A glimpse information about Pneumonia

Today, i want to write about something that i thought amazing. Okay, Let’s talk about Pneumonia.

What is Pneumonia?

From many definition of Pneumonia, I choose this definition. Pneumonia is respiratory disorder involving inflamation of the lung structures, such as the alveoli and bronchioles. This definition lead me into the main point of this condition, it is INFLAMATION. Where?. It is in the Lung. What specific part of the lung?. It is Alveoli and Bronchioles. See, it is easy.

Maybe you have ever heard about Bronchopneumonia. It is a twin sister or twin brother to Pneumonia. Bronchopneumonia is a type of pneumonia. There are two types of pneumonia: lobar and bronchial. Lobar pneumonia affects one or more sections, or lobes, or the lungs. Bronchopneumonia affects both lungs and the bronchi. Bronchopneumonia can be mild or severe, with viral bronchopneumonia usually being less severe. So, now we can see the difference, right?.

What is the epidemiology of this condition ? 

It is the right time to ask that question. This condition will effect every body in this world especially they are who at the high risk. UNICEF reported Pneumonia as one of the cause of death in children. This condition affect most of the children in the developing country and south asia.

Figure 1. Percentage of under-five deaths due to pneumonia and neonatal severe infections, by region (2000-2003).

Another figure will represent different perspective. Please look at Figure 2.

Figure 2. Incidence of childhood clinical pneumonia at the country level

from this image we can see clearly about incidence of pneumonia in children around the world. The sad news about this data is my country (Indonesia) it be a part of this dissemination and i’m not happy about it. This will be a reason to know well about Pneumonia and how to deal with it.

What are the sign and symptom in the person with pneumonia?

The signs and symptoms of pneumonia vary from mild to severe, depending on factors such as the type of germ causing the infection, and your age and overall health. Mild signs and symptoms often are similar to those of a cold or flu, but they last longer.

The most common symptoms of pneumonia are:

  • Cough (with some pneumonias you may cough up greenish or yellow mucus, or even bloody mucus)
  • Fever, which may be mild or high
  • Shaking chills and “teeth -chattering” chills. This condition happen because your body try to make heat and protect your own self. The heat will help your immune system against the invader from outside.
  • Shortness of breath (may only occur when you climb stairs or exert yourself, but it will happen when you just walk by your self, it depends on you own lung condition ).

Other symptoms include:

  • Confusion especially in older people. In Older people, all the system in their body has decreased. Lost of small amount of oxygen will give them a big trouble, like this confusion.
  • Excess sweating and clammy skin. This is happen because of the sweating process. Don’t be to shock.
  • Headache. This is the effect of lack of oxygen in your brain.
  • Lost of appetite low energy, and fatigue. You don’t have oxygen to burn your carbohydrate and protein, so can not want more, right?.
  • Malaise (not feeling well)
  • Sharp or stabbing chest pain that gets worse when you breathe deeply or cough
  • White nail syndrome, or leukonychia. You can see the Leukonychia images in the figure 3.

Figure 2. Leukonychia

What is the causes of Pneumonia? 

I don’t know, is my question right in here or not. I just want to excavate the cause of Pneumonia. Many germs can cause pneumonia. The most common are bacteria and viruses in the air we breathe. Your body usually prevents these germs from infecting your lungs. But sometimes these germs can overpower your immune system, even if your health is generally good. Let’s take a look the headline. It refer to the power of your immune system. Every body has a chance to have pneumonia as a disease but not luckiest enough to get it. The key in here is your body system.

in another resources, the writer divided the cause of pneumonia according to the types of germs that cause it and where you get the infection. I want to choose that as my part of information.

  1. Community-acquired pneumoniaCommunity-acquired pneumonia is the most common type of pneumonia. It occurs outside of hospitals or other health care facilities. It may be caused by:
    • Bacteria. The most common cause of bacterial pneumonia in the U.S. is Streptococcus pneumoniae. This type of pneumonia can occur on its own or after you’ve had a cold or the flu. It may affect one part (lobe) of the lung, a condition called lobar pneumonia.
    • Bacteria-like organisms. Mycoplasma pneumoniae also can cause pneumonia. It typically produces milder symptoms than do other types of pneumonia. Walking pneumonia, a term used to describe pneumonia that isn’t severe enough to require bed rest, may be caused by M. pneumoniae.
    • Viruses. Some of the viruses that cause colds and the flu can cause pneumonia. Viruses are the most common cause of pneumonia in children younger than 5 years. Viral pneumonia is usually mild. But in some cases it can become very serious.
    • Fungi. This type of pneumonia is most common in people with chronic health problems or weakened immune systems, and in people who have inhaled large doses of the organisms. The fungi that cause it can be found in soil or bird droppings.
  2. Hospital-acquired pneumonia

    Some people catch pneumonia during a hospital stay for another illness. This type of pneumonia can be serious because the bacteria causing it may be more resistant to antibiotics. People who are on breathing machines (ventilators), often used in intensive care units, are at higher risk of this type of pneumonia. They count it in 48 hours the patient live in the hospital. Nurses should be aware about this infection, because it will affect the hospital accreditation.

