Its aim is to raise public awareness of one of the most common diseases of the lower respiratory tract that affects child survival and records very high mortality rates.
Pneumonia is a serious infection of the lungs, ie an inflammation of infectious etiology of the lower respiratory tract. This is the most deadly infection. For the year 2019, an estimated 2.5 billion deaths, of which 670,000 involved children. Overall, pneumonia is the fifth leading cause of death in adults and the second leading cause of death in children under 5 years of age. Suffice it to say that one child dies worldwide from pneumonia every 20 seconds. The deaths from COVID-19 added another 2,000,000 deaths.
Greece presents a better picture of pneumonia mortality compared to other European countries.
“Pneumonia can be: community when transmission and infection occurs in everyday life, hospital when one is infected during hospital stay or respiratory pneumonia when the patient has pneumonia while being intubated, ie has an endotracheal tube for support of his breath “.
What causes it and who is most at risk
Pneumonia is mainly caused by microorganisms such as bacteria, viruses and more rarely fungi. The most common causative agent of community-acquired pneumonia is streptococcus pneumoniae. From 2020, special reference is made to COVID-19 as a result of infection by the new SARS-CoV-2 coronary strain, which often manifests as severe pneumonia. There is also aspiration pneumonia that results from the entry of solid or liquid substances into the lungs (food, vomit, chemicals, etc.).
Infants and children are at greater risk of getting sick because their immune systems are not yet fully developed. The elderly over the age of 65, the immunocompromised, the heart patients, the patients with chronic respiratory diseases, with renal insufficiency, the obese and those who live in high-density units are also at high risk. The most important risk factor for pneumonia in healthy adults is smoking. Aspiration pneumonia mainly affects the elderly and those who experience a decrease in swallowing (patients with acute stroke, brain injury, neurological diseases) and the level of consciousness (alcoholics, users of toxic substances).
Transmission
Pneumonia is transmitted by airborne droplets produced by coughing, sneezing and talking. Co-location increases transmission rates. Infection of the lungs can also occur hematogenously from other organs of the body. Symptoms of pneumonia include a cough that is usually productive with sputum that may include blood, a high fever with chills lasting more than 4 days, chest pain, loss of strength, easy fatigue and shortness of breath, tachycardia and some sometimes symptoms from the gastrointestinal tract such as nausea, vomiting and diarrhea. The remission of symptoms may be delayed for up to 4 weeks after the onset of the infection.
Patients with COVID-19 pneumonia present with symptoms similar to those of other viral infections. It is characteristic that the difficulty in breathing usually appears seven days after the onset of the disease and may be accompanied by loss of smell and taste.
Diagnosis
The diagnosis of pneumonia is based on the symptoms, the findings of the clinical examination and the chest x-ray and / or other imaging examinations of the chest (eg axial chest, transthoracic lung ultrasound). Other microbiological tests to identify the microorganism that causes pneumonia are only sent in special cases and are not routine tests. The diagnosis of COVID-19 is confirmed by the detection of viral RNA by the polymerase chain reaction (RT-PCR) technique.
Treatment
The treatment of pneumonia is usually effective and is based on antibiotics and antiviral preparations that are empirically administered by the specialist doctor in order to cover the most probable and common microorganisms for each patient. Patients with severe symptoms, no improvement with oral treatment, complications of the disease (eg complicated pleural effusion), severe underlying disease and poor living conditions should be referred immediately to the hospital where antibiotic treatment should be started first. of their arrival.
It is worth mentioning that pneumonia is a solvable health problem and an important preventive measure is the flu and pneumococcal vaccination where it is indicated, smoking cessation, the proper application of hygiene rules and breastfeeding to protect infants.
In summary, pneumonia is an infection of the lower respiratory tract with specific symptoms and clinical signs that is confirmed by pathological imaging findings in the lung. Proper monitoring of patients with pneumonia does not stop with the resolution of symptoms. The treating physician must also confirm the remission of the pathological imaging findings within 4 weeks. In case of their stay, the patient is referred to a specialist pulmonologist for further investigation and treatment. The patient undergoes an axial chest if absent and then bronchoscopy. Also in high-risk patients (eg smokers) where there is a suspicion of underlying malignancy, their referral should not be delayed until the expiration of four weeks if their imaging tests do not improve.
Writes:
Ms. Christina Goga, Pulmonologist specializing in invasive pulmonology,
Director of the 4th Metropolitan General Pulmonary Clinic
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