Inflammation of the lungs often occurs in the event of exposure to environmental toxins/irritants, allergens, or pathogens such as bacteria, viruses, fungi, etc. This HealthHearty write-up provides information about the treatment of lung inflammation, with the focus on pneumonia.
Did You Know?
2-4 million people in the United States develop community-acquired pneumonia (CAP) every year. Up to 10% of all adult hospitalizations are due to CAP.
The lungs are spongy paired organs that are located under the rib cage, on either side of the chest. They are an integral part of the human respiratory system. Besides the lungs, the respiratory system also comprises the pharynx, larynx, nasal passage, trachea, and the bronchi. These organs work in tandem. First of all, the inhaled air enters through the nose. It flows through the nasal cavity, pharynx, larynx, and the trachea. Thereafter, it flows through the left and right bronchial tubes, which branch into small airways called bronchioles. At the end of these bronchioles lie tiny alveolar sacs, wherein the exchange of oxygen and carbon dioxide takes place. This process of gas exchange is vital to our survival.
Lung function can get adversely affected in some cases. If pathogens, allergens, or environmental toxins/pollutants enter the lungs through the inhaled air, lung tissue can get inflamed. Basically, inflammation is the body’s response to trauma, infection, or hypersensitivity. The symptoms that are experienced during this time are due to the mechanisms that the body employs to defend itself against the foreign invaders.
The inflammation of the lung tissue is medically referred to as pneumonitis. It can be caused due to a wide range of reasons. These include:
➠ Inhalation of an allergen (hypersensitivity pneumonitis)
➠ Radiation therapy
➠ Adverse drug reactions
➠ Exposure to certain chemicals (chlorine, mercury, sodium hydroxide, etc.)
➠ Aspiration pneumonitis (aspiration of gastric contents into the lungs)
Among the aforementioned conditions or contributing factors, pneumonia is the most common reason behind the inflammation of the lungs.
Pneumonia is a form of pneumonitis that is characterized by fluid buildup in the alveolar sacs. Each of these sacs has a thin membrane that allows oxygen and carbon dioxide to pass in and out of the capillaries. As we breathe, oxygen from the inhaled air moves into the capillaries, and carbon dioxide that passes from the capillaries into the bloodstream is carried out of the body through the lungs. When fluid builds up in these sacs due to pneumonia, it has an adverse effect on the exchange of oxygen and carbon dioxide. This leads to a host of symptoms.
Pneumonia is mainly caused due to an infection. The causal organism for the infection could be a bacterium, virus, fungus, parasite, etc. Some of the common causal agents or pathogens include:
➠ Streptococcus pneumoniae
➠ Streptococcus pyogenes
➠ Staphylococcus aureus
➠ Klebsiella pneumoniae
➠ Haemophilus influenzae
➠ Mycoplasma pneumoniae
➠ Chlamydia pneumoniae
➠ Neisseria meningitidis
➠ Legionella pneumophila
➠ Respiratory syncytial virus
➠ Pneumocystis jiroveci
Streptococcus pneumoniae is a bacterium that is commonly responsible for causing pneumonia in adults, as well as children. Pneumonia can be community-acquired (infection that occurs due to person-to-person contact) or hospital-acquired (infection of the lungs that occurs during a hospital stay). More than one-third of the cases of community-acquired pneumonia are caused due to a virus. Care must be taken during the flu season, as flu can progress into pneumonia in the absence of treatment.
In about 20% of pneumonia cases, excess fluid can build up between the pleura, which is a two-layered membranous structure that lines the lungs. Normally, these two layers are separated by a small amount of fluid. This fluid acts as a lubricant and allows the layers to slide over each other as the lungs inflate and deflate. The abnormal fluid buildup in the pleural cavity is referred to as pleural effusion. This condition also affects one’s breathing pattern in an adverse manner.
At times, the fluid can become infected and get filled with pus. This condition is referred to as empyema. Empyema is more likely to occur in case of pneumonia, pleurisy (inflammation of pleura that could be caused by pneumonia, tuberculosis, lupus, rheumatoid arthritis, cancer, a pulmonary embolism, liver diseases, or a drug reaction), or pleural effusion that is caused by Staphylococcus aureus or Klebsiella pneumoniae. When both the lungs and the pleura get inflamed, one is diagnosed with pleura-pneumonia. Other complications of pneumonia include bacteremia, pneumothorax (air buildup between the pleural membranes that causes the lungs to collapse), acute respiratory distress syndrome, etc.
