Pneumonia: the Silent Killer

Pneumonia is an acute infection of the lungs, it can be caused by a variety of organisms entering the body – including bacteria, viruses or fungi. The infection causes an inflammation of the alveoli (air sacs) of the lungs and may result in the alveoli filling with fluid or other purulent material (Mayo Clinic, 2016). An accumulation of fluid within alveoli and portions of the lungs, can reduce the ability of the lungs to allow for oxygen diffusion across the alveoli walls. If oxygen saturation is low, it can cause the body’s cells to not work effectively. Therefore, the risk of the infection spreading through the body is increased – it is due to this reason, that pneumonia can be life-threatening (American Lung Foundation, 2016). Pneumonia

* Pneumonia is refers to an infection in the lungs that causes swelling in the lungs tissue and this inflammation

Pneumonia is described in Tabers cyclopedia medical dictionary, “as inflammation of the lungs, usually due to an infection with bacteria, viruses, or other pathogenic organisms” (p.1833)

J., Cormier, S., & Meyer, T. (2012). Reduction in the Incidence of Ventilator Associated Pneumonia: A Multidisciplinary Approach. Respiratory Care, 57(5). 688-696. DOI: 10.4187/respcare.01392

It was also noted that the patient had an influenza vaccine for this season, however a rapid influenza and RSV test were completed which resulted negative (Fahey, 2011). Fahey (2011) also discussed how difficult it is to identify organisms that cause pneumonia, and how cultures are not done a lot in the primary care setting (Fahey, 2011). A chest radiograph was ordered for suspected pneumonia and a confirmed diagnosis of left lobar pneumonia was received (Fahey, 2011). The most common organisms that cause pneumonia in children were discussed by age group (birth-3 weeks=group B streptococcus; 3 weeks-4 months= streptococcus or chlamydia pneumonia; 4 months-5 years=viruses and RSV in the younger than 2 year age group) (Fahey, 2011). It was discussed that pneumonia patients typically present with respiratory symptoms and fever (Fahey, 2011). This article also discussed the diagnosis of children older than 1 year is usually made through clinical/physical assessment, and it is not always possible to determine the pathogen causing the problem because cultures and lab work are not routinely done as an outpatient (Fahey, 2011). The requirements for the hospitalization of children were discussed, and the importance of practitioners using algorithms for CAP management

Pneumonia is an inflammation of the lung which results into an excess of fluid or pus accumulating into the alveoli of the lung. Pneumonia impairs gas exchange which leads to hypoxemia and is acquire by inhaling a contagious organism or an irritating agent. (Ignatavicius & Workman, 2013). Fungal, bacteria and viruses are the most common organisms that can be inhale. Pneumonia could be community-acquired or health care associated. Community –acquired pneumonia (CAP) occurs out of a healthcare facility while health care associated pneumonia (HAP) is acquired in a healthcare facility. HAP are more resistant to antibiotic and patients on ventilators and those receiving kidney dialysis have a higher risk factor. Infants, children and the elderly also have a higher risk of acquiring pneumonia due to their immune system inability to fight the virus. Pneumonia can also be classified as aspiration pneumonia if it arises by inhaling saliva, vomit, food or drink into the lungs. Patients with abnormal gag reflex, dysphagia, brain injury, and are abusing drug or alcohol have a higher risk of aspiration pneumonia (Mayo Clinic, 2013). In the case of patient E.O., this patient had rhonchi in the lower lobe and the upper lobe sound was coarse and diminished. Signs and symptoms of pneumonia include difficulty breathing, chest pain, wheezing, fever, headache, chills, cough, confusion, pain in muscle or

Pneumonia’s most common causes are bacteria and viruses that are present in the air we breathe. The body has its own filtering system in which helps prevent viral and bacterial infections from harming the body. However, this filtering system is compromised as one ages.

