What Are The Signs And Symptoms Of Pneumonia In Children
The signs and symptoms of pneumonia in children vary from child to child and also depend on your childs age, cause of the infection, and severity of their illness.
Usual symptoms include:
- Cry more than usual. Are restless or more fussy.
Adolescents have the same symptoms as adults, including:
- Difficulty breathing/shortness of breath.
- Chest pain.
Newborns are at greater risk of pneumonia caused by bacteria present in the birth canal. In young children, viruses are the main cause of pneumonia.
Pneumonia caused by bacteria tends to happen suddenly, starting with fever and fast breathing. Symptoms appear more slowly and tend to be less severe when pneumonia is caused by viruses.
Patient Eligibility And Data Collection
Inclusion criteria were age 60 years or older, no hospitalizations during the previous 14 days, new infiltration observed on chest radiographs, and one or more respiratory symptoms or signs. Because atypical pneumonia presentations are common among this age group, elderly patients with radiological evidence of pneumonia without symptoms were included. Patients were excluded if they were HIV-positive or receiving chemotherapy, or if pneumonia was unconfirmed.
Information regarding the demographic characteristics, signs, symptoms, clinical findings on presentation, comorbidities, laboratory parameters, microbiological/radiological findings, complications during hospitalization, the need for ICU admission, and outcomes after discharge were obtained from medical records. For the prospective study, the same data were collected on admission and patients were observed during their hospital stay. All patients were followed-up for 30 days after discharge from the hospital. A microbiological diagnosis was determined based on the results of culture and polymerase chain reaction testing of respiratory samples and blood culture test results.
Why Seniors Are More Susceptible To Pneumonia
According to the American Thoracic Society, approximately 1 million adults seek hospital care for pneumonia each year. Young, healthy people usually make a full recovery, but pneumonia in the elderly can be very seriouseven deadly. In fact, the Centers for Disease Control and Prevention , ranks pneumonia as one of the top 10 leading causes of death in the United States. Despite the prevalence of this disease, many seniors and their caregivers don’t know all the facts about pneumonia.
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Pneumonia In Elderly People
Pneumonia in elderly people may become serious due to the high risk of severe complications. They are also at a higher risk for pneumonia because their immune system becomes less capable of fighting diseases. It can also get complicated if older adults have chronic health conditions such as chronic obstructive pulmonary disorder . According to medical reports, such diseases can develop gradually across several days or suddenly over 1-2 days.
Pneumonia Owing To Less Common Pathogens Including Multidrug
Gram-negative bacilli are detected in 2.8% to 14.0% of CAP cases, and may colonize the respiratory tract of elderly patients with oropharyngeal dysphagia, particularly those admitted to the hospital from LTCFs., Among LTCF patients with severe aspiration pneumonia, enteric Gram-negative bacilli were detected as the predominant cause in 49% of cases.
In the Competence Network for Community-Acquired Pneumonia study, predictors of CAP owing to Enterobacteriaceae included age greater than 65 years, heart failure and cerebrovascular disease.Pseudomonas aeruginosa was reported in 2.0% to 17.1% of patients, and was associated with impaired swallowing, chronic obstructive pulmonary disease, bronchiectasis, severe disease, admission from nursing homes, and presence of a feeding tube., , , , Although there are no data that support empiric anti-Pseudomonas treatment in elderly patients, this pathogen should be considered in severe infection in the presence of structural lung disease and known prior colonization.
Resistant Streptococcus pneumoniae
Staphylococcus aureus including methicillin-resistant Staphylococcus aureus
Risk factors for community-acquired pneumonia owing to multidrug-resistant organisms
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Bacterial Vs Viral Pneumonia Symptoms
Bacteria and viruses are the most common causes of pneumonia. Fungi and parasites can sometimes cause it.
When the cause is bacteria, the illness can come on either slowly or quickly. It tends to be more serious than other types.
When a virus causes your pneumonia, youâre more likely to notice symptoms over several days. Early signs will look like the flu such as fever, dry cough, headache, and weakness but get worse in a day or two.
Why Are Older Adults More Vulnerable To Pneumonia
The aging body has to work harder to fight off infection. Seniors also have decreased muscle mass and may live with conditions like COPD, asthma, heart disease and diabetes.
Factors posing complications for seniors who contract pneumonia include:
- Muscle weakness and frailty, which can make coughing a challenge
- A weaker immune system that can no longer fight off infection like it used to
- Chronic health conditions increase an older adults chances of contracting pneumonia
- Recent surgery that has consumed the bodys resources for healing
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Urgent Advice: Get Urgent Medical Attention If:
- you have severe symptoms such as rapid breathing, chest pain or confusion
Pneumonia affects around 8 in 1,000 adults each year. Its more widespread in autumn and winter.
Pneumonia can affect people of any age. Its more common and can be more serious in certain groups of people, such as the very young or the elderly. People in these groups may need hospital treatment if they develop pneumonia.
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How Serious Is Pneumonia In Older Adults
Adults 65 and older are more susceptible to pneumonia than younger people are. Seniors with pneumonia are also at increased risk for hospitalization, complications, and death.
