Thursday, September 29, 2022

How Do Doctors Diagnose Pneumonia

Are Vaccines Available To Prevent Pneumonia

How to diagnose Pneumonia? – Dr. Hirennappa B Udnur

Yes, there are two types of vaccines specifically approved to prevent pneumonia caused by pneumococcal bacteria. Similar to a flu shot, these vaccines wont protect against all types of pneumonia, but if you do come down with pneumonia, its less likely to be as severe or potentially life-threatening especially for people who are at increased risk for pneumonia.

  • Bacterial pneumonia: Two pneumonia vaccines, Pneumovax23® and Prevnar13®, protect against the most common causes of bacterial pneumonia.
  • Pneumovax23® protects against 23 different types of pneumococcal bacteria. It is recommended for all adults 65 years of age and older and children over 2 years of age who are at increased risk for pneumonia.
  • Prevnar13® protects against 13 types of pneumonia bacteria. It is recommended for all adults 65 years of age and older and children under 2 years of age. Ask your healthcare provider about these vaccines.
  • Viral pneumonia: Get a flu vaccine once every year. Flu vaccines are prepared to protect against that years virus strain. Having the flu can make it easier to get bacterial pneumonia.
  • If you have children, ask their doctor about other vaccines they should get. Several childhood vaccines help prevent infections caused by the bacteria and viruses that can lead to pneumonia.

    Besides Vaccination What Else Can I Do To Prevent Bacterial And Viral Pneumonia

    Receiving all recommended vaccinations is one of the best ways to prevent pneumonia. Additionally, there are several other ways to prevent pneumonia, including:

    • Quitting smoking, and avoiding secondhand smoke. Smoking damages your lungs.
    • Washing your hands before eating, before handling food, after using the restroom, and after being outside. If soap is not available, use an alcohol-based hand sanitizer.
    • Avoiding being around people who are sick. Ask them to visit when they are feeling better.
    • Not touching or sharing objects that are shared with others. Germs can be transferred from object to you if you touch your nose or mouth without washing or sanitizing your hands first.
    • Eating a healthy diet, exercise, and get enough rest. Healthy habits keep your immune system strong.
    • Getting treated for any other infections or health conditions you may have. These conditions could weaken your immune system, which could increase your chance of infections.
    • Avoiding excessive consumption of alcohol.

    Key Points About Pneumonia

    • Pneumonia is an infection of one or both of the lungs caused by bacteria, viruses, or fungi.

    • There are more than 30 different causes of pneumonia, and theyre grouped by the cause. The main types of pneumonia are bacterial, viral, and mycoplasma pneumonia.

    • A cough that produces green, yellow, or bloody mucus is the most common symptom of pneumonia. Other symptoms include fever, shaking chills, shortness of breath, low energy, and extreme tiredness.

    • Pneumonia can often be diagnosed with a thorough history and physical exam. Tests used to look at the lungs, blood tests, and tests done on the sputum you cough up may also be used.

    • Treatment depends on the type of pneumonia you have. Antibiotics are used for bacterial pneumonia. It may also speed recovery from mycoplasma pneumonia and some special cases. Most viral pneumonias dont have a specific treatment and just get better on their own. Other treatment may include a healthy diet, more fluids, rest, oxygen therapy, and medicine for pain, cough, and fever control.

    • Most people with pneumonia respond well to treatment, but pneumonia can cause serious lung and infection problems. It can even be deadly.

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    Diagnostic Tests And Procedures

    If your doctor thinks you have pneumonia, he or she may do one or more of the following tests.

    • Chest X-ray to look for inflammation in your lungs. A chest X-ray is often used to diagnose pneumonia.
    • Blood tests, such as a complete blood count to see whether your immune system is fighting an infection.
    • Pulse oximetry to measure how much oxygen is in your blood. Pneumonia can keep your lungs from moving enough oxygen into your blood. To measure the levels, a small sensor called a pulse oximeter is attached to your finger or ear.

    If you are in the hospital, have serious symptoms, are older, or have other health problems, your doctor may do other tests to diagnose pneumonia.

    Causes And Risk Factors Of Pneumonia

    Bronchitis vs. pneumonia: How to tell

    How do you get pneumonia? The majority of the germs that cause infection are spread from person to person through droplets, from coughing or sneezing.

