Pneumonia: Care and Treatment

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Viral pneumonia

Most viral pneumonia appears subtle, with mild flu-like symptoms, mostly limited to a mild fever accompanied by a dry, irritating cough. Most of the time there is a spontaneous resolution of the disease, which can even remain undetected. Other times, however, the onset symptoms worsen over a period of 12-36 hours, with difficulty in breathing and an increase in the intensity of the cough, which becomes slightly productive.

In the most severe cases, breathing difficulties become particularly severe and the patient assumes a cyanotic appearance (bluish discoloration of the skin and lips). Viral pneumonia, in fact, can pave the way for the invasion of germs, becoming more complicated in the bacterial form.

The main pulmonary pathogens in early and late childhood are viruses. Among the infectious agents most commonly responsible for viral pneumonia we remember the influenza virus, the adenoviruses, the respiratory syncytial virus, the metapneumovirus, the herpes simplex, the coronavirus and the cytomegalovirus. These agents can cause pneumonia even in mature age; however, the common viruses in healthy adults are only influenza A, occasionally influenza B, and rarely varicella-zoster.

Mycoplasmic pneumonia

One of the main differences between viruses and bacteria is that the latter are capable of autonomous existence, while viruses, in order to live and reproduce, are forced to parasitize cells and exploit metabolic intermediates, enzymes and organelles. Among bacteria, mycoplasmas are outside this rule, being particularly small in size and presenting other characteristics similar to viruses.

Mycoplasma pneumoniae is the most common causative agent of primary atypical pneumonia, which occurs mainly in late childhood and young adults, typically in the spring. The most common symptom of this disease is cough, which tends to present with paroxysmal episodes (violent attacks) and is accompanied by traces of whitish mucus in the "sputum. At the onset, chills and fever appear, while some patients complain of nausea, vomiting. and weakness that lasts for several days.

Other Forms of Pneumonia

Pneumonia Pneumocystis carinii (PCP) is caused by the Pneumocystis jirovecii, an opportunistic fungus that causes disease in people with weakened immune systems, such as those with AIDS.

Chemical pneumonia occurs when material with a direct toxic effect on the lungs is inhaled or aspirated. The most common form is acid pneumonia from gastric juice inhalation. The sucked up material can also exert an obstructive mechanical effect.

Microorganisms not yet mentioned, but which can cause life-threatening pneumonia, are the tuberculosis bacillus, the H5N1 and H1N1 viruses, and that of SARS (Severe Acute Respiratory Syndrome).

Diagnosis

How is the diagnosis of pneumonia made?

The diagnosis of pneumonia is made on the basis of chest radiographic findings, clinical examination (investigation of symptoms, auscultation of the lungs with stethoscope) and sometimes on the results of culture of the sputum.

The value of this last diagnostic investigation is limited by the possible contamination of the sample by the normal oropharyngeal flora during the passage along the upper airways. Precisely identifying the microorganism responsible for pneumonia, or its category, allows to implement a targeted and effective therapeutic intervention.

Care and treatment

Pneumonia: what is the intended treatment?

See also: Medicines for the Treatment of Pneumonia

The treatment of pneumonia varies in relation to the severity of the symptoms, the type of organism responsible for the inflammatory process and the state of health of the patient, which can make the use of certain drugs contraindicated.

Bacterial pneumonia is usually treated with antibiotics; if the doctor prescribes these drugs, the patient must strictly adhere to what is prescribed, ending the therapy even when the symptoms disappear after a few days. This precaution decreases the risk of relapse and the selection of bacterial strains resistant to antibiotics.

In viral pneumonia, the intervention strategy is generally limited to rest and generous fluid intake. Only under certain circumstances are antiviral drugs prescribed.

Pneumonia caused by Mycoplasma pneumonias is treated with antibiotics. However, recovery may not be immediate and the patient may complain of physical fatigue even after the infection has been eradicated.

In the most severe forms, supportive respiratory therapy and drainage of empyema and large pleural effusions may be necessary. Painkillers and antitussives can be administered to relieve pleural pain and cough; the latter must in any case be used at the minimum dose necessary, since coughing is still useful for removing microbes from the lungs.

A young and healthy individual can return to normal daily activities after a few days of recovery. Middle-aged people, on the other hand, may need weeks to regain the strength, physical vigor and sense of well-being prior to the disease. As anticipated, some cases of pneumonia caused by Mycoplasma pneumonia can leave behind a trail of weakness for quite long periods.

In general, adequate rest is very important for recovery and recovery from the disease, as well as for preventing recurrence. In this sense, for the patient suffering from pneumonia, it is therefore important to respect medical indications, without forcing the return to normal daily activities.