Signs

There may be pulse rate, shortness of breath, lung auscultation and wet snoring sounds, or accompanied by reduced breathing sounds and bronchoalveolar breathing sounds.

Examination

Blood test

The total number of white blood cells can be increased or not high during routine blood tests, but more than half of them can see nuclear shift to the left, increased C-reactive protein, and accelerated erythrocyte sedimentation.

2. Arterial blood gas analysis

Arterial oxygen partial pressure may decrease, but when combined with chronic obstructive pulmonary disease, due to poor alveolar ventilation, carbon dioxide partial pressure increases.

3. Chest X-ray

Bronchial pneumonia showed radiological findings.

4. Water, electrolyte

Senile pneumonia is prone to water and electrolyte disorders and acidosis.
Causes of Pneumonia infection


What is the Diagnosis of Pneumonia?

Based on medical history and clinical manifestations and signs, combined with routine blood tests and chest X-ray examination can help diagnosis. 
The same pathogenic bacteria can be confirmed by sputum culture for 2 consecutive times.

What is the Treatment of Pneumonia?

The drug should be selected according to the type of germs and drug sensitivity results.
 Give oxygen inhalation and symptomatic treatment if symptoms such as hypoxia.
 Prevention of complications. Strengthen the nursing of elderly patients, the diet should be light and easy to digest.
Pneumonia (lower respiratory infection, infectious disease of the lungs)

Treatment of Pneumonia through vaccines

What are the symptoms of pneumonia?

Tell you more about the symptoms of pneumonia, especially the early symptoms of pneumonia. 
What is the manifestation of pneumonia? 
What happens if you get pneumonia?

What are the Early and Late Symptoms of pneumonia?

Early symptoms: For irritating dry cough, white mucus sputum or bloody sputum is coughed, often with severe lateral chest pain, often acupuncture-like, exacerbated by cough or deep breathing, and can be radiated to the shoulder or abdomen.

Dyspnea, rapid and shallow breathing due to pulmonary consolidation, insufficient ventilation, chest pain, and toxemia. 
A few have gastrointestinal symptoms such as nausea, vomiting, bloating or diarrhea.

Late Symptoms: Mucus, bloody sputum, or rusty sputum can be coughed, or purulent sputum can be present.

The amount of sputum increases during the dissipative phase, and the sputum is yellow and thin. 
Affects gas exchange, reduces arterial blood oxygen saturation and appears cyanosis. 
Blurred consciousness, irritability, lethargy, and coma may occur.

Related symptoms: fever, cough, expectoration, wet snoring, cough, sputum, sputum, bronchial mucosal edema, neonatal shortness of breath, wing flaps, wheezing, dyspnea, lung snoring

Symptoms: Most of them have a sudden onset, and they are often caused by cold rain, fatigue, and viral infection. 
About 1/3 of them have upper respiratory tract infection before they become sick. The course of disease is 7-10 days.

1. Chills, high fever: typical cases start with sudden chills, followed by high fever, body temperature can reach 39 - 40 , showing a fever type, often accompanied by headache, muscle aches, and reduced appetite. 
After the use of antibiotics, the heat type may be atypical, and the elderly and infirm may have low fever or no fever.

2. Cough and sputum: The initial stage is irritating dry cough, and then white mucus sputum or bloody sputum is coughed. 
After 1 to 2 days, mucus bloody sputum or rusty sputum can be coughed, and purulent sputum can also be dissipated. 
Phase sputum increased, sputum yellow and thin.

3. Chest pain: There are severe lateral chest pains, often acupuncture-like, which are exacerbated by cough or deep breathing, and can be radiated to the shoulder or abdomen. 
If it is inferior lobe pneumonia, it can stimulate the pleura and cause severe abdominal pain, which is easily misdiagnosed as acute abdomen.

