Pneumonia


Pneumonia

Description pneumonia

Pneumonia is the traditional name for a fairly wide variety of inflammation of lung tissue. I nezdravotníci But today often used to describe the technical term illness pneumonia.

Inflammation in general is a defensive reaction of the organism to the presence of microbes (viruses or bacteria) or tissue damage caused by the adverse effects of chemical or physical influences.So it is in the lungs, and the amount of infectious diseases (microbe-causing) predominates.

The course and severity of the disease they are intended primarily specific type of microbe (its ability to interfere with the body, penetrate into it, forming substances adversely acting on the whole organism, induce specific defense reaction of the body etc.). It is also an important factor in patient’s age, general physical condition, lifestyle and the possible presence of other diseases.

Various possibilities of developing the disease

Infectious pneumonia doctors usually divided into three types.

Community-acquired pneumonia is a disease that originated infection in normal human environment. Potential offender in this case, for example Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, and Chlamydia pneumoniae., Then various viruses (e.g., influenza virus). In the lungs are usually Deported inhaling small amounts of mucus from the upper decks of the airways.

Nosocomial pneumonia is pneumonia acquired in the hospital. The hospital environment is inhabited by specific strains of bacteria that have adapted to the local conditions, as they have developed specific mechanisms of resistance (eg. To disinfectants and antibiotics). Disposal of these organisms is very demanding and over the observance of the principles of hygiene are not kept completely out of the hospital environment is removed. Pseudomonas aeruginosa, Klebsiella pneumoniae or Staphylococcus aureus are examples of bacteria that can considerably weakened especially in hospitalized persons cause pneumonia.

Statistics show that the incidence of such diseases in the Czech Republic does not exceed 8 per 1,000 hospitalized. The disease is considered serious and always prolongs hospitalization.

The third type are the so-called emerging pneumonia. Immunocompromised persons.Immunosuppressed as are described, patients who are either on the basis of the disease (e.g. cancer, congenital disorders of the immune system, AIDS), or due to the treatments (administration of corticosteroids, conditions after operations and in particular transplant) reduced ability to self-defense of the organism. Pneumonia in these individuals generally extend heavily, often with fatal outcome. Unlike the previous two types are caused or fungi (Aspergillus, Candida) and protozoa(Pneumocystis carini).

Special mechanism promotes the emergence of hypostatic pneumonia. It may develop in patientswith prolonged restriction of movement (bedridden) due to accumulation of blood (and also mucus) in the back parts of the lungs. Due to insufficient exchange of blood is an enabling environment for such settlements. Staphylococci.

Non-infectious pneumonitis may occur via inhalation of acidic stomach contents during vomiting.Stomach contents causes its acidity violation of lung tissue and inflammation. In the same way can cause aggressive chemical substances that affected ingested and subsequently inhaled vomit which is contained. It is also possible aspiration of aggressive chemicals or inhaled foreign body directly.In these cases we are talking about aspiration pneumonia.

Inhalation pneumonia is characterized by the inhalation of toxic gases or vapors which irritate the entire respiratory tract to rise to inflammation.

 

Risk factors for pneumonia

Pneumonia are vulnerable people moving in infectious environments, which can be easily eg. Working group, school class or family, where members of the team are suffering from various respiratory diseases. It is possible that as the cause of these diseases and have sufficient potential to cause pneumonia, especially if they are backed by some of the following factors.

Significantly they are threatened, people above 60 years of age and newborns whose lungs can be settled by the microbe before labor (adnate pneumonia) during childbirth (perinatal pneumonia) or shortly after giving birth at the neonatal department (postnatal pneumonia). In elderly people, have a negative long-term unbalanced diet composition (vitamin deficiency, vegetarian lifestyle), frequent consumption of alcohol and smoking.

As a disease arises associated pneumonia in patients who have underlying diseases due to reduced quality of consciousness and / or failure of respiratory protective reflexes (nevykašlávají accumulated phlegm).

Similarly, the risk factor for long operation, since the patient is induced coma and he is entering into the airways intubation. Dangerous are all disorders in which the patient is bedridden patients(see. Above hypostatic pneumonia), and those in which the effect of treatment or the disease itself reached impaired immunity.

