Today, Monday, November 12, is World Pneumonia Day. This is one of the most lethal infectious diseases that mainly affects children under five years of age and men over 65 years of age with cardiopulmonary, respiratory or diabetic pathologies. Dr. Adalberto Pacheco Galván, specialist in Pneumology, explains the symptoms, causes and treatment.
What is pneumonia?
Pneumonia is an inflammatory process that affects the distal area of the bronchial tree and the alveoli, which are the millions of pulmonary sacs where gas exchange takes place, expelling carbon dioxide and capturing oxygen, fundamental as fuel for all the metabolic functions of the organism. Sometimes not only the alveoli are inflamed but also the small distal bronchi. In this case we can call the process bronchopneumonia. Usually the origin of the inflation is caused by microorganisms (bacteria, viruses and fungi) although non-microbial toxic agents, whether gaseous or liquid, can also cause this inflammation. In this last case some scientists admit the term pneumonitis to differentiate it from pneumonia, more linked to infectious agents.
In all cases a more or less extensive opacity is observed in the chest X-ray, which sometimes requires the use of more sophisticated radiological techniques such as thoracic CT.
Facts about pneumonia that stand out
Pneumonia is usually acquired by the entry from the throat into the bronchi and alveoli (aspiration) of gaseous or liquid material carrying microorganisms or toxic components such as fumes or material from the stomach. Another way of reaching the alveoli to produce pneumonia is the blood route, through which from another organ of the body normally infected, access is gained to the area of the alveoli; this route is much less frequent than the expiratory route. The inflammation inherent in pneumonia means that millions of alveoli are unable to perform the basic function of oxygen uptake, so that depending on the extent of the process, it can lead to a dangerous decrease in the amount of oxygen available for the normal functioning of the body in general.
What are the most common symptoms?
The most common symptoms are fever and chills, together with shortness of breath and cough, and in addition, if the inflammatory process affects the membrane covering the lungs, the pleura, it can trigger a sharp pain in the contact area typically costal and more pronounced on inspiration. Expectoration accompanying frequent cough is usually in infectious processes, thick and yellowish or greenish. Sometimes sputum stained with blood appears during the process.
There are pneumonias where the sputum production is scarce or null, the fever is of less intensity but the appearance in the chest X-ray is marked and we call it atypical pneumonia, produced by non-classical bacterial germs such as pneumococcus, such as: Mycoplasmas, Chlamydia, Legionella, viruses, etc.
What are the causes?
Usually the direct cause of pneumonia is the colonization of the upper airways (throat) by microbial agents and subsequent aspiration into the lungs; another mechanism is the inhalation of microbes in the air, or the much less frequent access of these microbes to the lungs via the bloodstream from elsewhere in the body. The immune status of the individual with pneumonia can be a determinant of the frequency and extent of pneumonias and therefore of their severity.
What is the treatment?
As the causes of pneumonia are usually bacteria, there is a wide antibiotic armamentarium to combat them that are more effective the more specific they are. For this we should have sputum samples to culture the germ or blood tests to determine the amount of antibodies, which if very high can indicate the specific causative organism.
The measures to be taken are: rest, hydration and sometimes oxygen. They are usually prescribed in direct proportion to the severity of the pneumonia and taking into account the basic conditions of the individual suffering from it: age, accompanying diseases, immune status, etc.
Have there been any advances in recent years?
There is an increase in the availability of increasingly effective antibiotics due to their need for less time to control the infection, although sometimes they are abused, causing the appearance of resistant strains of microorganisms, thus nullifying the efficacy of the antibiotic in question. This is a global health problem that requires research into increasingly sophisticated antibiotics for increasingly resistant germs, a sort of worrying spiral.