Internal Medicine

Pneumonia

introduction

Pneumonia is considered the deadliest infectious disease in industrialized nations. The reason for this is the often severe course of the disease.In the course of pneumonia, one must first differentiate between typical and atypical pneumonia. The typical disease course has a more severe course, but is usually discovered quickly and can be treated with antibiotics and thus causally. Atypical pneumonia is milder but is diagnosed later and can only be treated symptomatically. The most important factors in the course of the disease are the diagnosis of the disease and thus the time at which therapy is initiated. In addition, the complications play an important role in the course.

Typical pneumonia course

In pneumonia, a distinction is made between typical and atypical pneumonia. Pneumonia is typically caused by bacteria called pneumococci. These lead to a very rapid and severe course of the disease. Already within the first day there is a significantly increasing fever with chills. The inflammation in the lungs can impair the uptake of oxygen in the blood to such an extent that shortness of breath occurs. Shortly afterwards, other symptoms such as blue lips appear. Coughing, sometimes with yellowish-greenish, sometimes bloody expectoration, can occur. Usually the heart rate rises significantly as part of the fever. These symptoms usually worsen significantly within the first week.

Since typical pneumonia is triggered by bacteria, it can be treated well with antibiotics and symptoms improve quickly after the start of therapy. Typically pneumonia is usually healed after three to six weeks; recovery can take twice as long if the course is worse. Young people in particular usually recover completely from the disease without complications.

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Course of an atypical pneumonia

Atypical pneumonia has - as the name suggests - a rather atypical course. It is triggered by viral infections and usually results from a simple infection of the upper respiratory tract or the bronchi. The transition between such a cold and atypical pneumonia cannot be clearly defined, which is why atypical pneumonia is often discovered much later than the typical one.
Along with the viral infection, flu-like symptoms such as limb pain and headache often occur initially. Fever can also occur, but it is nowhere near as strong as in typical pneumonia. The cough is also much less pronounced than with typical pneumonia; there is usually no sputum when coughing. Viral pneumonia is usually healed faster than bacterial pneumonia and usually takes on a milder course. However, the cause of the disease cannot be treated with medication. Therapy is purely symptom-oriented. Due to the fluid transition and the associated often late diagnosis of atypical pneumonia, the disease is prolonged and chronified more frequently than with typical pneumonia.

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Pneumonia without a cough
Pneumonia without a fever

Duration of the entire course of pneumonia

In its most favorable form, pneumonia is mild and heals after one to two weeks. This mainly happens in young people who develop viral pneumonia. Bacterial (typical) pneumonia usually takes two to three weeks. If complications occur or if the course turns out to be less favorable, at least double the duration should be expected. The age of the sick person also plays an important role. In this way, younger people often recover in half the time that older people need. In old age you have to expect months of recovery.

Read more on this topic at: How long does pneumonia last?

This is how severe pneumonia can be recognized

Severe pneumonia is initially characterized by a rapid onset. The more severe courses usually occur with typical (bacterial) pneumonia. Characteristic is the rapid and high rise in fever and cough with sputum. In addition, tissue damage in the lungs occurs in the course of severe pneumonia. These can manifest themselves in the form of shortness of breath or even respiratory insufficiency. In the case of insufficiency, the lungs can no longer carry enough oxygen and blood due to the inflammation, so that there is an oxygen deficiency. Often this is accompanied by blue lips or even blue nails and fingers.

Especially severe courses occur when the pneumonia spreads to other organs. Due to the anatomical proximity, the heart is particularly at risk. The inner lining of the heart or the pericardium can be affected by an infection. In both cases, cardiac function deteriorates with very low blood pressures and either a reflexively higher pulse or, in the case of pronounced weakness, a low pulse. In the case of blood poisoning (i.e. the pathogen spreads throughout the body), other organ systems are also affected. If the brain is infected, it leads to confusion, headache, dizziness, vomiting and neurological failures. If the kidneys are damaged, waste products can no longer be adequately excreted from the body, as well as water retention, often in the legs and on the eyelids. Other organs mainly affect the absorption of nutrients, the metabolism and the excretion of metabolic products.

Read more on this topic at: Delayed pneumonia

This can be done to shorten the course of pneumonia

The best way to shorten the course of pneumonia is to treat the cause of the disease. However, this is only possible with a bacterial infection, i.e. typical pneumonia. In this case, antibiotics can be used against the pathogens. Usually the symptoms improve after just a few medications. All further measures can only be carried out symptom-oriented. For example, it is important to drink a lot. A lot of fluid is exuded from the fever. This amount of fluid has to be reabsorbed through drinking. In addition, a large amount of water in the body also helps against the low blood pressure, which is often associated with an infectious disease and which causes severe fatigue and headaches.

Various calming agents can be taken against the cough. A lot of fluids also helps here, for example the typical cold teas, which are also good for the throat, are good. If the fever rises too much with pneumonia, it can be reduced by using cold compresses (for example) calf compresses. However, the compress should only be used when the person is perspiring. In the case of chills, they counteract the body's reaction and are more likely to be counterproductive. Furthermore, a lot of physical rest and rest is important. This leaves the body with the energy it needs to fight the pathogen.

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