4. Dyspnea: due to pulmonary consolidation, insufficient ventilation, chest pain, and toxemia caused by dyspnea, fast and shallow breathing. 
When the condition is severe, gas exchange is affected, the arterial blood oxygen saturation decreases and cyanosis appears.

5. Other symptoms: a few have gastrointestinal symptoms such as nausea, vomiting, bloating or diarrhea. 
People with severe infections may have confusion, irritability, lethargy, and coma.
Chart Showing Pneumonia Symptoms


What is Pneumonia Diagnostic criteria?

The diagnosis of pneumonia must first distinguish pneumonia from upper and lower respiratory infections. 
Although respiratory infections have symptoms such as cough, sputum, and fever, each has its own characteristics.
Upper and lower respiratory infections do not have pulmonary parenchymal infiltration, and chest X-ray examination can identify them.
Second, pneumonia must be distinguished from other similar pneumonias. 
Pneumonia often needs to be distinguished from the following diseases.

1. Tuberculosis Tuberculosis has symptoms of systemic poisoning, such as low fever in the afternoon, night sweats, fatigue, weight loss, insomnia, and palpitations.
X-ray chest radiographs showed that the lesions were mostly on the apex of the lungs or above and below the clavicle, with uneven density, slow dissipation, and formation of cavities or dissemination in the lungs. 
Mycobacterium tuberculosis can be found in sputum. General antibacterial treatments are ineffective.

2. Lung cancer usually has no symptoms of acute infection and poisoning, sometimes bloodshot in sputum.
 The white blood cell count is not high, and if cancer cells are found in the sputum, the diagnosis can be confirmed.

Lung cancer can be accompanied by obstructive pneumonia. Pulmonary inflammation does not dissipate easily after antibiotic treatment, or hilar lymphadenopathy can be seen, and atelectasis sometimes occurs.

If pulmonary inflammation does not dissipate easily after antibiotic treatment, or pneumonia reappears in the same area after temporary dissipation, follow-up should be followed closely.
It is necessary to pay attention to patients with a history of smoking and older patients. 
If necessary, further CT, MRI, fiberoptic bronchoscopy, and exfoliated sputum cells are used to prevent misdiagnosis.

3. Acute lung abscess The early clinical manifestations are similar to those of Streptococcus pneumoniae pneumonia.
 However, as the course of the disease progressed, a large amount of pustular sputum was coughed as a special feature of lung abscess. The X-ray film showed the pus cavity and the level of gas and fluid, which could be easily distinguished from pneumonia.

4. Pulmonary thromboembolism. Pulmonary thromboembolism often has risk factors for venous thrombosis, such as history of thrombophlebitis, cardiopulmonary disease, trauma, surgery, and tumor.
 It can occur hemoptysis, syncope, dyspnea, and jugular vein filling.

X A chest radiograph showed a reduction in regional lung texture, sometimes a wedge-shaped shadow with the tip pointing to the hilum, and hypoxemia and hypocapnia were common in arterial blood gas analysis.
 Examinations such as D-dimer, CT pulmonary angiography, radionuclide lung ventilation / perfusion scan, and MRI can help identify.

5. Non-infective pulmonary infiltration Non-infectious pulmonary diseases such as pulmonary interstitial fibrosis, pulmonary edema, atelectasis, pulmonary eosinophil infiltration, and pulmonary vasculitis need to be excluded.
Detailed Chart showing Pneumonia


What is the Classification of Pneumonia?

1. Bacterial pneumonia such as Streptococcus pneumoniae (Pneumococcus), Staphylococcus aureus, Streptococcus aureus type A, Klebsiella pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, Escherichia coli, Green Pseudomonas and so on.