Pneumonia in elderly adults can often be serious and progress quickly. In fact, pneumonia is the second leading cause for hospitalization of Medicare beneficiaries, and most of the people who die from pneumonia each year are elderly adults, according to the American Lung Association . The death rate among elderly adults with severe pneumonia is as high as 20%.
Researchers and doctors dont fully understand why pneumonia is more aggressive in seniors. They believe it has to do with the normal aging process, which weakens the immune system and decreases lung function. Older adults also often have other underlying health conditions that can make pneumonia more severe, including asthma, chronic obstructive pulmonary disease , and heart disease.
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Pneumonia Complications For Seniors
As the body has a hard time fighting off pneumonia, older adults can quickly develop severe, potentially fatal complications, including:
- Bacteremia, an infection that starts in the lungs and can spread to other organs
- Pleurisy, inflammation of the membrane surrounding the lungs
- Lung abscesses
- Acute respiratory distress syndrome, which can lead to respiratory failure
- Organ damage from a lack of oxygen circulating throughout the body, in conjunction with pre-existing conditions
- A urinary tract infection, as bacteria from the lungs can gather in the kidneys, bladder or urethra
What Is The Recovery Time For Pneumonia In The Elderly
A simple Google search for that question makes us think that an elderly person can recover from pneumonia in in as little as two weeks but it may take two months or longer to recover completely.
A study that appeared in the Patient Related Outcome Measures Journal shed some light on the vast difference between a short recovery and a long one.
They begin by understanding the health status of the elderly person who is afflicted with pneumonia. For those that are in good health, expect a recovery time of about three weeks. In that period, shortness of breath, weakness, and fatigue are common. If the elderly person has existing health conditions, especially those that involve the respiratory system, such as COPD the recovery period can take as long as 60 or more days and be far more challenging.
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Pneumonia Diagnosis And Treatment
What should you do if you suspect that your older adult has pneumonia? Visit the doctor immediately.
A doctor can quickly order tests that will help diagnose pneumonia and find out what caused the infection.
These tests might include a chest x-ray, blood and sputum analyses, CT scans, or lung fluid cultures.
Pneumonia can be treated at home with antibiotics, cough medicine, and pain relievers or anti-inflammatories .
But in severe cases, hospitalization may be required.
If untreated, pneumonia can become life-threatening. It can result in serious complications like difficulty breathing, fluid building up around the lungs, and fluid-filled abscess forming in a lung cavity.
A bacterial infection could also spread from the lungs into the bloodstream and bodys tissues. This type of widespread infection is known as sepsis and could cause organ failure.
Rapidly Managing Pneumonia In Older People During A Pandemic
Carl Heneghan, Jeff Aronson, Richard Hobbs, Kamal Mahtani
Please Check NICE guidance for all prescribing recommendations.
3rd April: NICE guidance updated
For general advice on managing COVID-19 symptoms, see also the NICE COVID-19 rapid guideline on managing symptoms in the community.
RationaleThe current COVID-19 pandemic has highlighted the risk faced by older adults, who are more susceptible to complications, including acute respiratory distress syndrome, usually as a result of pneumonia. Comorbidities, impaired immunity and frailty, including a reduced ability to cough and to clear secretions from the lungs, can all contribute to this complication. Older people are therefore more likely to develop severe pneumonia, suffer from respiratory failure, and die.
Viruses are thought to cause about 50% of cases of pneumonia. Viral pneumonia is generally less severe than bacterial pneumonia but can act as a precursor to it. Preventing any pneumonia in older adults is preferable to treating it.
Identification of the early stages of pneumonia in older patients can prove difficult. Traditional symptoms and signs, including fever, may be absent. Limited evidence suggests that many tests that are useful in younger patients do not help diagnose infections in older adults. The onset of pneumonia in elderly people can often be rapid, and the prognosis is poor in severe pneumonia: as many as one in five will die. The older you are, the more prevalent severe pneumonia becomes.
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Therapeutic Strategies To Manage Cap In Elderly Patients
Antimicrobials are the cornerstone of therapy for CAP in any population, including the elderly. In addition, some nonantibiotic strategies may be important when treating CAP in elderly populations. In older patients, the pneumonia process often extends beyond the lung parenchyma, presenting as a systemic disease with higher severity of illness. This is supported by the finding that many elderly CAP patients present with primarily nonpulmonary symptoms, such as mental status changes or renal dysfunction. Owing to this fact, the following discussion will focus on both the antibiotic and nonantibiotic therapies for elderly patients with CAP. The therapeutic strategies reviewed next are an update from our prior work published in Aging Health, and the discussion is designed to serve as a review of the most relevant literature since the initial publication in 2006 .