 

Preventing pneumonia

Due to the large number of causative pneumonia and mainly due to the amount of uncontrollable interacting factors (age, other diseases), disease prevention is difficult. Mainly related to a healthy lifestyle, which should include a varied diet, moderation in alcohol consumption and efforts to maintain physical fitness. It is important to properly treat even seemingly trivial respiratory illness while keeping your basic therapeutic element, which is rest.

For people older than 60 are recommended for influenza vaccination. It is also possible to vaccinate against pneumococcus, and that’s from two months of age. Similarly, early it is possible to vaccinate against Haemophilus influenzae. Opinions on the suitability of haemophilus and pneumococcal vaccines are among the experts differ, the details are beyond the scope of this text.

As with other bacterial infections, there is a problem of the increase of resistance of bacterial strains to common antibiotics. If such a resistant strain of pneumonia caused, the disease does not respond to first generally recommended antibiotics and the duration of the disease is prolonged.

In severe pneumonia that can be fatal complications. Given that bacterial resistance is mainly caused by overuse of antibiotics in the population (their prescription to viral disease, which are ineffective), it is necessary that the patients themselves at ailments to antibiotic therapy did not last.

Expectant mothers can discuss with your gynecologist to perform a bacteriological examination of the vagina with a focus on bacteria that during labor may cause neonatal pneumonia (especially Streptococcus agalactiae).

 

Symptoms of pneumonia and examination

Symptoms can vary depending on the disease agents (bacterial / viral). Common symptoms arecough, possible irritable and dry, then with phlegm, fever until fever.

Furthermore always occur chest pain intensities or stinging spicy character. In more severe pneumonia is present shortness of breath. For viral diseases may be present flu-like symptoms, or a total schvácenost with headache, muscle and joint pain, nausea and vomiting.

The doctor diagnoses the disease based on your described difficulties, physical examination (especially listening and tapping on the chest), and after checking the results of blood tests. The main guideline is for him radiograph demonstrates that inflammatory changes in the lung tissue.

Detection of the disease is difficult, says that up to half the pneumonia originator can not be established. However, if the disease is not responding to therapy (see. The amount of resistant bacteria) it may be necessary to use invasive sampling techniques of bronchial lavage or lung effusion that the originator collected and tested for susceptibility to antibiotics.

 

Treatment of pneumonia

Based on the severity of the current state of the patient’s age and the presence of other diseases doctor will decide on the need for hospitalization. Otherwise healthy patients aged under 60 years old (or older) can be treated at home (such patients are the majority), patients with severe course of pneumonia are hospitalized every time.

In addition, if there is any sign of disturbance of consciousness, instability of blood circulation or breathing disorders, the patient is treated at the intensive care unit.

In all cases immediately (without knowledge of the originator, only on the basis of the clinical picture) started antibiotic therapy whose effectiveness can be evaluated after about 3 days (home treatment, patients are invited to check). In a significant majority of cases this treatment is successful. Only about 10% of cases treatment fails. Then there is substantial efforts to capture agent of the disease and therapy changes in accordance with its sensitivity to antibiotics.

Other treatment may involve the use of drugs dissolving phlegm, cough medicines and other drugs if the patient’s condition requires.

For non-infectious pneumonia are administered corticosteroids.

The treatment duration is usually between 10 to 21 days to complete correction mode (return of physical well-being) occurs in approximately one month.

 

How can I help myself

During treatment it is necessary to keep calm, always first on the bed, abstain from consuming alcoholic beverages and smoking. Important is sufficient fluid intake (herbal teas for respiratory illnesses, mineral water) and varied diet. Beneficial wraps chest. The patient should stay in an environment with ambient temperature, air can be moistened by a humidifier or eg. By placing wet fabrics on heating.

 

Complications of pneumonia

For inadequately treated persons exists the possibility of lung abscesses, aggravation of the original disease patient (obstructive pulmonary disease, pulmonary fibrosis, etc.), or permanent damage to the lung tissue with a reduction in lung function.

Pneumonia is a serious illness character and patients in poor physical condition and death (up to 35% of cases). For patients who are initially treated on an outpatient basis, with fatal complications include rather exceptional, but not impossible. Very severe pneumonia in neonates are younger than 5 days.

Other names: pneumonia, pneumonia, pneumonia, bronchopneumonia, community-acquired pneumonia, nosocomial pneumonia, aspiration pneumonia, inhalation pneumonia

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