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Pneumonia

This is a general term used to describe any lung inflammation, usually conditions in which fluid is discharged into the alveoli. The different types of pneumonia can be divided into two main groups: the specific type, in which the disease is caused by a specific harmful organism, either a bacterium or a virus; and the aspiration, or secondary, type, in which some abnormality in the respiratory system predisposes the lungs to infection by otherwise fairly harmless organisms.

Pneumococcal pneumonia (sometimes called acute lobar pneumonia), caused by pneumococcus bacteria, is a specific type of pneumonia. It affects one or more lobes, or segments, of a lung; if both lungs are affected it is commonly known as double pneumonia. The affected lobes become congested and the blood vessels distended, causing the lung to be enlarged and heavy.

Another type of specific pneumonia is caused by staphylococcal-type bacteria. It resembles pneumococcal pneumonia and may be confused with it. It is often a complication of influenza.

The aspiration types of pneumonia are not caused by bacteria or viruses; the infection generally reaches the lungs by being breathed in from other parts of the respiratory tract. It may occur as part of another infection such as tuberculosis, or after major surgery, an accident, or breathing in some poisonous chemical. Whenever there is an excess of secretions in the respiratory tract and the mechanisms for preventing these accumulating in the bronchi are ineffective (if the person is 100 weak 10 cough, for example), the secretions and any organisms within them are carried deeply into the lungs and may cause infection. Acute pneumonia (or bronchopneumonia) is the most common type of aspiration pneumonia, and is a result of a spreading bronchial infection.

Symptoms

Pneumonia, which can occur at any age, most commonly in winter, begins suddenly, with a fever which may rise to 38.8° to 40°C (102° to 104°F) in a few hours. There is a cough, and may also be a headache and general feeling of chill. A sharp pain in the chest, shoulder or abdomen develops, and breathing is fast, shallow and painful. The cough, dry at first, becomes productive, and the sputum may be a distinctive rust colour, sometimes containing blood. The pulse is rapid, and sometimes the blood pressure drops. The skin is hot and dry and the face flushed, with a slightly blue tinge (cyanosis). The severity of symptoms depends on the size of the area in the lung that is affected.

Treatment

Even though many cases of pneumonia are mild in otherwise healthy people, admission to hospital is usually advised because the disease can suddenly become severe. Close medical supervision is therefore desirable, particularly if the sufferer's health is generally poor. Treatment is with antibiotics chosen to deal with the specific cause of the inflammation, as detected by laboratory tests. Analgesics may also be given for any pain in the chest. In severe cases of breathlessness and cyanosis oxygen may be given.

In nearly all cases the chances of rapid recovery are good. Within one or two days the temperature, pulse and breathing rate drop rapidly, and the lung inflammation is dramatically relieved. Other symptoms may take longer 10 disappear, but a healthy young person will normally recover completely within a week or two. However, in the very young, very old, heavy smokers and those suffering from a chronic illness or alcoholism, the outlook is less good. A person in one of these high risk groups may rapidly weaken and die of circulatory failure or hypoxia (insufficient oxygen in the bloodstream).

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