2. Pneumonia caused by atypical pathogens such as Legionella, Mycoplasma and Chlamydia.

3. Viral pneumonia such as coronavirus, adenovirus, influenza virus, cytomegalovirus, herpes simplex virus and so on.

4. Fungal pneumonia such as Candida albicans, Aspergillus, Actinomyces.

5. Pneumonia caused by other pathogens (such as Rickettsia, Toxoplasma, Protozoa, parasites such as pulmonary hydatid, pneumocystis, schistosomiasis) and so on.
People with low immunity (such as those with AIDS) are likely to be infected with Pneumocystis carinii, Legionella, Mycobacterium avian, Tuberculosis, and Toxoplasma.

6. Pneumonia caused by physical and chemical factors such as radiation pneumonia, gastric acid inhalation, chemical pneumonia caused by drugs, etc.

7. Mycoplasma pneumonia caused by pneumonia gas.



With regard to pediatric pneumonia what are the concerns of parents?

If pneumonia is not treated in a timely, standardized and thorough manner, it may cause recurrence or exacerbation of the disease, or even induce other complications, such as heart failure, empyema, lung abscess, myocarditis or toxic encephalitis. The faster-moving pneumonia is even. 

One test, two tests and three listening tests

 Pediatric pneumonia is an acute, severe, and fast-moving disease. 
It is a disease that threatens children's health and even life, but sometimes it is similar to the symptoms of pediatric colds and is easy to be confused. 
It is not difficult for parents to identify them, they can start with "one test, two sees, three listens".

What is the Diagnostic criteria for bronchial pneumonia?

Typical bronchial pneumonia usually has fever, cough, and shortness of breath. 
The lungs have a fixed, medium-fine wet rales, which can be diagnosed accordingly.

What is Mycoplasma Pneumonia?

Mycoplasma pneumonia is an acute respiratory infection associated with pneumonia caused by Mycoplasma pneumoniae. 
Of the pathogens used to be called primary atypical pneumonia, Mycoplasma pneumoniae is the most common.
Can cause epidemics, accounting for about 10% of various pneumonia which are severe.

How to distinguish between typical and atypical pneumonia?

"Atypical pneumonia" is a well-known medical term in Asia. 
It is not only well-known in the medical profession, but also familiar to the majority of non-professionals.
 However, due to SARS (Severe Acute Respiratory Syndrome), the term was originally called "atypical pneumonia" in China, and later changed to "infectious atypical pneumonia". 
The spoken language and the media often referred to as "SARS".
Showing Diagrammatic view of Chest condition in Pneumonia
The so-called pneumonia refers to the inflammation that occurs in the lung tissue, and is divided into two categories of infectious pneumonia and non-infectious pneumonia according to the cause. 
Infectious pneumonia refers to pneumonia caused by infection with pathogens such as bacteria, viruses, fungi, mycoplasma, chlamydia, rickettsia, parasites, and spirochaetes.

Non-infectious pneumonia refers to pneumonia caused by factors other than infectious pathogens, such as drug-induced pneumonia, radiation pneumonitis, chemical pneumonia, allergic pneumonia and connective tissue disease pneumonia.

Clinically referred to as pneumonia refers to infectious pneumonia, which is defined as: inflammation and consolidation of lung tissue caused by infectious pathogens. 
The most common pathogens are bacteria, followed by viruses, mycoplasma, chlamydia, and fungi.

Typical pneumonia (TP) refers to lobar pneumonia or bronchial pneumonia caused by common bacteria such as Streptococcus pneumoniae, Staphylococcus, Klebsiella pneumoniae, and Haemophilus influenzae.
Clinical features are:
Acute onset, sudden fever, chills, cough, sputum (especially rust-colored sputum), chest pain and dyspnea.
Elevated peripheral white blood cell counts.
Sputum examination can detect common Gram-positive cocci or Gram-negative bacilli.
Cchest X-ray shows consolidation of lung lobes or segments antibiotic treatment is effective.
 Types of Pneumonia Chart Diagram
Initially, atypical pneumonia was generally used to describe a group of diseases that usually have insidious onset, systemic symptoms are more pronounced, and lung signs are fewer.
The prognosis is better than ordinary bacterial pneumonia. After mycoplasma pneumoniae was identified as the main pathogen of atypical pneumonia in 1966, atypical pneumonia was almost equivalent to mycoplasma pneumonia for a considerable period of time.

