Pneumonia can still take your breath away
In Victorian days pneumonia was a dreaded disease that often proved fatal; even when our generation was young pneumonia was a word that carried with it a certain amount of dread and forboding.
Today you don’t hear the word so often, and with modern treatments it is not associated with the horror of a century or so ago. However, pneumonia is still quite common, it affects around one in ten adults every year, and if not treated promptly it can still be very serious indeed, especially for the over 65s.
Pneumonia is simply an inflammation of the tissue in one or both of the lungs and is caused by infection, usually a bacterial infection. Some people think that pneumonia can be caused by a severe cold or chill, and while these can lower your immunity or lead to secondary bacterial infections, these will not be the direct cause of pneumonia itself.
There are many types of infection that can lead to pneumonia; the most common one is streptococcus pneumonia. However, viruses can sometimes cause pneumonia, for instance the flu caused by type A or B virus can lead to pneumonia as a resultant infection. Far rarer is aspiration pneumonia when the disease is caused by breathing in a foreign object such as a peanut or even vomit. There is one other type of pneumonia caused by a fungal infection of the lungs. This is very rare in the UK and more likely to be found in South America and Africa.
Whatever the initial cause of the infection, when pneumonia takes holds, it inflames the tiny air sacs called the alveoli that are found at the end of the breathing tubes in the lungs. The sacs are in clusters and as they become inflamed they fill up with fluid which causes a cough and also makes it hard to breathe. To help fight this infection, the body directs white blood cells to the lungs which can help kill the germs but can also make it harder for the lungs to pass oxygen into the bloodstream, thus hindering the body’s ability to absorb oxygen.
One result is that you may feel breathless or breathe faster than usual; you may also experience a pain in the chest when you breathe in or out.
In cases of mild pneumonia, it can be thought that the symptoms are just part of a severe cough and cold or even caused by asthma and a definite diagnosis can sometimes be difficult. Doctors will usually listen to the back and front of your chest to check for any rattling sound, or tap the chest because when the lungs are filled with fluid, they produce a different sound to healthy lungs. In more severe cases, or if the symptoms haven’t started to improve within two days, then a chest x-ray may be suggested. This can show far more clearly the cause of the problems and can also help to identify whether the problem is pneumonia or another disease which can cause similar symptoms.
Sometimes it becomes more complicated, for instance some people can develop bronchitis, an infection of the main airways of the lungs, at the same time, or the pneumonia can lead on to pleurisy, an inflammation of thin linings between the lungs and the ribcage. Rarely, pneumococcal pneumonia can cause an infection of the membranes of the brain.
The good news is that today pneumonia can be treated in several ways; often a course of antibiotics together with rest and plenty of fluids will alleviate the problem and most people will return to full health. However, older people or those who have other health problems may need to go to hospital if their breathing is badly affected where more powerful antibiotics, fluids through a drip and extra oxygen can be given or, in really severe cases, a ventilator or artificial breathing machine can be used.
Despite all the treatments, people still die of pneumonia and it is not a disease to be taken lightly.
Knowledge is increasing all the time and at the moment there are two types of vaccine available for the most common form of pneumonia, the streptococcus pneumonia bacterium. One of these vaccines, the PPV, is now available for people over 65 and usually only one vaccine is needed. The British Lung Foundation (www.lunguk.org) offers more information and the European Lung Foundation offers a downloadable fact sheet:
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