8/16/2019 Infectologia - Neumonia (Jama 2016)

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Copyright 2016 American Medical Association. All rig hts reserved.

JAMA PATIENT PAGE | Pulmonary

Pneumonia

Pneumonia is a lung infection that can be caused by bacteria,

viruses, or fungi.Whenyou breathe in,oxygen-richair travels intothe bodythroughtheairways(trachea,bronchi, andbronchioles) inyour lungs.Attheendsof theairways,oxygen isexchanged forcarbondioxide,whichtravelsoutofthebodywhenyoubreatheout. Alveoli areverysmallairsacsat theendsof theairwaybrancheswhere this gasexchangeoccurs. Pneumoniacausesalveolito become inflamed andto fillupwith fluid.

Bacteria are the most common cause of pneumonia in adults,while viruses arethe mostcommon cause inchildrenyoungerthan5 years.

SymptomsThesymptomsof pneumoniarange from mild to severe. Commonsymptoms include cough with phlegm (“wet cough”), difficultybreathing, fever, chestpain, fatigue, and confusion.

At-RiskPopulationsWhileanyonecanget pneumonia,certaingroupsareathigherriskof developingthedisease.Childrenyoungerthan2 yearsandadultsolderthan65 years are atincreased risk.Your risk is alsohigher if you• Have a weakened immune system• Have chronic lung disease, such asCOPD,asthma,orcysticfibrosis• Haveotherchronichealthproblems,suchasdiabetesorheartdisease• Smoke cigarettes

PreventionVaccinescanhelppreventpneumonia.Pneumococcal vaccine helpsprotectyoufrom acommoncause ofseverepneumonia.Getting theflu vaccine every year helps prevent pneumonia that is caused bytheinfluenza virus orthat occursasa complicationof havingthe flu.Pertussis,measles,varicella(chickenpox),andHib vaccineshelp pre-vent less common causesof pneumonia.

Washing your hands with soap and water or using hand sani-tizerregularlycanhelppreventthespreadofgerms that causepneu-monia. Quitting smoking increases your lungs’ ability to filter outgermsand fightinfections.

Diagnosis and Treatment

To diagnosepneumonia, yourdoctor will ask questionsabout yoursymptoms and your health history. Certain tests, including chestx-ray, blood tests, and sputum (phlegm) culture, may be per-formedto help make thediagnosis.

Treatment is based on what kind of germ is causing the infec-tion and how severe your symptoms are. Bacterial pneumonia istreated withantibiotic medicines.Antibiotics will not help in casesof viral pneumonia, whichoften improves without treatment.

Pneumoniacanbe acquired invarioussettings.Causativegermsandtreatment maydifferdependingon whether youhave commu-nity-acquired pneumonia (CAP), hospital-acquired pneumonia, orhealth care–associatedpneumonia.

Manycasesofpneumoniacanbetreatedathome.Ifyoursymp-toms aresevere or you have otherhealth problems,you mayneedto be treated in the hospital. A studyin theFebruary 9,2016, issueof JAMAreportsonantibiotictherapyinadultshospitalizedwithCAP.

Author: AmyE. Thompson,MD

Conflict of InterestDisclosures: Theauthorhas completedand submittedthe ICMJEFormfor Disclosure of Potential Conflictsof Interestand nonewere reported.

Sources: Centers forDiseaseControland Prevention;National Heart, Lung, and BloodInstitute.

TheJAMAPatient Pageis a publicservice of JAMA. Theinformationandrecommendations appearingon thispage areappropriate in mostinstances, buttheyarenot a substitute formedicaldiagnosis. Forspecificinformation concerning yourpersonal medical condition, JAMAsuggests thatyou consultyour physician. Thispagemaybe photocopiednoncommercially by physicians andother health careprofessionalsto sharewithpatients. Topurchase bulkreprints, call312/464-0776.

BLOOD(in capillary)

Gas exchange

Carbondioxide

Oxygen

AIR(in alveolus)

CapillaryCapillary

Trachea

Bronchi

Bronchioles

Alveoli

Bronchiole Bronchiole

Healthy alveoliAir in alveoli

PneumoniaIn lammatory cells and luid in alveoli

Bronchiole

Lung anatomy and gas exchange

FORMORE INFORMATIONNational Heart, Lung, and Blood Institute

www.nhlbi.nih.gov/health/health-topics/topics/hlw/systemwww.nhlbi.nih.gov/health/health-topics/topics/pnu

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