  3.  Health care-acquired pneumonia

    Health care-acquired pneumonia is a bacterial infection that occurs in people who are living in long-term care facilities or have been treated in outpatient clinics, including kidney dialysis centers. Like hospital-acquired pneumonia, health care-acquired pneumonia can be caused by bacteria that are more resistant to antibiotics. This is something that the nurse should consider really well when take care of the patient. The nurse will become mediator for this inflammation process. it is really important  to keep personal hygiene and protection of the nurses before they meet the patient.

  4. Aspiration pneumoniaAspiration pneumonia occurs when you inhale food, drink, vomit or saliva into your lungs. Aspiration is more likely if something disturbs your normal gag reflex, such as a brain injury or swallowing problem, or excessive use of alcohol or drugs. in this condition, the nurse must be aware with the patient who has passive activation on the bed. When the nurse helps the patient to eat their food, the nurse should be wary with aspiration. Because, the clear reason in here. it will refer to aspiration and next pneumonia.

Who are the people who at risk for this condition ? 

Pneumonia can affect anyone. But the two age groups at highest risk are:

  • Children who are 2 years old or younger developing
  • People who are age 65 or older

Other risk factors include:

  • Chronic disease. You’re more likely to get pneumonia if you have asthma, chronic obstructive pulmonary disease or heart disease.
  • Weakened or suppressed immune system. People who have HIV/AIDS, who’ve had an organ transplant, or who receive chemotherapy or long-term steroids are at risk.
  • Smoking. Smoking damages your body’s natural defenses against the bacteria and viruses that cause pneumonia.
  • Being hospitalized. You’re at greater risk of pneumonia if you’re in a hospital intensive care unit, especially if you’re on a machine that helps you breathe (a ventilator).

WHO reported that Risk factors related to the host and the environment that affect incidence of childhood clinical pneumonia in the community in developing countries are in the below. Why in children ?. As you know, and we had explained it to you in above, that children is a high risk age to have this condition.

Definite risk factors
Malnutrition (weight-for-age z-score < –2)
Low birth weight (≤ 2500 g)
Non-exclusive breastfeeding (during the first 4 months of life)
Lack of measles immunization (within the first 12 months of life)
Indoor air pollution
Likely risk factors
Parental smoking
Zinc deficiency
Mother’s experience as a caregiver
Concomitant diseases (e.g. diarrhoea, heart disease, asthma)
Possible risk factors
Mother’s education
Day-care attendance
Rainfall (humidity)
High altitude (cold air)
Vitamin A deficiency
Birth order
Outdoor air pollution

How Is Pneumonia develop in our body ? 

Answering that question, I need an another figure to explain that. Please take a look for next Figure.

Figure 4. The Pathophysiology of the Pneumonia.

In the picture, bacteria or viruses (we call it microorganism) will invade the lung (respiratory system), the location is depends on the microorganism. Next, our immune system will respond and release their chemical systematic army against the microorganism as an alien. The war between immune system and the enemy will make both of them being killed and it will appear in ‘fluid’ form and the sign of inflammation. This sign of inflammation and fluid will make the sign and symptom to the body and you will recognize it by looking on it or assess it. This is my simple and quick patopysiology of the pneumonia as a disease. If you have more explanation about it, please share. I plan to make a special article about it.

Figure. 5 Another Patophysiology for pneumonia.

Alcohol contributes to develop Pneumonia. For the complete information, please click http://pubs.niaaa.nih.gov/publications/10report/chap04b.pdf.

The quick cheat about it: Alcohol will increase immunological level in the body especially IgA . Increase of this immunologic level will develop immunodeficiency.

So, I think this is all for this simple article. I don’t hope many things will change constantly in a few minutes when you read it or when i reread it. I just want to make a quick trigger that lead you to find complete information about this topics. We had discussed about the definition of pneumonia, the quick simple epidemiology and we end up with the same conclusion that “pneumonia is very important to know”. We discussed about cause and effect of pneumonia and my simple explanation of Pneumonia’s patophysiology. I hope, your journey to find the information never end up in here, it occur to my self also. so, never mind.

Have a great day, reader.

The resources that i used for this article, are:

  1. http://www.mayoclinic.org/diseases-conditions/pneumonia/basics/causes/con-20020032
  2. http://www.mayoclinic.org/diseases-conditions/pneumonia/basics/risk-factors/con-20020032
  3. http://www.who.int/bulletin/volumes/86/5/07-048769/en/
  4. https://www.nlm.nih.gov/medlineplus/ency/article/000145.htm
  5. http://www.webmd.com/lung/tc/pneumonia-topic-overview

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