|
Pneumonia
Pneumonia refers to a bacterial or viral infection of the lung tissue. The most common forms of pneumonia are bacterial (Pneumococcus and Mycoplasma) and both require antibiotic therapy. Generally, Mycoplasmal pneumonia is less severe and will resolve in the majority of cases with only supportive treatment. Viral pneumonias can be quite severe and can result in frank respiratory failure. Antibiotics have NO effect on viral infections. Smokers, the elderly and the immunocompromised (diabetics, cancer patients) are at increased risk for SERIOUS pneumonia. Aspiration pneumonia is also seen more frequently in this group.
Common symptoms include: a yellow or green productive (expectorated mucus) cough, fever, and shaking chills. More severe pneumonia may have associated shortness of breath or pleuritic chest pain (pain worse with coughing). Evaluation will include: history and physical examination for evidence of fever or upper respiratory infection. A chest x-ray can diagnose pneumonia, and, in most cases, is necessary for definitive diagnosis. Blood tests (blood counts, blood cultures, blood chemistry) and sputum cultures (material produced with coughing) will aid in the evaluation. Treatment is based on the patient's overall health, age, and the extent of the pneumonia. Older patients, and those with diabetes or pre-existing lung disease will be admitted for IV antibiotics. Younger patients with no significant medical history, and no evidence for respiratory compromise, can be treated at home with oral antibiotic medications. Close medical follow-up is suggested. Any patient SHORT OF BREATH while at rest, or with evidence for inadequate oxygenation by arterial blood gas analysis, will require admission to the hospital. A vaccine known as the Pneumovax is available as protection against potentially serious bacterial pneumonia in those patients considered at high risk for infection. This group would include those over age 65, those suffering from chronic obstructive pulmonary disease, the chronically debilitated, or those who have had their spleen removed.
|