    People who smoke are at higher risk for pneumonia, as are people on immunosuppressive medications, and people who are frequently in close, crowded spaces with others, such as college students and military personnel.

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    How Can I Tell If I Have Pneumonia Versus The Common Cold Or The Flu

    Do I have a cold or could it be the flu or even pneumonia? Its tough to tell the difference but critical to know when to seek medical care

    Watch for these ongoing symptoms that occur in pneumonia:

    • Serious congestion or chest pain.
    • Difficulty breathing.
    • A fever of 102 or higher.
    • Coughing that produces pus.

    Pneumonia symptoms last longer than cold and flu. If your symptoms arent severe, its okay to try such home remedies as getting more rest, drinking more fluids and taking some over-the-counter medicines and see what happens. But if you dont see improvement in your symptoms after three to five days, or if you are experiencing more serious symptoms such as dizziness or severe difficulty breathing, see your healthcare provider. Dont let it go. Pneumonia-like symptoms in very young children or in adults older than 65 are a cause for concern. Also, pneumonia can cause permanent lung damage if left untreated for too long. And always seek immediate care if you experience chest pain or have breathing difficulties.

    Critical Role Of Pneumococcal Vaccine In Preventing Pneumonia

    In children aged three months to four years, the most common type of bacterial pneumonia is Strep. pneumoniae. In children greater than age four, it remains in the top three most common types. The pneumococcal vaccine series, started at two months of age, significantly reduces the rates of bacterial pneumonia from Strep. Pneumoniae. The vaccine is usually administered during wellness or prevention visits and cannot be given to a child with a fever. This emphasizes the need for healthcare access globally.6

    With global vaccination rates currently plateauing, the challenges of diagnosing and treating community acquired pneumonia are even more pertinent for prevention of severe respiratory illness. Vaccine uptake challenges can be overcome with global measures to increase the access and use of vaccines. Addressing vaccine use and providing education about common pneumonia symptoms can aid in early diagnosis of pneumonia and lower the rate of severe respiratory illness and prolonged hospitalization.

    References

  • World Health Organization Health Topics. Immunization, Vaccines and Biologicals: National programs and systems on improving vaccination demand and addressing hesitancy. 17 June 2020 update.

  • Popovsky EY, Florin TA. Community-Acquired Pneumonia in Childhood. Reference Module in Biomedical Sciences. 2020 B978-0-08-102723-3.00013-5. doi:10.1016/B978-0-08-102723-3.00013-5

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    Tests To Find The Cause Of Pneumonia

    Pneumonia testing may include a range of tests to identify why pneumonia occurred. There are many potential causes of pneumonia including an infection with a bacteria, virus, or fungus. When the cause is known, the doctor can choose a tailored therapy that offers the most benefit and least risk.

    This kind of testing is not routinely performed in patients with mild cases of pneumonia. Trying to identify the cause is of greater importance when a patient is hospitalized or at higher risk of severe complications from pneumonia.

    Although many tests are available to look for the underlying cause, in the majority of cases, no single cause can be conclusively identified.

    The following sections describe different types of tests that may be used to detect the cause of pneumonia. Each section is organized based on the type of sample that is used for testing.

    Sputum tests

    Sputum is a thick kind of mucus produced in the lungs that is also known as phlegm. It is distinct from saliva or spit because its thickness helps it trap and remove pathogens from the lungs. For this reason, sputum can be analyzed to check for signs of bacteria, viruses, or other pathogens.

    There are three main ways that a sputum sample can be obtained. The least invasive way of collecting sputum is by coughing deeply so that sputum can be spit into a cup. Before this, you may inhale a vapor that makes it easier to produce a testable amount of sputum.

    Throat or nasal swab tests

    Blood tests

    Urine tests

    What Are The Complications Of Pneumonia

    Are lung ultrasounds accurate to diagnose pneumonia in children?

