| Pneumonia |
Pneumonia (the ancient Greek word for lungs) is defined as an infection involving the alveoli of the lungs. It occurs in patients of all age groups, but young children and the elderly, as well as immunocompromised and immune deficient patients, are especially at risk. Causal therapy is with antibiotics.
Signs and symptoms
Symptoms may include:
Common
- Cough with greenish or yellow mucus
- Fever with shaking chills (rigors)
- Sharp or stabbing chest pain, worsened by deep breaths or coughs
- Rapid, shallow breathing (painful quick breathing)
- Shortness of breath
- Fever of 39.5°C (103°F) and higher
- Painful cough
Rarer
- Bloody mucus
- Headache, including migraine headache
- Excessive sweating and clammy skin
- Loss of appetite
- Excessive fatigue
- Cyanosis
Pneumonia can progress to sepsis ("blood poisoning") and acute respiratory distress syndrome if untreated. These are the main causes of death in patients with untreated pneumonia.
Diagnosis
For the diagnosis of pneumonia, an infiltrate on an X-ray of the chest is the gold standard. Supportive diagnostic tests are microbiological culture of sputum and/or blood. Blood tests are generally performed when a pneumonia is suspected: a full blood count often shows neutrophilia (except in some immunocompromised and all neutropenic patients). Renal function may have deteriorated if there is sepsis. Electrolytes can show hyponatremia (low sodium levels); this is often due to secretion antidiuretic hormone by pulmonary tissue; it is thought to be more frequent in tuberculosis and legionaires' disease. Is possible to perform serological assays for atypical pathogens (Mycoplasma, Legionella and Chlamydia).
In nosocomial (hospital-acquired) pneumonia and the pneumonias of the immunocompromised, diagnosis can be difficult, and CT scanning of the lungs can be required to differentiate possible causes (e.g. pulmonary embolism). CT scanning is also used when the symptoms and physical examination point at possible different causes for the complaints (e.g. vasculitis, sarcoidosis, lung cancer).
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