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Learn About Pneumonia

Bacterial Pneumonia

CAUSES | SYMPTOMS | DIAGNOSIS | TREATMENT

Bacterial pneumonia can strike at any stage, right from infancy to old age. Those with weakened immune systems like post operative patients, people already suffering from respiratory ailments or viral infections and alcoholics are more prone to catching this disease.
Traces of Pneumonia bacteria could also be present in some healthy throats. When body defenses are lowered in some way, by illness, advanced age, malnutrition, general debility or impaired immunity, the bacteria can thrive and cause grave harm. Usually, when a person’s resistance is reduced, bacteria work their way into the lungs and inflame the air sacs. These air sacs called alveoli then get filled with fluid and are unable to effectively transfer oxygen into the blood and eliminate carbon dioxide from it. In this way, gradually the entire lung gets infected and the infection spreads to the whole body through the bloodstream.

The streptococcus pneumonia or pneumococcal is the most common cause of bacterial pneumonia. It is also one of the most common infections occurring in children, causing meningitis, infections of the bloodstream and pneumonia in children especially under five years of age. Haemophilius influenza, Chlamydia trachomatis, Mycoplasma pneumonia and Legionella pneumophila are the other major bacteria that cause pneumonia. Vaccines providing immunity from bacterial pneumonia are now readily available.

Bacterial pneumonia develops when bacteria usually living harmlessly in the throat enter the lungs. This usually happens when the body’s immune system is weakened for some reason like an upper respiratory infection, or influenza. The already weakened lungs allow the bacteria to spread the infection, filling the alveoli (tiny air sacs present in the lungs with fluid). This in turn affects the elasticity of the lungs and their efficiency to bring about the exchange of gases is greatly hampered. The lungs are unable to satisfy the body’s oxygen requirements and hence cause shortness of breath which is the most common symptom of pneumonia. The inflammation also causes other symptoms like chest pain and fever.

Pneumonia can turn very serious, because it directly interferes with your body’s ability to exchange carbon dioxide and oxygen. Pneumonia differs in this way from acute bronchitis, which is another disease that can cause fever, cough, chest pain, and shortness of breath. Bronchitis is caused by a swelling of the air passages (bronchi) leading to the alveoli, not the alveoli themselves. Sometimes it is very difficult, even for a doctor, to distinguish between pneumonia and bronchitis. Their symptoms and can often be identical. In most cases a chest x-ray is the only way to tell the two apart.

The most common way to catch pneumonia is to inhale infected air droplets from an infected individual. A poorly cleaned air conditioner could also be a cause of pneumonia. An infection in another part of the body could also render the immunity to be lowered and lower the resistance of the lungs to fight the infection. The risk factor is also determined by the intensity of exposure to the bacteria, the type of bacteria and the general immunity of the body. You will not contract pneumonia by being out in the cold or by getting wet in the rain.

Bacterial Pneumonia Causes

The most common causes of pneumonia are generally the different species of bacteria. It is often difficult to identify the specific species of bacteria that cause pneumonia. Usually, the categorization of the species of bacteria is done by a staining procedure called the Gram Stain. In this procedure, a smear of bacteria is treated to Gram Stain and then it is examined under the microscope. The color of the bacteria after the staining procedure, determines if they are gram-negative or gram-positive bacteria. This gives a clear idea of the characteristics of the bacteria and thus the physician can judge the severity of pneumonia.

Gram-Positive Bacteria: In the Gram Stain procedure, these types of bacteria appear blue in color. The following are the common gram-positive bacteria:

  • Staphylococcus aureus, another gram-positive bacterium is responsible for 10% of bacterial pneumonia cases. Nosocomial pneumonia that occurs in hospitals can be attributed to this strain of bacteria. It is not common in normal healthy individuals and usually infects susceptible individuals. It can develop, five days after viral influenza, in people with weak immune systems. Children, hospitalized patients, and drug abusers who use needles are also susceptible to this strain of bacteria.
  • Gram-positive Streptococcus pneumoniae is the most common cause of pneumonia. This bacterium is also called as S. pneumoniae or pneumococcal pneumonia. In the beginning, it was assumed that 95% of community-acquired bacterial infection was caused by this species, but recent studies have revealed that the cases were far less, accounting for approximately half of all cases. Some research studies suggest that it may be only responsible for even fewer cases (10% to 30% of cases) than what was earlier reported.
  • Streptococcus pyogenes or Group A Streptococcus are also responsible for causing pneumonia.

Gram-Negative Bacteria: In the Gram Stain procedure, these bacteria stain pink in color. Gram-negative bacteria commonly cause diseases in hospitalized or nursing home patients, children with cystic fibrosis, and people with chronic lung conditions.

  • Moraxella catarrhalis, is normally found in the nasal and oral passages. Research reveals that this bacterium is a cause of certain pneumonias, especially in people with lung problems, like asthma or emphysema.
  • Klebsiella pneumoniae, usually causes pneumonia in alcoholics and other people, who are physically debilitated.
  • Haemophilus influenzae is the most common gram-negative species that cause pneumonia, generally in patients with chronic lung disease, older patients, and alcoholics.
  • Neisseria meningitidis causes meningitis, which is the central nervous system infection. However, this organism has been reported in cases of pneumonia, especially in epidemics occurring in military recruits.
  • Pseudomonas aeruginosa is responsible for causing pneumonia in hospitals (nosocomial pneumonia). It is commonly seen in pneumonia patients suffering from chronic or severe lung disease.
  • Other gram-negative bacteria that cause pneumonia are E. coli, mostly in newborns, Proteus and Enterobacter.