    Anyone can experience complications from pneumonia. However, people in high-risk groups are more likely to develop complications, including:

    • Breathing difficulties: Pneumonia can make breathing difficult. Pneumonia plus an existing lung disorder can make breathing even more difficult. Breathing difficulties may require a hospital stay to receive oxygen therapy or breathing and healing assistance with the use of a breathing machine .
    • Fluid buildup in the lungs : Pneumonia can cause a buildup in the fluid between the membranes that line the lungs and the inside of the chest cavity. It is a serious condition that makes breathing difficult. Pleural effusion can be treated by draining excess fluid with a catheter, chest tube or by surgery.
    • Bacteria in the bloodstream : The bacteria that cause pneumonia can leave your lungs and enter your bloodstream, spreading the infection to other organs. This condition is treated with antibiotics.
    • Lung abscess. A lung abscess is a pus-filled cavity in the lung that is caused by a bacterial infection. It can be treated by draining the pus with a long needle or removing it by surgery.

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    Inpatient Vs Outpatient Care

    The costs of hospitalization and potential for nosocomial infections and thromboembolic events necessitate careful consideration of risk factors for severe CAP when considering appropriate level of care .6,20 Decision support tools such as the Pneumonia Severity Index assist in predicting the risk of 30-day mortality and severe CAP requiring ICU admission. Table 5 summarizes the more widely adopted CURB-65 and CRB-65 prediction scores,6,31 which have greater ease of use, but weaker predictive power for 30-day mortality.24,31,32 Among low-risk patients , the LR for 30-day mortality using the index is 0.08, and 0.21 using CURB-65.31 Sensitivity for predicting ICU admission was reported as 74% vs. 39% to 50% for Pneumonia Severity Index vs. CURB-65, respectively.24,32

    CURB-65 and CRB-65 Mortality Prediction Tools for Patients with Community-Acquired Pneumonia

    Prognostic variables

    Confusion

    Urea nitrogen level > 20 mg per dL *

    Respiratory rate 30 breaths per minute

    Blood pressure

    Age 65 years

    30-day mortality for CURB-65

    Score

    30-day observed mortality by score

    CURB-65

    LR+ = positive likelihood ratio LR = negative likelihood ratio.

    *Excluded in CRB-65.

    Derived from a pooled cohort of 15 studies with 1,136 events in a sample of 13,319 individuals.

    Derived from a pooled cohort of nine studies with 55,302 events in a sample of 395,802 individuals.

    Information from references 6 and 31.

    Prognostic variables

    *Excluded in CRB-65.

    Information from references 6 and 31.

    What Stands Out About Yale Medicines Approach To Pneumonia

    Pneumonia is a common infection in both children and adults and can often be easily treated. However, if specialized care is required, Yale Medicine physicians practice at both Yale New Haven Hospital and Yale New Haven Childrens Hospital.

    Furthermore, our researchers are involved in developing ways to more quickly and accurately diagnose lung infections through the Yale Center for Pulmonary Infection Research and Treatment . We dont tend to think of pneumonia as a chronic condition. But some patients end up with longer-term problems, says Dr. Dela Cruz, director of the CPIRT. The center focuses on finding new potential treatment options and running clinical trials to better understand the disease.

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    Types Of Pneumonia Tests

    Various types of pneumonia tests may be performed based on a patients symptoms and overall health. In most cases, initial testing for pneumonia involves a physical examination, medical history review, and a chest x-ray. These steps often allow for an initial diagnosis to be made.

    Recommendations for further testing are tailored to a patients situation. In general, patients who have more severe symptoms, may require hospitalization, or who are at higher risk of complications are more likely to undergo additional pneumonia testing.

    The following sections provide details about the different types of tests that may be involved in the diagnosis and evaluation of pneumonia.

    Pneumonia Can Lead To Acute Respiratory Disease Syndrome

    Prevent Pneumococcal Disease in Adults

    A score developed to quantify #COVID19 pneumonia severity appeared to predict mortality in U.S. patients, and may help to eventually guide treatment decisions, reported Jurgena Tusha, MD, at #CHEST2020. By . #coronavirus

    MedPage Today

    Pneumonia is defined as when fluid fills in the alveoli of the lungs ARDS occurs when a build-up of fluid in the alveoli causes the surfactant of the lungs a substance that helps the lungs expand to take in the air to break down and also causes other areas of the lungs to scar and stiffen, according to the National Heart, Lung and Blood Institute. The Institute noted that these changes prevent the lungs from filling properly with air and moving enough oxygen into the bloodstream and throughout the body. The lung tissue may scar and become stiff.

