Pneumonia is a serious lung infection, especially after 65 years. It can affect one or two lungs (bilateral pneumonia).
Each year in France, 500,000 cases of pneumonia are identified. “”Pneumonia represents the leading cause of mortality by infection worldwide. You have to take it seriously “ Recalls Louis Stoffaes, internal in pulmonology of the association of young pulmonologists (AJPO2). Pneumonia is easily different from bronchitis because “In bronchitis, you will rarely have a high fever resistant to paracetamol, explains Louis Stoffaes. In addition, bronchitis is ‘epidemic’, very often due to a simple virus. ” Pneumonia is also different from COPD (chronic obstructive broncho-pneumopathy) which is a chronic condition of bronchi and lungs, essentially linked to tobacco.
Definition: What is pneumonia?
Pneumonia is an acute lung infection caused by a bacteria or a virus. The infectious agent reaches pulmonary alveoli, areas for the transfer of oxygen which are located at the end of the bronchioles. The cells then fill with liquid, which causes symptoms of pneumonia (including cough). It can touch a lung or both. In this second case, we are talking about “bilateral pneumonia”.
► Bacterial pneumonia most often caused by pneumococcus. The Haemophilus influenzae, the Legionella pneumophila, the mycoplasma pneumoniae, the chlamydia pneumoniae, the klebsiella pneumoniae or the staphylococcus are the other bacteria most often in question. Bacterial pneumonia generally affects a single lobe (we speak of “acute frank lobar pneumonia”) or pulmonary segment. Bacterial pneumonia can also be of the “atypical pneumonia” type.
► Viral pneumonia caused by a virus, the most frequently of influenza viruses, syncytial respiratory virus (VRS) or rhinovirus. This type of pneumonia primarily affects children. Most viral pneumonia are benign and circumscribed to a single pulmonary lobe.
What is atypical pneumonia?
Atypical pneumonia is an infection caused by “atypical” germs, often bacteria such as Legionella pneumophila, mycoplasma pneumoniae (often in young adults) or chlamydophila pneumoniae. They mainly concern the young patient. If the bronchi are also affected, we then speak of bronchopneumonia.
What is a broncho-pneumonia?
Broncho-pneumonia designates the combination of inflammation in the bronchi, but also in the pulmonary tissue.
The germs present in the air penetrate into the lungs through the respiratory tract when you breathe. They can also come from the oral cavity or the ENT sphere (Oto-Rhino-Laryngologique). When these bacteria enter the cells, they cause inflammation. The alveoli then filled with pus and liquid, which leads to the symptoms of pneumonia.
What are the symptoms of pneumonia?
The manifestations vary according to the intensity and severity of the disease as well as the age of the patient. May appear:
- a cough,
- respiratory discomfort,
- a yellowish or greenish expectoration,
- fatigue,
- a drop in blood pressure,
- chest pain,
- a fever that can reach 41 ° C,
- Chills and the appearance of a bluish color of the nails and lips are sometimes noted, testifying to the severity of the involvement.
Beware of atypical bacterial pneumonia, which can cause symptoms that are not characteristic of respiratory disease, such as headache, vomiting or convulsions.
Pneumonia, especially contagious when it is viral
► Viral pneumonia: viral pneumonia can be contagious. “Viruses are known to be transmitted via airborne droplets (cough, sneezing) or even handle. “ In order to avoid being contaminated, minimum precautions are essential: ventilate the rooms, wear a mask if you are facing the patient for a while, sneeze in a handkerchief, wash your hands …
► Bacterial pneumonia: it’s more complex. Some may find themselves in the environment while others are already present, in our throat or digestive tract for example, and take advantage of a false road or an inflection of the immune system to proliferate and cause pneumonia.
The patient’s interrogation and auscultation direct the doctor to the diagnosis of pneumonia. “You can diagnose bronchitis from pneumonia to stethoscope because it produces a very particular noise which testifies to the congestion of the alveoli in the affected area: crackling” assures Louis Stoffaes. A chest radio (lung radio) is essential to confirm this hypothesis, because “It will show a pulmonary parenchyma condensation zone”. An infectious assessment and a bacteriological analysis of bronchopulmonary secretions complete the diagnosis. “We can also take the urine to find signs of infection of certain bacteria.”
Pneumonia is serious: what are the people at risk?
Pneumonia is a potentially serious disease, especially if it occurs in a fragile or elderly person, that is to say:
- People over 65
- People with heart failure
- People who have made a stroke (stroke)
- People with chronic kidney disease
- People with liver disease (cirrhosis, hepatic steatosis, for example)
- People with a broncho-pneumopathy-chronics-tostructive (COPD)
- People with immunosuppression (HIV, cancer …)
- People with sickle cell anemia
- People who have already had bacterial pneumonia
- People who live in an institution (in retirement homes, for example)
What is the treatment of pneumonia?
Treatment varies according to the cause and intensity of pneumonia. “Progress in antibiotic therapy has made it possible to manage the majority of acute home pneumonia between 7 and 21 days in a young patient without comorbidity. But around 50,000 patients are hospitalized each year in France and sometimes even require intensive care, which can last a certain time according to their general condition ” Indicates Louis Stoffaes.
As for the treatment of viral pneumonia, it sometimes involves taking antiviral drugs, but most often the treatment is symptomatic, with paracetamol and rest.
For bacterial pneumonia, antibiotic therapy is essential. In the elderly, babies or those showing signs indicating severe pulmonary involvement, hospitalization is often required. The treatment consists in this case in considering antibiotic therapy adapted to the microbe in question (which remains unknown in more than 50% of cases), administered using a infusion. Rehydration and respiratory assistance such as an oro-tracheal intubation its necessary in the most serious cases.
Is there a pneumonia vaccine?
Pneumococcus is a bacteria responsible for many infections including pneumonia in children and adults. Vaccination is compulsory in all infants born since October 1, 2018 (Prevenar® vaccine). It consists of two injections and a reminder. Adults over 18 at risk of pneumococcal infection can also be vaccinated. Going closer to the attending physician or the pharmacist to request this vaccination.
Evolution and duration of pneumonia: how long to heal?
The duration of pneumonia cannot be encrypted. It depends on each case, on each patient. The severity of pneumonia depends on the extent of the pulmonary area which is affected but also on the microbe in question, the age and the medical history of the affected person. It generally evolves favorably thanks to antibiotic treatment. With early and suitable treatment, symptoms quickly improve in a few days. If the fever persists, you should re-consult your doctor. Signs to radiography (or scanner) can become normal again up to three months after healing.
Thanks to Louis Stoffaes, internal in pulmonology and member of the association of young pulmonologists – AJPO2.
