Pneumonia

RESPIRATORY HEALTH

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Pneumonia

Pneumonia is one of the most common respiratory infections we see in our specialist clinic.

Pneumonia is an inflammation of the lungs caused by infection. The infection affects the air sacs in the lungs rather than the tubes that transport air in and out of the lungs. The air sacs are filled with fluid that contains white blood cells. Bacteria, viruses, fungi or parasites can cause pneumonia.

Anybody can contract pneumonia, including people who are fit and healthy. The elderly (> 65 years old), the very young, patients who are immunocompromised (e.g. patients with cancer, patients on long term steroids etc.) are high risk groups. Smokers are also more prone to pneumonia due to weaker lung defenses. viral pneumonia e.g. SARS and H1N1 influenza can occur during certain periods of time in the form of an outbreak.

Pneumonia can range in seriousness from mild to life-threatening. Common symptoms include:

  1. Cough, sometimes with yellow, green or blood-tinged phlegm
  2. Shortness of breath
  3. Chest pain, which may get worse when inspire
  4. High fever
  5. Chills and rigors
  6. Loss of appetite
  7. Generalized weakness

A physical examination and history taking may suggest the diagnosis of pneumonia. Also, a chest x-ray is necessary to confirm the diagnosis.

Treatment will depend on the cause of the pneumonia. If bacteria is suspected, antibiotics will be prescribed. In suspected viral pneumonia due to influenza, anti-viral medicine like tamiflu is prescribed. Most patients can be seen in the outpatient clinic and can get better at home. However, seriously ill patients should be admitted to the hospital for oxygen therapy and be given fluids through a drip.

Most symptoms such as chest pain and fever should resolve in a few days once the appropriate antibiotics are started. The cough may take up to 3 weeks to resolve. However, tiredness and weakness may take as long as a few months to clear completely.

Prevention 

The most common cause of bacterial pneumonia is the streptococcus peumoniae (causing about 40% of all bacterial pneumonia). Pneumococcal vaccination is available in our clinic; it is safe and often given to the elderly and those with chronic lung, heart and kidney diseases.

We also strongly recommend yearly influenza vaccination in the elderly and those with chronic medical conditions.

Complications

  1.  Bacteria entering the blood, resulting in septicemia
  2. Septic shock where normal circulation fails, resulting in multiple organ dysfunction including kidney failure, blood clotting abnormalities and drop in blood pressure
  3. Pleural effusion – fluid accumulation around the lung
  4. Lung abscess (a cavity containing pus)