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lower respiratory tract infection and Pneumonia
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Pneumonia Introduction

 

Pneumonia is an inflammation of the lower respiratory tract caused by acute infection.  It affects the alveolar (air sac) spaces and the interstitial space (area in between cells).  Pneumonia is classified in two distinct ways.  First, is the area or part of the lung affected.  Secondly, by the organism that causes infection. Pneumonia can be caused by a myriad of bacterium (strep, staph, klebsiella, H.influenza), dozens of different viruses, including influenza A and B, and by certain types of fungus.  The categorization of pneumonia, including its diagnosis, is defined by location or distribution in the lung. 

  • Lobar pneumonia: affects a section (lobe) of one lung

  • Lobular pneumonia: occurring in one lobe or part of a lung

  • Bronchopneumonia: patches of lung are infected in both lungs

  • Interstitial pneumonia: involves the interstitial, or connective tissues of the lung

 

Bacteria are the most common cause of pneumonia in adults, with Streptococcus pneumoniae being the most common pathogen.  Walking pneumonia is most common among young adults, and is caused by the bacteria-like organism, Mycoplasma pneumoniae. The major cause of pneumonia in children and infants is Respiratory Syncytial virus, or RSV. Individuals who are immunocompromised are more likely to get pneumonia from a fungus, or less well-known (atypical) bacteria or virus. [1]

 

Because of the difficulty in ascertaining which infectious agent actually caused the infection, pneumonia is classified into two separate classifications, both used to define origin of location.

  • Community Acquired Pneumonia: This type of pneumonia is also defined as an infection contracted outside of the hospital.  Affecting nearly 4 million Americans every year, this type of pneumonia is most prevalent following a viral respiratory infection.

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  • Hospital-acquired, or nonsocomial pneumonia: Contracted during a hospital stay, this type of pneumonia is considered far more dangerous than the community-based variety.  Individuals in hospital have weekend immune system response.  This immunological compromise is often due to certain  illnesses which adversely affect natural defense mechanisms.  In addition, organisms encountered in a hospital are considered more dangerous than those in the community.

Pneumonia Symptoms

 

Typical symptoms of pneumonia include cough, fever, and sputum production.  The onset is usually insidious. In many cases pneumonia will develop after a URI.  In severe cases individuals will have pleurisy, or painful breathing.  This may be due to excessive coughing or irritation of the lung tissue by the infection.  The sputum may, in severe cases, be blood tinged.  Systemic symptoms such as muscle aches and pains, arthralgia (joint pain), loss of appetite, nausea, vomiting, and sweating, can also occur. [2]

 

Diagnostic signs include an increased respiratory rate, 'crackling' in the breath sounds, and x-rays, typically used to show a consolidation pattern, and are dependant upon type of pneumonia. [3]

 

 

Pneumonia Statistics
  • In the US there are an estimated 4 million cases of pneumonia each year, with Streptococcus pneumonia causing over 500,000 cases alone.
     

  • Pneumonia is the 5th leading cause of death in the US. It is the 3rd leading cause of death in children under the age of 5.
     

  • Each year between 70,000 and 90,000 individuals in the US will die from pneumonia, with an estimated 3.5 million deaths occurring worldwide each year.
     

  • African Americans are 3 times as likely to die, Native Americans are 5-10 times likely to die from pneumonia than whites. [4]

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