    An article published in the journal Critical Care called Acute respiratory failure in COVID-19: is it typical ARDS?reported thatinjury to the alveolar epithelial cells was the main cause of COVID-19-related ARDS. Their research of patients with the lung disease also found that it was often not diagnosed until 8-12 days after the onset of worsening respiratory symptoms.

    The article reported that corticosteroids such as methylprednisolone and ventilation are the most common treatment types.

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    Take Steps To Protect Yourself And Others

    The following steps can help you prevent spreading the infection to others around you.

    • Cover your nose and mouth while coughing or sneezing.
    • Get rid of used tissues right away.
    • Limit contact with family and friends.
    • Wash your hands often, especially after coughing and sneezing.

    Some people get pneumonia again and again. Tell your doctor if this happens. Return to Prevention to find more strategies to help prevent pneumonia.

    Types Of Antibiotics For Pneumonia

    There are multiple types of antibiotics that work in slightly different ways. Some are more commonly used to treat pneumonia than others based on things like:

    • The bacteria causing infection
    • The severity of the infection
    • If youre in a patient group at greatest risk from pneumonia

    The types of antibiotics that your doctor might typically prescribe for pneumonia include the following:

    Antibiotics prescribed for children with pneumonia include the following:

    • Infants, preschoolers, and school-aged children with suspected bacterial pneumonia may be treated with amoxicillin.
    • Children with suspected atypical pneumonia can be treated with macrolides.
    • Children allergic to penicillin will be treated with other antibiotics as needed for the specific pathogen.
    • Hospitalized, immunized children can be treated with ampicillin or penicillin G.
    • Hospitalized children and infants who are not fully vaccinated may be treated with a cephalosporin.
    • Hospitalized children with suspected M. pneumoniae or C. pneumoniae infection may be treated with combination therapy of a macrolide and a beta-lactam antibiotic .
    • Hospitalized children with suspected S. aureus infections might be treated with a combination of Vancocin or clindamycin and a beta-lactam.

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    Is There A Vaccine For Pneumonia

    There isnt a vaccine for all types of pneumonia, but 2 vaccines are available. These help prevent pneumonia caused by pneumococcal bacteria. The first is recommended for all children younger than 5 years of age. The second is recommended for anyone age 2 or older who is at increased risk for pneumonia. Getting the pneumonia vaccine is especially important if you:

    • Are 65 years of age or older.
    • Smoke.
    • Have certain chronic conditions, such as asthma, lung disease, diabetes, heart disease, sickle cell disease, or cirrhosis.
    • Have a weakened immune system because of HIV/AIDS, kidney failure, a damaged or removed spleen, a recent organ transplant, or receiving chemotherapy.
    • Have cochlear implants .

    The pneumococcal vaccines cant prevent all cases of pneumonia. But they can make it less likely that people who are at risk will experience the severe, and possibly life-threatening, complications of pneumonia.

    Case History #: The California Welder

    Patient Diagnosed With Pneumonia Did Not Qualify For COVID-19 Test | NBC News NOW

    This case comes to us via WebMD writer Kathleen Doheny, who documented the illness and recovery of Lincoln Rennie, a 23-year-old welder from Orange, CA.

    Doctors first suspected a urinary tract infection. Two days later, they diagnosed acute respiratory distress syndrome, related to vaping.

    Rennie woke up in late August feeling ill, with a stomach ache and fever. He took to bed, but the fever kept rising, eventually hitting 104 degrees. His fiancé, Viri Alvarado, insisted he go with her to the hospital on Aug. 31. At the emergency room, doctors first suspected a urinary tract infection. It wasnt until the third day that medical staff settled on a diagnosis of acute respiratory distress syndrome, related to vaping.

    Ultimately, Rennie recovered with a combination of oxygen and corticosteroids.

    Looking back, it may have been a switch to cheaper cannabis vaping cartridges that put him in the hospital. Rennie told WebMD that hed been using medical cannabis vape cartridges for about ten years to help him sleep. In June 2019, he decided to start buying street-market cartridges, because they were far cheaper than carts sold in legal, state-licensed stores .

    I was too trusting, Rennie told WebMD. I believe there are safe options, and regulating the industry more would make it safer

    The scariest part of the bootleg is, they look the same. They will take a brand-name cart, refill it, and say its the same brand.

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