Streptococcus pneumoniae also called as pneumococcus, is the most common cause of bacterial pneumonia. It causes lobar pneumonia by attacking an entire lobe or portion of a lobe of the lung. In case of double pneumonia, this bacterium attacks both the lungs. Pneumococcal lobar pneumonia usually occurs in winter after a severe upper respiratory viral infection. The most common symptoms are chills followed by high fever i.e about 40°C (104°F), chest congestion and pain in the chest while breathing and cough with blood-streaked sputum.

Other bacteria that are known to cause pneumonia are Klebsiella pneumoniae, Haemophilus influenzae, Legionella pneumophilia (the bacterium that causes Legionnaires’ disease), and various species of staphylococci and streptococci bacteria. These organisms primarily cause bronchopneumonia and the onset of symptoms is usually slower than with lobar pneumonia.

Bacterial Pneumonia Symptoms

Doctors often classify the disease as typical and atypical pneumonia based on the visible signs and symptoms. This enables easy identification of the bacteria causing pneumonia, the estimation of duration of illness and the optimal course of treatment.

  • Symptoms of typical pneumonia.
    • Typical pneumonia develops very quickly.
    • It usually causes high fever and chills.
    • The sputum appears yellow or brown after a spell of coughing.
    • There could be chest pain which worsens with deep breathing or with coughing. The chest may also be sore and painful to touch.
    • There could be shortness of breath which could be more acute if patient also suffers from chronic lung ailments like asthma or emphysema.
    • Since chest pain could also be a symptom of other serious ailments, it is not advisable to self-diagnose. It is important to consult a specialist in case you experience any of the above symptoms.
  • Symptoms of atypical pneumonia.
    • Atypical pneumonia develops gradually.
    • It is also called ‘walking’ pneumonia.
    • It may follow another illness which may have developed a few days or weeks earlier.
    • The fever is generally lower and there are fewer chances of chills.
    • Headaches, body ache and joint and abdominal pain but no chest pain.
    • There could be a dry cough accompanied by little or no sputum.
    • General fatigue and a feeling of tiredness.
    • Older people may experience disorientation or confusion which could be a sign of atypical pneumonia.

Diagnosis of Bacterial Pneumonia

To diagnose pneumonia, the doctor begins with checking the medical history and conducting physical examination. With the help of a stethoscope, the doctor can clearly listen to coarse breathing and wheezing. To strengthen its diagnosis, a doctor may even ask for additional tests such as chest x-ray, a blood test or Gram Stain of the sputum. The chest x-ray that indicates pneumonia may show an area that is blotchy-white and the air sacs of the lungs may have fluid and pus accumulated in them. The cause and the severity of the condition may often be known through Gram Stain test of the sputum or the blood test.

If the doctor is not satisfied with the results of these tests, he may perform a procedure called a Bronchoscopy. In this test, after the local anesthetic is administered, a thin, flexible and lit viewing tube is inserted into the nose or mouth. The doctor can then examine the breathing passages and can also extract specimens from the infected part of the lung.

Treatment of Bacterial Pneumonia

Home Treatment

If you experience the signs or symptoms of Pneumonia, it is best to consult the doctor rather than wait for the situation to worsen. Home treatment for pneumonia is not possible. Therefore, it is best to visit a doctor, if the symptoms persist even after administering some Over The Counter (OTC) medications like cough suppressants, expectorants, or fever-lowering drugs. It is always better to consult the doctor before you administer any of the OTC medications to avoid complications.

Medical Treatment

Bacterial pneumonia can be treated with the help of antibiotics. While prescribing the antibiotic, the doctor will look at various aspects; your age, history of antibiotic allergy, your chronic medical conditions, whether you are a smoker or you drink alcohol. Your doctor should be aware of your medical history to help him choose the right antibiotic for you.

Staying hydrated helps you to fight pneumonia. Drinking plenty of non-alcoholic fluids is necessary. Anti-inflammatory or fever reducing medicines such as acetaminophen (Tylenol) or ibuprofen (Advil) may help you feel better. Your doctor might restrict your use of cough suppressants as coughing helps to clear infection that is prevalent in your lungs.

Ensure that you stay away from cigarette or alcohol during the recovery process of pneumonia. Smoking or consumption of alcohol lowers the ability of the body to fight infection, thereby increasing the time taken for you to heal. Serious conditions like shortness of breath, poor circulation of oxygen levels in your bloodstream need immediate medical attention. In such cases, you may be required to be admitted in the hospital to ensure that proper oxygen level is maintained for easy breathing. Antibiotics could be administered through IV.

If the condition of pneumonia is severe, a breathing tube may be inserted in your windpipe to facilitate breathing. Severe case of pneumonia is usually treated in an intensive care unit of the hospital.