What is pneumonia?

* Under a lung inflammation (pneumonia) is usually a disease caused by acute inflammation of the lungs understood. A variety of pathogens (bacteria, viruses, fungi, and parasites) can cause pneumonia. This may be directly to an inflammation of the lung tissue or lung inflammation develops as a complication of the initial inflammation of the bronchi (bronchitis), which then spills over the lung tissue (bronchopneumonia).
* There is a distinction between primary and secondary pneumonia differed. Primary pneumonia occurs independently of an existing heart-lung disease. In the case of secondary pneumonia is also a heart-lung disease.

Causes

Pneumonia caused by bacteria

* Streptococcus pneumonia
* Klebsiella pneumonia
* Legionella pneumonia
* Haemophylus influenzae
* Staphylococcus aureus
* Chlamydia psittaci
* Etc.

Pneumonia caused by viruses

* Influenza Virus
* Adenoviruses
* Respiratory Syncytial Virus (RSV)
* Parainfluenzaviren
* Epstein-Barr virus (EBV)
* Cytomegalovirus (CMV)
Measles virus *
* Enteroviruses
* Herpes virus (HSV)
* Etc.

Pneumonia caused by fungi

* Candidiasis (Moniliasis)
* Cryptococcosis (Torulose)
* Aspergillosis
* Geotrichose (Mucormycosis)
* Blastomycosis
* Histoplasmosis

Pneumonia caused by parasites

* Pneumocystis carinii
* Toxoplasmosis gondii

Various symptoms depending on the pathogen

* Typical symptoms (eg, pneumococcal pneumonia): Acute onset, chills, high fever, cough with reddish-purulent sputum, increased respiratory rate, shortness of breath, breathless ev-dependent chest pain (with additional Brustfellentzündung).
* “Atypical” symptoms (eg, chlamydia, mycoplasma, Legionella, Viruspneumonien): Creeping illness with mild fever, muscle limb pain, headaches, low ejection. The diagnosis is much harder to make, and relies primarily on blood tests and an X-ray of the lungs.

Diagnosis: body, blood and X-ray examination

* The diagnosis is based on the physical examination and collection of medical history (anamnesis):
Ev. Can be reduced by medical history already important indications for the cause of the pneumonia to be found. The physical examination helps especially in the “typical” pneumonia continues. There is a characteristic finding interception (ohrnahe sounding rattle noises), while tapping a damping of the lung, as well as an increased conductance for low frequencies (Stimmfremitus).
The “atpischen ‘pneumonia, the physical examination findings except for the increased respiratory rate despite pneumonia revealed little.

* Blood tests: blood sedimentation reaction (BSR) and C-reactive protein (CRP) is increased. The number of white blood cells (leukocytes) in blood provides clues as to whether it is a bacterial or viral infection acts. Any further investigations are necessary: for example, examination of the ejection (sputum), determination of specific antibodies, blood gas, Erregenachweis by blood cultures, etc.

* X-ray diffraction: The X-ray of the lungs shows shading of each lung districts

Example: X-ray in upper lobe pneumonia with shading in the mid to upper lung area right

Therapy

In the course of severe (respiratory rate above 30 breaths per minute, hypotension, and significantly lowered oxygen in the blood) is a required hospitalization for monitoring. For a lighter course outpatient treatment can take place.

General measures

* Bed rest
* Adequate hydration (possibly via infusion)
* Measures antipyretic (paracetamol, calves)
* Mukolytika, ev. Inhalations order to liquefy the secretions
* Breathing exercises, possibly knocking massages
* EV Thromboembolieprophylaxe
* With a pronounced lack of oxygen in addition oxygenation
* For different diseases (eg diabetes, Aklkoholabhängigkeit, nicotine addiction, immune deficiency, the elderly, cardiovascular disease, etc.), there is an increased risk of pneumonia to cancer. For the Prevention recommends annual flu vaccination

Drugs

* Antibiotic therapy is of course dependent on the pathogens. It often starts with broad-spectrum antibiotics and attempts by blood cultures or other diagnostic measures to determine the pathogen by a targeted antibiotic therapy to be implemented
* For viral pneumonia antibiotics do not help. They are but where suspicion exists that the initial viral infection or bacterial infections occur (bacterial super-infection)

Forecast

The prognosis is generally good, because the antibiotic therapy, most pneumonia can be treated well. On the other hand, there is now a growing danger of antibiotic resistance by untargeted antibiotic charges.

Especially for older people or in other existing diseases (heart disease, diabetes, Alcohol-and nicotine addiction, immune weakness, etc.), a pneumonia quite difficult course and their complications can occur. Therefore, the influenza vaccination is recommended.
Possible complications

* Bacterial sepsis (spread of pathogens from the lungs into the blood, which is also in areas lungenfernen infection can occur as heart valve infection (endocarditis), meningitis (meningitis), Nierenabszess, Hirnabszess etc.
* Lungenabszess, pleural effusion, Pleuraempyem (pus collection in the field of chest hair)
* Pulmonary embolism, venous thrombosis (by the bed and promotes fluid loss)
* Heart and circulatory failure, pulmonary failure (global respiratory insufficiency), renal failure