Later, the pathogens of atypical pneumonia include Chlamydia pneumoniae, Chlamydia psittaci, Legionella pneumophila, Rickettsia burgdorferi, and many respiratory viruses such as influenza viruses A and B, parainfluenza viruses, respiratory syncytial virus, and Some other microorganisms.

Before SARS

Before the onset of SARS, the concept of atypical pneumonia was: Atypical pneumonia refers to a group of pneumonia that has clinical features similar to pneumonia, chest X-ray characteristics, and responds to antibiotic treatment.

Its clinical characteristics are: Occult onset, mostly dry cough, occasional hemoptysis, X-ray chest radiographs mainly show interstitial infiltration. 
The disease process is usually mild, and patients rarely die as a result (good prognosis).
Its pathogens mainly include Mycoplasma pneumoniae and Chlamydia pneumoniae.

After SARS

After the SARS epidemic, because people do not know what the disease is at the beginning of the disease. 
This unknown pneumonia was also named "atypical pneumonia", and later changed to "infectious atypical pneumonia".
 This concept has been widely used. Accepted by non-professionals and ordinary people, namely, atypical pneumonia (SARS) = SARS.

On September 30, 2003, the Chinese Medical Association and the Chinese Academy of Traditional Chinese Medicine gave an authoritative definition of "SARS": Infectious atypical pneumonia is a kind of apparently infectious, caused by SARS coronavirus (SARS-Cov).

Special pneumonia that can affect multiple organ systems, the World Health Organization (WHO) has named it severe acute respiratory syndrome (SARS). 

Clinical manifestations include fever, fatigue, headache, muscle and joint pain and other systemic symptoms and dry cough, chest tightness, dyspnea and other respiratory symptoms. 
Some cases may have digestive symptoms such as diarrhea. 

Chest X-ray examination can show inflammatory infiltrates in the lungs. Pneumonia lesions spread faster than typical pneumonia. 

Diagram Showing Pneumonia Virus

Most of the lesions involve both lungs during peak periods, and the lesions appear ground-glass-like, while typical pneumonia is mainly unilateral, and lesions are mainly sheet-shaped. 
Laboratory tests have normal white blood cell counts. Or reduced ineffective antibacterial treatment is an important feature.
Severe cases show marked dyspnea and can quickly develop into acute respiratory distress syndrome (ARDS).

The Middle East Respiratory Syndrome (MERS) is an acute respiratory disease caused by a new coronavirus discovered in September 2012. The disease was named "Middle East Respiratory Syndrome" by the World Health Organization on May 23, 2013.
The virus first appeared in Saudi Arabia, and then spread in other countries in the Middle East and Europe. 

The main clinical manifestations of the disease are: severe severe respiratory infections such as fever, cough, shortness of breath, and dyspnea. 

Some cases will have renal failure, and a small number of cases only show mild or asymptomatic respiratory symptoms, which are often found in examinations.
 Pneumonia manifestations. Some people call the "Middle Eastern Respiratory Syndrome" "Middle Eastern SARS".

Logically, since there is the concept of "typical pneumonia" and "atypical pneumonia", "atypical" pneumonia should include all pneumonia (referring to infectious pneumonia) except "typical" pneumonia.
However, the diseases with respiratory symptoms manifested by SARS now have a proprietary name, such as the new coronavirus, named COVID-19, which will not be simply called "atypical pneumonia".




Author's Bio

Doctor Shawna Reason, Virologist
Dr. Shawna Reason
Name: Shawna Reason

Education: MBBS, MD

Occupation: Medical Doctor / Virologist 

Specialization: Medical Science, Micro Biology / Virology, Natural Treatment

Experience: 15 Years as a Medical Practitioner

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