Pneumonia: Etiology And Pathophysiology
Pneumonia is also classified by its physio-pathological mechanism or, if identified, by the etiological pathogen . Jain et al. showed that the presence of influenza and S. pneumoniae was five times higher in pneumonia patients older than 65 years when compared to younger ones, and rhinovirus presence was ten times higher . Obtaining high-quality samples is difficult with older patients and only 6% could provide high-quality sputum . Comprehensive molecular testing performed in nasopharyngeal and oropharyngeal swabs is poorly predictive of the presence of pneumonia and proved less sensitive than routine microbiological methods for old patients in a cohort of 199 with a mean age of 83 years . In a review of 33 studies published between January 2005 and July 2012 and focusing on the etiology and treatment of CAP among adults in Europe, Torres et al. concluded that Streptococcus pneumoniae, Haemophilus influenzae and respiratory viruses were the most frequently observed pathogens, and that Mycoplasma pneumoniae was less frequently found among patients65 years old . General hygiene measures as contact and droplet precaution and use of masks are necessary tools to tackle global respiratory infections, among which viral infections .
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Precautions For Drug Selection
Long-acting pharmaceutical preparations should not be used to control rapidly developing symptoms.
If death is approaching and the patient has already taken a stable dose of transdermal fentanyl, he should continue using it and adding additional short-acting opioids to increase comfort. Morphine and hydromorphone are listed as opioids because they are generally available and can be used in a variety of ways.
End Of Life Care Pneumonia
Pneumonia is an inflammation of the lungs that affects alveoli and consolidation . Pneumonia is a common disease that will seriously affect the morbidity and mortality of the elderly. Pneumonia is usually a terminal event that complicates long-term conditions . Anyone can get pneumonia, with symptoms ranging from mild to severe. Older people may be more susceptible to pneumonia and encountering serious complications. Because of these higher risks, caregivers need to recognize the early symptoms of pneumonia in the elderly.
Elderly patients will have some clinical problems, which must be considered when deciding the best care environment: delirium, hypoxic respiratory failure and severe sepsis. The assessment of the severity of the disease helps determine the best care environment. Patients with dementia often get pneumonia and often die from pneumonia, which is associated with high levels of discomfort.
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Rsv In Older Adults And Adults With Chronic Medical Conditions
RSV infections can be dangerous for certain adults. Each year, it is estimated that more than 177,000 older adults are hospitalized and 14,000 of them die in the United States due to RSV infection. Adults at highest risk for severe RSV infection include
- Older adults, especially those 65 years and older
- Adults with chronic heart or lung disease
- Adults with weakened immune systems
When an adult gets RSV infection, they typically have mild cold-like symptoms. But RSV can sometimes lead to serious conditions such as
- More severe symptoms for people with asthma
- More severe symptoms for people with chronic obstructive pulmonary disease
- Congestive heart failure
Older adults who get very sick from RSV may need to be hospitalized. Some may even die. Older adults are at greater risk than young adults for serious complications from RSV because our immune systems weaken when we are older.
RSV season occurs each year in most regions of the U.S. during fall, winter, and spring. If you are at high risk for severe RSV infection, or if you interact with an older adult, you should take extra care to keep them healthy:
There is no vaccine to prevent RSV infection yet, but scientists are working hard to develop one. If you are concerned about your risk for RSV, talk to your healthcare provider.
Treatment And Medication Options For Pneumonia
A lot of treatment aspects, as well as outcome, depend on the person, as well as the type of pneumonia they have, says Dr. Barron. Sometimes youll be fine just resting, but if you have things like trouble breathing, you should get to a doctor right away.
Your doctor will outline a plan thats specific to you, considering the type of pneumonia you have, the severity of the condition, your age, and your overall health. From there, youll know whether you can be treated at home or need to go to the hospital, and whether you require antibiotics.
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Pneumonia Can Be Caused By:
- Viruses: The influenza virus enters the lungs and multiplies. It is the most common cause of viral pneumonia.
- Fungi: When people expose themselves to fungi through contaminated soil or bird droppings, they may be at risk of developing fungal pneumonia.
- Bacteria: This can develop after a person has the flu or viral cold. Bacterial pneumonia in the U.S. is mostly caused by Streptococcus pneumonia.
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.
The Usual Symptoms Of Pneumonia Include:
- Difficulty in swallowing or dysphagia
- Chronic liver disease
- Patients with a compromised immune system, e.g., patients facing HIV/AIDs or undergoing chemotherapy, long-term steroid use, and patients whove had an organ transplant.
- Neurological disorders, such as epilepsy, Parkinsons disease, and dementia
- History of respiratory disease and lung conditions like COPD, cystic fibrosis, etc.
- Hospitalization, especially if patients were in an ICU needing a ventilator to breathe
Box 2curb65 Score For Mortality Risk Assessment In Hospital
CURB65 score is calculated by giving 1 point for each of the following prognostic features:
- age 65 years or more.
- 0 or 1: low risk
- 2: intermediate risk
- 3 to 5: high risk .
LimWS, van der EerdenMM, LaingR, et al. Defining community-acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax58: 37782
For guidance on delirium, see the NICE guideline on delirium.
Use clinical judgement in conjunction with the CURB65 score to guide the management of community-acquired pneumonia, as follows:
- consider home-based care for patients with a CURB65 score of 0 or 1
- consider hospital-based care for patients with a CURB65 score of 2 or more
- consider intensive care assessment for patients with a CURB65 score of 3 or more.
Stratify patients presenting with community-acquired pneumonia into those with low-, moderate- or high-severity disease. The grade of severity will usually correspond to the risk of death.
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