There are at least 30 different causes of pneumonia but the most common cause is “bacterial pneumonia” streptococcus pneumonia.

pneumoniae and there chemotactic signals and the host cell’s alternate pathway, invade the alveoli. Also red blood cells are recruited to this site. In the third stage, mostly neutrophils are packed into the alveoli and very few bacteria remain. In the final stage, macrophages eliminate the remaining residue from the inflammatory response. As one can see, the damage which is done to the lung is largely a result of the host’s inflammatory response, which causes the build up of fluids in the lungs. If S. pneumoniae is allowed to persist in the lungs it can then invade the blood, which causes bacteremia. When in the blood it can traverse the blood-brain barrier and infect the meninges, which results in meningitis. S. pneumoniae is also associated with diseases in other parts of the respiratory tract including the paranasal sinuses, which is better known as sinusitis, and the middle ear can become infected, which is known as otitis media. It has also been known to cause peritonitis, an inflammation of the peritoneum, the membrane that lines the abdominal wall, and it is also implicated in causing arthritis.

Pneumonia is an illness of the lower respiratory tract in which the lungs become inflamed and congested and alveolar spaces are filled with fluid and cells-polymorphs and lymphocytes (Mandell L.A). It is an inflammatory condition of the lung and it is one of the most serious infections, causing two million deaths annually among the young and elderly. Pneumonia is the largest killer, accounting for 28% to 34% of all child deaths below five years of age in low-income countries and is an important cause of mortality in the elderly in high-income countries (Suárez).

Pneumonia- Pneumonia has many possible causes, but it is usually an infection of the streptococcus or mycoplasma bacteria. These bacteria can live in the human body without causing infection for years, and only surface when another illness has lowered the person's immunity to disease. Streptococcus pneumoniae causes streptococcal pneumonia, the most common kind, which is more severe than mycoplasmal pneumonia. S. pneumoniae is responsible for more than 100,000 hospitalizations for pneumonia annually, as well as many as 6 million cases of otitis media and as well as over 60,000 cases of invasive diseases such as

Based on the preceding observations, it was concluded that suppurative pneumonia is affecting the entirety of the lung, including the parenchyma and pleura. In tissues other than pulmonary tissues, the presence of macrophages would indicate chronic or sub-acute inflammation. The lung, however, has a large macrophage reservoir, that is mobilized much more rapidly than in other tissues. The differentiation of this sample as either acute, subacute or chronic inflammation, was based on the presence of fibrin and fibrinous tissue, lymphocyte dominance, and the extent of the inflammation. In acute to subacute inflammation, lymphocytes are present, but in fewer numbers than neutrophils. The dominance of cells in this sample by neutrophils and vascular changes indicates that the inflammation is either acute or sub-acute. The complete obliteration of the alveoli, however, and the large numbers of neutrophils also indicate inflammation that has been occurring for long enough for a mass increase and mobilization of cells to occur. The sample was thus classified as subacute.

M. pneumoniae is generally referred to as primary atypical or walking pneumonia because the symptoms are not as sever as pneumonia. The symptoms include a dry hacking cough, fever, and headache. The symptoms will last for about 2 to 3 weeks. M. pneumoniae affects people worldwide. Typically only 33 % of people who have M. pneumoniae will get atypical pneumonia. The majority, 77 %, will come down with an upper tract infection (tracheaobronchitis). (Pulmonary Disorders pg 609) M. pneumoniae is transmitted through aerosol droplets. The bacterium is capable of infecting anyone at any time but it has a pattern of coming in the fall and winter and causing an outbreak every 4 to 8 years, although more tight communities occur more frequently. The pathogen rarely occurs on children less than 4 years of age. Since the bacterium lacks a cell wall, B-lactums are futile against them. The body’s immune system is responsible for killing the pathogen. There were 2 million cases in the US with 100,000 requiring hospitalization. The mortality rate is very low with only occasional fatalities among the elderly and sickle cell anemia persons. ( ).

The clinical manifestations of pneumonia will be different according to the causative organism and the patient’s underlying conditions and/or comorbidities (Smeltzer, et al). Some of the manifestations are

Pneumonia is an inflammation or infection of the lungs most commonly caused by a bacteria or virus. Pneumonia can also be caused by inhaling vomit or other foreign substances. In all cases, the lungs' air sacs fill with pus , mucous, and other liquids and cannot function properly. This means oxygen cannot reach the blood and the cells of the body.