|
If you have pneumonia, you may be working hard to breathe, or may be breathing fast. Crackles are heard when listening to your chest with a stethoscope. Other abnormal breathing sounds may also be heard through the stethoscope or via percussion (tapping on your chest wall).
The following tests may show signs of pneumonia:
- Chest x-ray
- Gram's stain and culture of your sputum to look for the organism causing your symptoms
- CBC to check white blood cell count; if high, this suggests bacterial infection
- Arterial blood gases to check how well you are oxygenating your blood
- Thoracic CT
- Pulmonary ventilation/perfusion scan
- Pleural fluid culture if there is fluid in the space surrounding the lungs
|
|
Treatment for Commuity Acquired Pneumonia varies according to the organism responsible for the infection. If the cause is bacterial, then the goal of treatment is to cure the infection with antibiotics, which can typically be taken orally at home if the infection is not severe. If the infection is severe, if the person is having difficulty breathing, or has other chronic medical conditions, then intravenous (IV—injected into a vein) antibiotics may be needed and are usually administered in a hospital. If the infection is viral, the goal is to alleviate any signs and symptoms of the infection through supportive care (such as fever reduction with acetaminophen) since there is no cure for a virus.
Because several treatment guidelines are available, the specific drug(s) that your doctor may use to treat your CAP may vary. Clinical expertise/preference and antibiotic drug resistance in a particular area are two factors that may affect a doctor’s drug of choice for treating CAP.
At the initial visit to the doctor, he or she will question you about your past medical history and perform a physical examination. It may be necessary to perform a chest X-ray. Next, your doctor will determine how much your infection places your life at risk. Your doctor may have a laboratory test done on samples of your sputum, blood, urine, or sometimes all to confirm your CAP diagnosis. Doctors will usually prescribe "empiric therapy"—prescribing therapy based on the suspected cause (bacteria, virus, or fungi) using clinical or practical expertise—because the specific organism responsible for the infection is usually not identified when treatment is initiated. After the organism is identified, therapy can be tailored to treat that specific organism. The following chart describes the guidelines from the Infectious Diseases Society of America for outpatient therapy.
When CAP patients require hospitalization, IV antibiotics will generally be initiated along with oxygen therapy to help breathing. Studies have shown that bacterial CAP can affectively be treated with 5 to 14 days of antibiotics. However, this duration of therapy may be longer if the cause of the infection is found to be from specific bacterial organisms such as Legionella or Pseudomonas, fungal organisms, or if you have other medical conditions that may compromise your recovery. Regardless of the drug chosen, it is important to remember to take the entire antibiotic prescribed by your physician. Many people take their medication only until they feel better. This can contribute to antibiotic resistance and allow an infection to recur with even greater severity in the near future. Development of resistance can also have the potential to prevent a given antibiotic from working well to treat other patients with the same infection in your family or community.
Steps that you can take at home include:
- Drink plenty of fluids to help loosen secretions and bring up phlegm.
- Get lots of rest. For example, have someone else cook and do light work around the house.
- Control your fever with aspirin or acetaminophen. Aspirin must NOT be given to children.
When in the hospital, respiratory treatments to remove secretions may be necessary. Occasionally, steroid medications may be used to reduce wheezing if there is an underlying lung disease.
|
