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Diff: Pneumonia

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Pneumonia is a common and potentially serious respiratory infection that affects the [[lungs]], causing inflammation and fluid build-up in the air sacs. It can result from various pathogens, such as [[bacteria]], [[Virus\|viruses]], [[fungi]], and even certain chemicals, leading to a range of symptoms and complications. Pneumonia can affect individuals of all ages, but certain groups, such as the elderly, young children, and those with weakened immune systems, are more vulnerable to its effects.

== Classification ==
Pneumonia is classified based on the causative agent and the way it is acquired:

=== 1. Community-Acquired Pneumonia (CAP): ===
CAP refers to pneumonia acquired outside of healthcare facilities. Common pathogens causing CAP include Streptococcus pneumoniae, Haemophilus influenzae, and viruses like influenza and respiratory syncytial virus (RSV).
	'''Pneumonia''' is inflammation and infection of the lungs. It usually affects the small air sacs where oxygen passes into the blood, causing them to fill with fluid or pus. Pneumonia can be mild, but it can also become serious, especially in older adults, babies, young children and people with heart, lung or immune-system problems.

=== 2. Hospital-Acquired Pneumonia (HAP): ===
HAP occurs during a hospital stay, often affecting patients with compromised health. Bacteria such as Staphylococcus aureus, Klebsiella pneumoniae, and Pseudomonas aeruginosa are frequently associated with HAP.
	Most cases are caused by bacteria or viruses. Less commonly, fungi, aspiration of stomach contents, or hospital-related infection can be involved.

=== 3. Ventilator-Associated Pneumonia (VAP): ===
VAP specifically affects individuals on mechanical ventilation. It is often caused by multidrug-resistant bacteria and poses a significant challenge in intensive care settings.
	== Symptoms ==
	Common symptoms include a cough, fever, sweating or shivering, shortness of breath, chest pain that is worse when breathing or coughing, tiredness, loss of appetite and feeling generally unwell. The cough may produce yellow, green, brown or blood-stained phlegm.

=== 4. Aspiration Pneumonia: ===
Aspiration pneumonia results from inhaling foreign material, such as food, liquid, or vomit, into the lungs. This can lead to infection due to the introduction of bacteria from the mouth or stomach.
	Older people may present with confusion or a sudden decline rather than obvious chest symptoms. Babies and young children may have fast breathing, poor feeding, drowsiness or grunting.

== Symptoms and Diagnosis ==
Pneumonia symptoms vary but commonly include:
	== Causes and Types ==
	Community-acquired pneumonia starts outside hospital. Hospital-acquired pneumonia develops during or shortly after a hospital stay and can involve different organisms or more resistant bacteria. Aspiration pneumonia happens when material such as food, liquid or vomit enters the lungs.

* Cough: Often producing phlegm or pus.
* Fever: High body temperature.
* Shortness of Breath: Difficulty breathing, especially during physical activity.
* Chest Pain: Sharp or stabbing pain when breathing or coughing.
* Fatigue: Feeling tired and weak.
* Confusion: Particularly in older adults.
* Bluish Lips or Nails: Indicating poor oxygenation.
	The most common bacterial cause is often Streptococcus pneumoniae, but the exact cause is not always identified. Viral pneumonia can follow infections such as influenza, COVID-19 or respiratory syncytial virus.

A healthcare professional may diagnose pneumonia through physical examination, chest X-rays, blood tests, and, in some cases, collecting a sample of respiratory secretions for laboratory analysis.
	== Diagnosis ==
	Diagnosis is based on symptoms, examination and, when needed, tests such as oxygen saturation, blood tests, sputum tests and a chest X-ray. A clinician may listen for crackles or reduced breath sounds.

== Pathogenesis ==
Pneumonia typically begins when pathogens enter the lungs through inhalation or aspiration. In response, the immune system triggers inflammation, causing air sacs to fill with fluid and pus. This hinders oxygen exchange and can lead to respiratory distress.
	Severity is important. Someone with low oxygen levels, confusion, low blood pressure, dehydration, severe breathlessness, chest pain, or a high-risk background may need urgent assessment or hospital care.

== Treatment ==	== Treatment ==
Treatment of pneumonia depends on its cause and severity:
	Treatment depends on the likely cause and severity. Bacterial pneumonia is usually treated with antibiotics. Rest, fluids and pain or fever relief may also help. People with mild pneumonia often recover at home, while severe cases may need hospital treatment with oxygen, intravenous antibiotics, fluids or breathing support.

* Bacterial Pneumonia: Often treated with antibiotics, guided by the specific bacteria causing the infection.
* Viral Pneumonia: Antiviral medications may be prescribed, particularly for influenza-related pneumonia.
* Fungal Pneumonia: Antifungal drugs are used to combat fungal infections.
* Supportive Care: Adequate hydration, rest, and over-the-counter pain relievers can help alleviate symptoms.
	Most people start to improve after treatment, but recovery time varies. Asthma + Lung UK notes that many people feel better within 2 to 4 weeks, although tiredness and breathlessness can last longer.

== Prevention ==	== Prevention ==
Preventive measures include:
	Prevention includes vaccination where eligible, stopping smoking, hand hygiene, reducing exposure to respiratory infection, and managing long-term conditions such as asthma, COPD, diabetes or heart disease.

* Vaccination: Vaccines against Streptococcus pneumoniae, Haemophilus influenzae, and influenza are recommended.
* Hand Hygiene: Frequent handwashing to reduce the risk of infection transmission.
* Respiratory Hygiene: Covering the mouth and nose when coughing or sneezing.
* Smoking Cessation: Quitting smoking reduces the risk of respiratory infections.
	Vaccines that may reduce pneumonia risk include pneumococcal vaccination, annual flu vaccination and COVID-19 vaccination for eligible groups.

== Complications ==	== Complications ==
Pneumonia can lead to severe complications, such as respiratory failure, sepsis, lung abscesses, and pleural effusion (accumulation of fluid around the lungs). Early diagnosis and appropriate treatment are crucial to prevent complications.

== Conclusion ==
Pneumonia is a significant public health concern, affecting millions of individuals worldwide. Understanding its various forms, causes, symptoms, and treatment options is essential for effective management and prevention. Through vaccination, hygiene practices, and prompt medical intervention, the impact of pneumonia on individual health and public health systems can be mitigated.
	Possible complications include pleural effusion, lung abscess, sepsis, respiratory failure and worsening of existing heart or lung disease. Prompt treatment is especially important for people who are frail, immunosuppressed or already unwell.

== See Also ==	== See Also ==

* [[Respiratory System]]
* [[Infectious Diseases]]
	* [[Respiratory_System]]
	* [[Infectious_Diseases]]
* [[Vaccination]]	* [[Vaccination]]
	* [[Bacteria]]
	* [[Virus]]

	== References ==
	* [https://www.nhs.uk/conditions/pneumonia/ NHS: Pneumonia]
	* [https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/pneumonia/ NHS inform: Pneumonia]
	* [https://www.asthmaandlung.org.uk/conditions/pneumonia Asthma + Lung UK: Pneumonia]
	* [https://www.gloshospitals.nhs.uk/your-visit/patient-information-leaflets/pneumonia-and-what-to-expect-after-discharge-ghpi1645/ Gloucestershire Hospitals NHS Foundation Trust: Pneumonia and what to expect after discharge]

	[[Category:Medicine]]
	[[Category:Respiratory disease]]
	[[Category:Infectious disease]]