- generalized discomfort and aches
- fatigue
- chest discomfort or PAIN, especially with inhala-
tion - DYSPNEA (shortness of breath) or TACHYPNEA
(rapid BREATHING)
Symptoms may develop gradually or come on
suddenly. Though the pattern of the symptoms
provides good clues as to the cause of the pneu-
monia, the doctor cannot determine whether the
infection is viral or bacterial without sputum or
blood tests. Viral pneumonia does not respond to
antibiotic therapy, though a good number of peo-
ple who have viral pneumonia develop secondary
bacterial pneumonia that does require antibiotics.
The diagnostic path typically includes chest X-ray,
which shows the areas of infiltration (fluid or pus
accumulation) within the lungs. Other factors that
help determine the kind of pneumonia include
knowledge of local or regional outbreaks of viral
or bacterial pneumonia, history of recent upper
respiratory infection or influenza, and the pres-
ence of other health conditions such as HIV/AIDS.
Sputum culture may also help in the diagnosis
although most viruses and atypical bacteria do not
readily grow in culture.
Treatment Options and OutlookTreatment depends on the cause of the infection
and may include antibiotics for bacterial pneumo-
nia, antiviral medications or management of
symptoms for viral pneumonia, and antifungal
medications for fungal pneumonia. Because sec-
ondary bacterial pneumonia can develop as a
complication of other types of bacteria, symptoms
that fail to improve within 10 days or that worsen
require further medical evaluation. Most people
who are otherwise healthy make full recovery
from pneumonia, though may take six to eight
weeks to feel back to normal.
Risk Factors and Preventive MeasuresThe very young, the very old, and those who have
serious health conditions of any kind are at great-
est risk for pneumonia. Health experts recom-
mend annual influenza IMMUNIZATION and
pneumococcal vaccination for people who have
such risks. Diligent HAND WASHING and conscien-
tious cough and SNEEZEprecautions help reduce
the spread of infectious agents. Early diagnosis
and appropriate treatment reduce the likelihood
of complications.
See also ASPERGILLOSIS; CHEST PAIN; LEGIONNAIRES’
DISEASE; NOSOCOMIAL INFECTIONS.pneumonitis INFLAMMATIONof the LUNGSresulting
from exposure to an irritant. The inflammation
causes the airways to narrow and to increase
mucus secretion, reducing the pathways for the
flow of air. The major types of pneumonitis are- aspiration pneumonitis, which develops when
foreign matter, such as vomitus or water, enters
the airways and lungs - chemical pneumonitis, which results from
inhaling toxic fumes - hypersensitivity pneumonitis, which is an
IMMUNE REACTIONto an inhaled substance - radiation pneumonitis, which occurs as a SIDE
EFFECT of RADIATION THERAPY to the chest and
lower neck, such as to treat LUNG CANCER, THY-
ROID CANCER, orBREAST CANCER
The primary symptoms of pneumonitis are per-
sistent COUGHand DYSPNEA(shortness of breath).
The doctor makes the diagnosis on the basis of the
history of the symptoms, including when they
began, what circumstances existed, and in particu-
lar any known or suspected exposures that
occurred. Near drowning, for example, may result
in aspiration of water. SWALLOWING DISORDERSmay
allow food or drink to enter the airways. Chemical
pneumonitis and hypersensitivity pneumonitis
often result from occupational exposures (and
sometimes exposure to pets such as birds) and
may indicate the early stages of pulmonary disease
related to exposures such as to dusts and fibers.
Chest X-ray, arterial BLOODgases, pulmonary func-
tion tests, and chest computed tomography (chest
CT) are among the diagnostic procedures that may
help identify the extent of pulmonary involve-
ment and its effect on oxygenation.
Treatment is often CORTICOSTEROID MEDICATIONS
to relieve inflammation, which may allow the
lungs to return to normal function. The doctor
may also prescribe ANTIBIOTIC MEDICATIONSto treat222 The Pulmonary System