What is Pneumonia?

Age is the first epidemiological factor to take into account when faced with pneumonia, since each age group is related to specific microorganisms.

How it is produced

There are several entry mechanisms for infectious agents:

• By bronchopulmonary microaspiration from oropharyngeal secretions: it is the most frequent mechanism in the production of pneumonia.
• By inhalation from the air of contaminated aerosols (most frequent mechanism of viral pneumonia, by Coxiella, Legionella, Mycoplasma or Chlamiydia).
• By blood dissemination (Stapilococcus pneumonia in injecting drug addicts).
• Due to contiguity, from infections of structures or organs near the lung from the outside, from wounds or after surgery (exceptional).

In all these cases there is an alteration of the pulmonary defense mechanisms, as well as an excessive presence of microbes that exceed these mechanisms.

Symptoms of pneumonia

Depending on whether or not the infection has been in the hospital, two large groups of pneumonia are distinguished:

Pneumonia caught outside the hospital

• Typical syndrome: It is preceded by a viral picture after which a high fever, productive cough, pleuritic pain in the tip of the side begins abruptly, which increases with cough and with deep inspiration, chills and dyspnea. In 10-15% a cold sore can be identified. It is characteristic of Streptococcus pneumoniae and Haemophilus influenzae.
• Atypical syndrome: More insidious onset, with fever without chills, irritating cough and extrapulmonary symptoms such as headache, myalgia, arthralgia, sore throat, nausea, vomiting and diarrhea. It is typical of Mycoplasma pneumoniae and Chlamydia.

In the elderly, this differentiation is not usually so clear, and pneumonia can occur without fever, chills or dyspnea, and may present with altered state of consciousness and other nonspecific symptoms and signs.

Pneumonia caught in the hospital

It can present in a similar way to community-acquired pneumonia, either as the typical form with fever, chills, and productive cough or on other occasions, the clinic is very scarce and with a slower onset. Depending on the underlying pathology of the hospitalized patient, some infectious agents or others predominate, for example, E.coli pneumonia is common in diabetics.

Diagnosing pneumonia

A chest X-ray is required if pneumonia is suspected in order to diagnose it. Typical community-acquired pneumonias present with a characteristic pattern that is that of a alveolar condensation with air bronchogram (80% of cases in the form of pulmonary crackles). The atypical ones present radiologically with an interstitial infiltrate, being characteristic the radiological clinical dissociation (the physical examination is usually normal).

The sputum examination it has a low profitability, both due to the normal contamination of the oropharyngeal flora and due to the previous administration of antibiotics. It is only positive in half of bacterial pneumonia.

There are no specific radiographic patterns to identify the infectious agent.

There are immunological techniques to try to identify infectious agents from sputum, blood and urine.

Treatment

It consists of the use of antibiotics depending on the patient to be treated, which can be empirical (the causative germ is not known) or specific if the infectious agent has been recognized. antibiotic treatment must be accompanied by a series of general measures such as repose, quit smoking, hydrate, and take pain relievers for fever and / or pleuritic pain.

In cases in which the patient meets two of the following criteria: significant alteration on the chest x-ray (involvement of more than one lobe or bilateral, pleural effusion or lung cavitation), problems following treatment at home, lack of tolerance to oral treatment, decompensation of his underlying disease and / or immunosuppression, he should be referred to a hospital for treatment.

In pneumonia in-hospital Treatment will be based on the results of cultures from the sputum sample. They are usually treatments of up to 21 days duration. In the case of acquired pneumonia In the community, treatment is usually empirical with a duration of 7-10 days.

Prevention

There is a moderately effective vaccine, with 60% effectiveness. It is indicated in adults over 65 years of age and in children over 2 years of age and in adults at high risk of infection by pneumococcus : asplenia, renal failure or nephrotic syndrome, sickle cell anemia, HIV, immunosuppressed, cystic fibrosis, diabetes mellitus, transplant patients, alcoholism, liver cirrhosis, chronic lung diseases, cardiovascular diseases, CSF fistula carriers.

They offer policyholders the most comprehensive guarantees to protect their well-being and that of their family. We inform you of the insurance that best suits your needs.

CALCULATE YOUR PRICE