Pneumonia

 Pneumonia is describes any of the acute infections of the lungs in which the lining of the air sacs is inflamed and swollen, and cells and fluid fill the air spaces, making it difficult to breath. A number of common terms describe various forms of disease. "Double pneumonia" refers to involvement in both lungs. Involvement localized to one or more lobes of the lung, is called "lobar pneumonia." A scattered or patchy infection in one or both the lungs is called "bronchopneumonia." Still another is "atypical pneumonia" caused by Mycoplasma organisms.
  The inflammation can be caused by any one of a number of germs (bacteria, viruses, fungi) to which one is frequently exposed, and irritant poisonous gases. The pneumonia may be mild to severe, depending on the organism and the measure of health of the person. Predisposing factors include hearth disease. cancer, stroke, coma, other infections of the respiratory tract (common cold, influenza), inhaled foreign material, alcoholism, malnutrition, drugs given to suppress immunity, and often any debilitating or terminal illness.
 The precise symptoms of pneumonia will vary with the infecting organism, and may have an abrupt or gradual onset. Those most commonly observed are cough, fever (up to 105 digress F), and shortness of breath. Others include chills, sweating. headache, nausea, vomiting, rapid, shallow breathing, chest pain, bloody sputum, and blueness of the skin (cyanosis).

 Viral pneumonia, generally mild, are commonly associated with the common cold. In fact, they not infrequently pass as a severe cold. These common pneumonias account for about 75 percent of lung infections. However, influenza A virus pneumonia can  be severe, and even fatal. Usually carried by droplets of moisture expelled by sneezing, this virus does not respond to antibiotic therapy.

Bacterial pneumonias -- usually more severe and dangerous -- are commonly caused by the pneumococcus. If untreated, the disease runs it course in about two weeks, ending in death in more than 30 percent of the cases and in prompt improvement (by "crisis") in the remaining 70 percent. Treatment with antibiotics (penicillin G) or sulfonamides reduces the mortality to less than 5 percent. A vaccine is now available which protects against this type of pneumonia. Other bacteria which may cause pneumonia include streptococcus, Klebsiella, Haemophilus, and, worst of all staphylococcus. They also respond to antibiotics. Complications of bacterial pneumonias include pleurisy, empyema, lung abscess, infection of the heart (pericarditis or endocarditis), and meningitis.

A. Bronchopneumonia with pussy exudate in the terminal bronchiole.
B. Lobar pneumonia showing air sacs filled with fibrinous exudate.

Mycoplasmal pneumonia most commonly appears among adolescents and young adults, It is caused by a tiny bacterium like organism, Mycoplasma. The illness starts gradually with a chest cold, dry cough, and fever, and may reach epidemic proportions in the military and in schools. It responds to antibiotics (erythromycins and tetracyclines, not penicillins). When untreated, spontaneous recovery usually occurs in about ten days. It is spread by droplets produced by the sneezing and coughing of an infected individual. 

Legionnaires' pneumonia or Legionnaires' disease, first observe in epidemic proportions in 1976 in Philadelphia during an American Legion convention, is caused by  a bacterium named Legionella pneumoplilia. Unlike the typical persons-to-person transmittal, these bacteria carried by the air, in some cases by a contaminated air-conditioning system. The symptoms parallel those of a severe pneumonia. The disease progresses rapidly, and the sufferer should be hospitalized and treated with an appropriate antibiotic, A possible complication is kidney failure. 

 

What you can do. Great care should be taken in attempting to treat cases of pneumonia at home. Infants and the elderly (excepts as a terminal event) are best cared for in a hospital. After a careful evaluation of the condition, your physician will determine what is best. Under his direction, you can carry out certain procedures if you or a family member are treated in your home, or after returning home from the hospital. These are discussed bellow. 

What your physician can do. Your physician will probably hospitalized you and then determine the cause and extent of your problem. Laboratory examination of your sputum, and possibly blood, will reveal the organism involved. X-rays of the lungs will also aid in determining the type of pneumonia. This will direct in the selection of the most effective medication. 

Bed rest, the administration of fluids to avoid dehydration, and oxygen, if necessary, will be supportive. The inhaling of steam from a vaporizer or a kettle of water (be careful not to get burned) will open the air passages and help from coughing up mucus. Hydrotherapy treatments in the form of a hot foot bath along with fomentations to the chest and back, repeated twice and given three or four times a day, will be helpful until the infection subsides. And a program of exercise to tolerance, adequate rest and sleep, and a good nutritious diet will speed recovery.