Adult pneumonia

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What is it about ?

Respiration passes through the respiratory tract. We distinguish the upper and lower respiratory tract.

  • The nose and throat form the upper respiratory tract.
  • The trachea, bronchi, and lung tissue (alveoli) are some of the lower respiratory tract.

When we breathe, the bronchi carry oxygen to the pulmonary alveoli, where it is sent to the blood. It is also by this route that carbon dioxide (CO2) is rejected to the outside.

Since pneumonia is an infection of the lung tissue, it is one of the most common lower respiratory tract infections. Infection of the bronchi (bronchitis) also belongs to this category. the common cold and theangina are, for their part, examples ofupper respiratory tract infections.

You can contract pneumonia in hospital, but also in everyday life, eg at school, at work, at home,… after being infected with the pathogenic germ (bacteria or virus).

Causes of pneumonia

Pneumonia can be caused by both a virus and bacteria. In view of the severity of the condition, however, all pneumonia is considered to be bacterial and treated with antibiotics.

  • The most common bacteria causing pneumonia are, in order, Streptococcus pneumoniae (‘pneumococci‘), Mycoplasma pneumoniae, Chlamydophila pneumoniae and Haemophilus influenzae.
  • The most common virus that can cause pneumonia is influenza type A virus ( flu).
Swallowing pneumonia

Aspiration pneumonia or aspiration pneumonia is a special form of the disease, which occurs when a foreign object such as food, drink or vomit reaches the lungs after a wrong drive (when you ‘swallow askew’ ). Once there, it triggers inflammation. This form of pneumonia mainly affects older people and people with swallowing problems.

What is its frequency?

Each year, the general practitioner diagnoses pneumonia in about 9 out of 1,000 consultations.1 Its frequency is the highest among young children and the elderly.

How to recognize it?

Symptoms of pneumonia and acute bronchitis are very similar, but they are usually more severe in pneumonia.

The most common symptoms are:

Symptoms may appear quickly (acutely) or symptoms of a existing respiratory tract infection can get worse.

In older people, the symptoms are often not so characteristic. For example, a third of older people with pneumonia have no fever. The following general symptoms may be due to pneumonia:

How is the diagnosis made?

Discussion and reviews

The doctor will ask you questions about your symptoms and perform the following tests:

  • The doctor will listen carefully to your lungs using a stethoscope (lung auscultation). Slight crackles are heard in most people with pneumonia. In some cases, the lungs appear healthy on auscultation.
  • If the doctor suspects pneumonia, x-ray of the lungs will be performed. This can confirm the diagnosis and help tell the difference between pneumonia and bronchitis. Sometimes, when the pneumonia is at an early stage, the x-ray does not reveal any anomalies.
  • A blood test will be performed to assess inflammation.
  • If symptoms persist, phlegm can be analyzed in the laboratory.
  • The elderly will be subject to a urine analysis. In fact, antibodies directed against the pathogenic bacteria can sometimes be found in the urine.

It is not always necessary to identify the bacteria or virus that causes pneumonia. If the patient is seriously ill and pneumonia is suspected, a antibiotic therapy is systematically introduced, even if we do not yet know the pathogenic bacteria.

Underlying conditions

The doctor will also consider the presence of other conditions that may explain the symptoms, such as heart failure, or the possible worsening of known conditions, such as diabetes.

What can you do ?

Pneumococcal vaccination

You can get vaccinated against the leading cause of pneumonia (pneumococcal infection). Vaccination is recommended for:

  • all children: in Belgium, ONE administers the pneumococcal vaccine free of charge at the age of 2, 4 and 12 months, in accordance with the recommendations of the Superior Health Council.
  • all people aged 65 to 85;
  • people with any of the following conditions:
  • people with weakened immune systems, such as with chemotherapy, infection with HIV or from leukemia ;
  • people who have had their spleen removed;
  • people who have had pneumonia in the past;
  • permanent residents of a care facility.
Flu vaccination

The virus flu (typa A influenza virus) can also cause pneumonia. You can get the flu shot every year.

Other preventive measures
  • It is important tostop smoking. Passive smoking is also an additional risk factor for pneumonia.
  • If you have a respiratory tract infection, be vigilanthand hygiene. Most viruses and bacteria are spread through fine droplets, which can get on your hands when you cough or sneeze. So wash your hands frequently and disinfect them with a hydro-alcoholic gel.
  • Preferably avoid cough medicine : their effectiveness is not proven and they can cause unwanted effects, such as constipation. Cough medicines can also prevent the expectoration of purulent mucus.

What can your doctor do?

Antibiotic therapy

Pneumonia is always treated with antibiotics. Most often, the doctor will prescribe amoxicillin for a week. In some cases, eg if you have other conditions or if you are allergic to penicillin, he will choose another type of antibiotic. If there is no improvement after two to four days, a second antibiotic will be added to the treatment.

Hospitalization

If you are seriously ill (e.g. ultra-rapid breathing, low blood pressure, strong fever), the doctor will direct you to the hospital emergency department. You will be able to receive antibiotics infusion and put on oxygen. Likewise, if home care is not possible, because no one can help you, for example, it may be necessary to start treatment in hospital.

Control

After a few days, the doctor will check whether the chosen treatment provides sufficient improvement. Otherwise, he may prescribe additional examinations or additional medication.

If you are over 50 and smoke, a x-ray control will be carried out after approximately two months. This examination is not necessary in other cases.

Healing

It often takes a long time to recover from pneumonia. Symptoms may still persist for some time after the bacteria have disappeared. If you are professionally active, the doctor will prescribe a work stoppage until your full recovery.

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