Tuberculosis is a contagious infection that is caused by Mycobacterium tuberculosis. Pneumonia and tuberculosis can both cause pleurisy, which may cause sharp chest pain when inhaling, coughing or sneezing. Lung inflammation could even be a symptom of other lung diseases such as asthma, chest colds, chronic bronchitis, pulmonary embolism, chronic obstructive pulmonary disease, cystic fibrosis, emphysema, or lung cancer.
An individual affected by lung inflammation might experience the following symptoms:
➠ Fever with chills
➠ Coughing up phlegm
➠ Rapid breathing and shortness of breath
➠ Weakness and fatigue
➠ Chest pain that might worsen while taking deep breaths or coughing
➠ Mental confusion or disorientation in older patients
Besides a physical examination, study of medical history, and analysis of the symptoms, doctors are also likely to conduct certain diagnostic tests. These might include:
➠ Blood culture
➠ Sputum analysis
➠ Chest X-ray
➠ Pulse oximetry
➠ Bronchoscopy (in severe cases)
It is extremely essential to determine whether the patient can be treated at home or needs to be hospitalized. For prompt treatment and speedy recovery, it is necessary to identify the underlying cause of lung inflammation. For instance, blood culture test results can help the doctors identify the causal pathogen in case of infections. These tests also help the doctors identify the appropriate drug.
The aim of the treatment is to cure the infection and prevent any complications. More often than not, people affected by community-acquired pneumonia can be treated at home with appropriate drugs and self-care measures.
➠ In case of a bacterial infection, the treatment involves the use of antibiotics. These include macrolides (azithromycin, erythromycin, or clarithromycin), tetracycline (doxycycline, tetracycline, and minocycline), fluoroquinolones (gemifloxacin, levofloxacin, or moxifloxacin), cephalosporins (cefadroxil, cefprozil, cefuroxime, or cephalexin), penicillins (amoxicillin, ampicillin, or piperacillin), etc. In case of patients who are allergic to macrolides, amoxicillin and clavulanate might be recommended. It must be noted that tetracyclines are not recommended for children under the age of 8 years.
➠ If the infection is caused by a virus, antibiotic therapy will not help. In such cases, antiviral drugs will be prescribed. The drugs will be prescribed according to the causal virus. Drugs such as oseltamivir and zanamivir are prescribed for treating infection caused by the Influenza virus, whereas ribavirin is recommended for Parainfluenza virus,Adenovirus, and Respiratory syncytial virus. In case of Varicella-zoster virus and Herpes simplex virus, acyclovir is recommended. It must be noted that individuals affected by viral pneumonia might also be given antibiotics to prevent bacterial pneumonia.
➠ In severe cases, where the patient is unable to take the drugs orally, intravenous administration of drugs is required.
➠ Doctors take the patient’s overall health into consideration while prescribing drugs. The doctors must be informed about any pre-existing medical condition, allergies to drugs, and the medicines that the patient is taking currently.
➠ Hospitalization might be needed if the patient is experiencing symptoms such as mental confusion, low body temperature, rapid breathing, persistent nausea and vomiting, low blood pressure, etc. Since infants (especially those who are younger than 3 months) and adults older than 65 years come under the high-risk group, they might need to be hospitalized in some cases. Hospitalization becomes a necessity in case the patient cannot breathe. In severe cases, the patient might have to be admitted in an ICU and placed on a ventilator.
➠ Hospitalization might be needed for children with symptoms such as dehydration, excessive sleepiness, breathing problems, low blood oxygen levels, and low body temperature.
➠ Besides antibiotics/antivirals, drugs such as antipyretics (fever reducers), expectorants (for loosening cough), and non-steroidal anti-inflammatory drugs might be prescribed.
➠ Besides drug therapy, following self-care measures such as staying hydrated and taking ample rest will also prove beneficial.
➠ If the contributing factor for lung inflammation is hypersensitivity pneumonitis (inhalation of an allergen), exposure to chemicals, or a drug reaction, then the offending substance must be avoided. The use of anti-inflammatory drugs might also help in such cases.
➠ If the patient is affected by pleural effusion, the treatment will involve the drainage of fluid. This will help normalize breathing.
➠ In case of dry pleurisy, anti-inflammatory medicines are prescribed. If the symptoms are severe, doctors might prescribe corticosteroids. At times, inflammation is so severe that the patient might have to be hospitalized.
Inflammation of the lungs can have an adverse effect on one’s health, as lungs perform the vital function of exchange of oxygen and carbon dioxide. If left untreated, inflammation can become life-threatening. While acute inflammation is observed in case of pneumonia and acute respiratory distress syndrome (ARDS), conditions such as asthma and chronic obstructive pulmonary disease are associated with chronic inflammation. It’s extremely essential to diagnose lung infections or other contributing factors of inflammation, so that the lung function is restored to normal.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.