INTRODUCTION

Pneumonia is an inflammatory condition of the lung. It is often characterized as including

inflammation of the parenchyma of the lung (that is, the alveoli) and abnormal alveolar filling with
fluid (consolidation and exudation).

The alveoli are microscopic air filled sacs in the lungs responsible for gas exchange. Pneumonia can
result from a variety of causes, including infection with bacteria, viruses, fungi, or parasites, and
chemical or physical injury to the lungs. Its cause may also be officially described as unknown when
infectious causes have been excluded.

Typical symptoms associated with pneumonia include cough, chest pain, fever, and difficulty in
breathing. Diagnostic tools include x-rays and examination of the sputum. Treatment depends on
the cause of pneumonia; bacterial pneumonia is treated with antibiotics.

Pneumonia is common, occurring in all age groups, and is a leading cause of death among the young,
the old, and the chronically ill. Vaccines to prevent certain types of pneumonia are available. The
prognosis depends on the type of pneumonia, the treatment, any complications, and the person's
underlying health.

CLASSIFICATION:

Pneumonia is sometimes classified according to the cause of pneumonia:

1. Community-acquired pneumonia. This refers to pneumonia you acquire in the course of your
daily life — at school, work or the gym, for instance. The most common cause is the
bacterium Streptococcus pneumonia.

2. Hospital-acquired (nosocomial) pneumonia. If you're hospitalized, you're at a higher risk of

pneumonia, especially if you're breathing with the help of a mechanical ventilator, in an
intensive care unit or have a weakened immune system.

3. Aspiration pneumonia. This type of pneumonia occurs when you aspirate foreign matter into
your lungs — most often when the contents of your stomach enter your lungs after you
vomit. This commonly happens when a brain injury or other condition affects your normal
gag reflex.

4. Pneumonia caused by opportunistic organisms. This type of pneumonia strikes people with
weakened immune systems.

5. Other pathogens. Outbreaks of the H5N1 influenza (bird flu) virus and severe acute
respiratory syndrome (SARS) have caused serious, sometimes deadly pneumonia infections,
even in otherwise healthy people. Although rare, anthrax, plague and tularemia also may
cause pneumonia. Some forms of fungi, when inhaled can cause pneumonia. Tuberculosis in
the lung also can cause pneumonia.
 ANATOMY and PHYSIOLOGY

What is respiration?

Respiration is the act of breathing:

 inhaling (inspiration) - taking in oxygen

 exhaling (expiration) - giving off carbon dioxide

THE UPPER AIRWAY AND TRACHEA

When you breathe in, air enters your body through your nose or mouth. From there, it travels
down your throat through the larynx (or voice box) and into the trachea (or windpipe)
before entering your lungs. All these structures act to funnel fresh air down from the outside
world into your body. The upper airway is important because it must always stay open for
you to be able to breathe. It also helps to moisten and warm the air before it reaches your
lungs.

THE LUNGS

The lungs are a pair of cone-shaped organs made up of spongy, pinkish-gray tissue. They take up
most of the space in the chest, or the thorax (the part of the body between the base of the neck and
diaphragm).

The lungs are separated from each other by the mediastinum, an area that contains the following:
  heart and its large vessels
 trachea (windpipe)
 esophagus
 thymus
 lymph nodes

The right lung has three sections, called lobes. The left lung has two lobes. When you breathe, the
air:
 enters the body through the nose or the mouth
 travels down the throat through the larynx (voice box) and trachea (windpipe)
 goes into the lungs through tubes called main-stem bronchi
o one main-stem bronchus leads to the right lung and one to the left lung
o in the lungs, the main-stem bronchi divide into smaller bronchi
o and then into even smaller tubes called bronchioles
o bronchioles end in tiny air sacs called alveoli

CAUSES:

 Microorganisms (Virus, bacteria, parasitic)

 Idiopathic

SIGNS and SYMPTOMS:

 Fever  Chest pain that fluctuates with breathing

 Cough (pleurisy)
 Shortness of breath  Headache
 Sweating  Muscle pain
 Shaking chills  Fatigue
DIAGNOSTICS:

Pneumonia as seen on chest x-ray. A: Normal chest x-ray. B: Abnormal chest x-ray with shadowing
from pneumonia in the right lung (white area, left side of image)

CHEST X-RAY
 To confirm the diagnosis of pneumonia.
SPUTUM EXAM
 Sputum samples can be collected and examined under the microscope. If the
pneumonia is caused by bacteria or fungi, the organisms can often be detected by this
examination.
BLOOD TEST
 A blood test that measures white blood cell count (WBC) may be performed. An
individual's white blood cell count can often give a hint as to the severity of the
pneumonia and whether it is caused by bacteria or a virus.
BRONCHOSCOPY
 Bronchoscopy is a procedure in which a thin, flexible, lighted viewing tube is inserted
into the nose or mouth after a local anesthetic is administered. The breathing passages
can then be directly examined by the doctor, and specimens from the infected part of
the lung can be obtained.

Treatments and drugs

Pneumonia treatments vary, depending on the severity of your symptoms and the type of
pneumonia you have.
  Bacterial. Doctors usually treat bacterial pneumonia with antibiotics. Although you may start
to feel better shortly after beginning your medication, be sure to complete the entire course
of antibiotics. Stopping medication too soon may cause your pneumonia to return. It also
helps create strains of bacteria that are resistant to antibiotics.
 Viral. Antibiotics aren't effective against most viral forms of pneumonia. And although a few
viral pneumonias may be treated with antiviral medications, the recommended treatment
generally is rest and plenty of fluids.

 Mycoplasma. Mycoplasma pneumonias are treated with antibiotics. Even so, recovery may
not be immediate. In some cases fatigue may continue long after the infection itself has
cleared. Many cases of mycoplasma pneumonia go undiagnosed and untreated. The signs and
symptoms mimic those of a bad chest cold, so some people never seek medical attention. The
symptoms generally go away on their own.

 Fungal. If your pneumonia is caused by a fungus, you'll likely be treated with antifungal
medication.

Lifestyle and home remedies

If you have pneumonia, the following measures can help you recover more quickly and decrease your
risk of complications:

 Get plenty of rest. Even when you start to feel better, be careful not to overdo it.
 Stay home from school or work until after your temperature returns to normal and you stop
coughing up mucus. This advice depends partially on how sick you were. If uncertain, ask
your doctor. Because pneumonia can recur within a week or so, it may be better not to
return to a full workload until you're sure you're well.
 Drink plenty of fluids, especially water. Liquids keep you from becoming dehydrated and help
loosen mucus in your lungs.
 Take the entire course of any prescribed medications. Stopping medication too soon can
cause your pneumonia to come back and contributes to the development of antibiotic-
resistant bacteria.
 Keep all of your follow-up appointments. Even though you feel better, your lungs may still be
infected. It's important to have your doctor monitor your progress.

Prevention

 Get vaccinated
 Wash your hands: Your hands are in almost constant contact with germs that can cause
pneumonia.
 Don't smoke: Smoking damages your lungs' natural defenses against respiratory infections.
 Take care of yourself: Proper rest and a diet rich in fruits, vegetables and whole grains along
with moderate exercise can help keep your immune system strong.
 Get treatment for GERD: Treat symptomatic GERD, and lose weight if you're overweight.
 Protect others from infection: If you have pneumonia, try to stay away from anyone with a
compromised immune system.