Pneumonia | |
---|---|
Other names | Pneumonitis |
Chest X-ray of a pneumonia caused by influenza and Haemophilus influenzae, with patchy consolidations, mainly in the right upper lobe (arrow) | |
Pronunciation | |
Specialty | Pulmonology, infectious disease |
Symptoms | Cough, shortness of breath, chest pain, fever[1] |
Duration | Few weeks[2] |
Causes | Bacteria, virus, aspiration[3][4] |
Risk factors | Cystic fibrosis, COPD, sickle cell disease, asthma, diabetes, heart failure, history of smoking, very young age, older age[5][6][7] |
Diagnostic method | Based on symptoms, chest X-ray[8] |
Differential diagnosis | COPD, asthma, pulmonary edema, pulmonary embolism[9] |
Prevention | Vaccines, handwashing, not smoking[10] |
Medication | Antibiotics, antivirals, oxygen therapy[11][12] |
Frequency | 450 million (7%) per year[12][13] |
Deaths | Four million per year[12][13] |
Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli.[3][14] Symptoms typically include some combination of productive or dry cough, chest pain, fever, and difficulty breathing.[15] The severity of the condition is variable.[15]
Pneumonia is usually caused by infection with viruses or bacteria, and less commonly by other microorganisms.[a] Identifying the responsible pathogen can be difficult. Diagnosis is often based on symptoms and physical examination.[8] Chest X-rays, blood tests, and culture of the sputum may help confirm the diagnosis.[8] The disease may be classified by where it was acquired, such as community- or hospital-acquired or healthcare-associated pneumonia.[18]
Risk factors for pneumonia include cystic fibrosis, chronic obstructive pulmonary disease (COPD), sickle cell disease, asthma, diabetes, heart failure, a history of smoking, a poor ability to cough (such as following a stroke), and a weak immune system.[5][7]
Vaccines to prevent certain types of pneumonia (such as those caused by Streptococcus pneumoniae bacteria, linked to influenza, or linked to COVID-19) are available.[10] Other methods of prevention include hand washing to prevent infection, and not smoking.[10]
Treatment depends on the underlying cause.[19] Pneumonia believed to be due to bacteria is treated with antibiotics.[11] If the pneumonia is severe, the affected person is generally hospitalized.[19] Oxygen therapy may be used if oxygen levels are low.[11]
Each year, pneumonia affects about 450 million people globally (7% of the population) and results in about 4 million deaths.[12][13] With the introduction of antibiotics and vaccines in the 20th century, survival has greatly improved.[12] Nevertheless, pneumonia remains a leading cause of death in developing countries, and also among the very old, the very young, and the chronically ill.[12][20] Pneumonia often shortens the period of suffering among those already close to death and has thus been called "the old man's friend".[21]
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BMJ06
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