Pneumonia is a serious infection of the lungs, especially after age 65.
Each year in France, 500,000 cases of pneumonia are recorded. “Pneumonia represents the leading cause of death from infection in the world. You have to take it serious“ reminds us Louis Stoffaes, pulmonology intern at the Association of Young Pulmonologists (AJPO2). The singer Véronique Sanson aged 75 has been hospitalized for pneumonia on the night of Saturday April 27 to Sunday April 28, 2024 forcing him to cancel a concert, informed his press officer to AFP. “Nothing serious” according to comments from those around him reported to Le Parisien.
Definition: what is pneumonia?
Pneumonia is a infection acute lung caused by bacteria or viruses. We thus distinguish:
► Bacterial pneumonia most often caused by Streptococcus Pneumoniae abbreviated to Pneumococcus. Haemophilus influenzae, Legionella pneumophila, THE Mycoplasma pneumoniae, the Chlamydia pneumoniae, Klebsiella pneumoniae or staphylococcus are the other bacteria most often involved. Bacterial pneumonia usually affects a single lobe (we speak of “acute frank lobar pneumonia”) or pulmonary segment. Bacterial pneumonia can also be of the “atypical pneumonia” type.
► Viral pneumonia caused by a virus, most frequently influenza viruses, respiratory syncytial virus (RSV) or rhinoviruses. This type of pneumonia primarily affects children. Most viral pneumonias are benign and limited to a single lung lobe.
In cases of pneumonia, the infectious agent reaches the pulmonary alveoli, balloon-like oxygen transfer zones located at the end of the bronchioles. The alveoli then fill with fluid, which causes the symptoms of pneumonia.
What is atypical pneumonia?
Atypical pneumonia is a infection caused by “atypical” germs, often bacteria such as Legionella pneumophila, Mycoplasma pneumoniae (often in young adults) or Chlamydophila pneumoniae. They mainly concern young patients. If the bronchi are also affected, we then speak of bronchopneumonia.
What is bronchopneumonia?
Bronchopneumonia refers to the association of inflammation in the bronchi, but also in the lung tissue.
Germs in the air enter the lungs through the respiratory tract when we breathe. They can also come from the oral cavity or the ENT (otolaryngological) sphere. When these bacteria enter the alveoli, they cause inflammation. The alveoli then fill with pus and fluid, causing the symptoms of pneumonia.
What are the symptoms of pneumonia?
Manifestations vary depending on the intensity and severity of the disease as well as the age of the patient. May appear:
- a cough,
- respiratory discomfort,
- yellowish or greenish sputum,
- tiredness,
- a drop in blood pressure,
- a chest pain,
- a fever which can reach 41°C,
- chills and the appearance of a bluish color of the nails and lips are sometimes observed, indicating the seriousness of the attack.
Beware of atypical bacterial pneumoniawhich can cause symptoms uncharacteristic of a respiratory illness, such as headache, vomiting or seizures.
It is possible to differentiate pneumonia from bronchitis because “in bronchitis, you will rarely have a high fever resistant to paracetamol, explains Louis Stoffaes. In addition, bronchitis is ‘epidemic’, very often due to a simple virus.” Pneumonia is also different from COPD (Chronic Obstructive Pulmonary Disease) which is a chronic condition of the bronchi and lungs, mainly linked to tobacco.
Pneumonia, especially contagious when it is viral
► Viral pneumonia : pneumonia of viral origin can be contagious. “Viruses are known to be transmitted via airborne droplets (coughs, sneezes) or even handled.” In order to avoid becoming contaminated, minimum precautions are necessary: ventilate the rooms, wear a mask if you are in front of the patient for a certain moment, sneeze into a tissue, wash your hands…
► Bacterial pneumonia: it’s more complex. Some can be found in the environment while others are already present, in our throat or digestive tract for example, and take advantage of a misdirection or a change in the immune system to proliferate and cause pneumonia.
Lquestioning and auscultation of the patient direct the doctor to the diagnosis of pneumonia. “You can diagnose bronchitis from pneumonia with a stethoscope because it produces a very particular noise which testifies to the congestion of the alveoli in the affected area: the crackles” assures Louis Stoffaes. A chest x-ray (lung x-ray) is essential to confirm this hypothesis, because “it will show an area of condensation of the pulmonary parenchyma”. An infectious assessment and bacteriological analysis of bronchopulmonary secretions complete the diagnosis. “Can also collect urine to find signs of infection of certain bacteria.”
Pneumonia is serious: who are at risk?
Pneumonia is a potentially serious illness, especially if it occurs in a frail or elderly person, i.e.:
- People over 65 years old
- People with heart failure
- People who have had a stroke
- People with chronic kidney disease
- People with liver disease (e.g. cirrhosis, fatty liver)
- People with chronic obstructive pulmonary disease (COPD)
- People with immunosuppression (HIV, cancer, etc.)
- People with sickle cell disease
- People who have already had bacterial pneumonia
- People who live in institutions (in a retirement home, for example)
What is the treatment for pneumonia?
Treatment varies depending on the cause and severity of the pneumonia. “Progress in antibiotic therapy made it possible to manage the majority of acute pneumonia at home between 7 and 21 days in a young patient without comorbidity. But around 50,000 patients are hospitalized each year in France and sometimes even require medical treatment. intensive care, which can last a certain time depending on their general condition” says Louis Stoffaes.
As for the treatment of viral pneumoniait sometimes involves taking antiviral drugs, but most often the treatment is symptomatic, with paracetamol and rest.
For bacterial pneumonia, antibiotic therapy is essential. In the elderly, babies, or those who show signs indicating severe lung damage, hospitalization is often required. In this case, treatment consists of considering antibiotic therapy adapted to the microbe in question (which remains unknown in more than 50% of cases), administered using an infusion. Rehydration and respiratory assistance such as oro-tracheal intubation are necessary in the most serious cases.
Is there a vaccine against pneumonia?
Pneumococcus is a bacteria responsible for many infections including pneumonia in children and adults. Vaccination is compulsory for all infants born since October 1, 2018 (Prevenar® vaccine). It consists of two injections and a booster. Adults over 18 at risk of pneumococcus infection can also get vaccinated. Contact your doctor or pharmacist to request this vaccination.
Evolution and duration of pneumonia: how long does it take to recover?
The duration of pneumonia cannot be quantified. She depends on each case, of each patient. There gravity of pneumonia depends on the extent of the lung area which is affected but also on the microbe in question, age and background medical conditions of the affected person. It generally progresses favorably thanks to antibiotic treatment. With early and appropriate treatment, symptoms improve quickly, within a few days. If the fever persists, you should consult your doctor again. The signs on the x-ray (or scanner) can return to normal up to three months after recovery.
Thanks to Louis Stoffaes, pulmonology intern and member of the Association of Young Pulmonologists – AJPO2.