Understanding Pneumonia

What Is Pneumonia?
Pneumonia is an infection in one or both of your lungs. Many small germs, such as bacteria, viruses, and fungi, can cause pneumonia. Pneumonia is not a single
disease. It can have more than 30 different causes. Understanding the cause of pneumonia is important because pneumonia treatment depends on its cause.
Approximately one-third of the pneumonia cases in the United States each year are caused by respiratory viruses. These viruses are the most common cause of
pneumonia in children and young adults.
The flu virus is the most common cause of viral pneumonia in adults. Other viruses that cause pneumonia include respiratory syncytial virus, rhinovirus, herpes
simplex virus, severe acute respiratory syndrome (SARS) virus, and more.
How Does Pneumonia Affect Your Body?
Most of the time, your nose and airways filter germs out of the air you breathe. This keeps your lungs from becoming infected. But germs sometimes find a way
to enter the lungs and cause infections. This is more likely to occur when:
Your immune system is weak.
A germ is very strong or present in large amounts.
Your body fails to filter germs out of the air you breathe.
When the germs that cause pneumonia reach your lungs, the lungs' air sacs (alveoli) become inflamed and fill up with fluid. This causes the symptoms of
pneumonia, such as a cough, fever, chills, and trouble breathing.
When you have pneumonia, oxygen may have trouble reaching your blood. If there is too little oxygen in your blood, your body cells can't work properly.
Because of this and the infection spreading through the body, pneumonia can cause death.
Pneumonia affects your lungs in two ways. It may be in only one part, or lobe, of your lung, which is called lobar pneumonia. Or, it may be widespread with
patches throughout both lungs, which is called bronchial pneumonia (or bronchopneumonia).
What Causes Pneumonia?
Many different germs can cause pneumonia. There are five main causes of pneumonia:
Bacteria
Viruses
Mycoplasmas
Other infectious agents, such as fungiincluding pneumocystis
Various chemicals
If you have viral pneumonia, you also are at risk of getting bacterial pneumonia.
What Are the Different Types of Pneumonia?
Bacterial Pneumonia
Bacterial pneumonia can attack anyone, at any age.
Bacterial pneumonia can occur on its own or develop after you've had a cold or the flu.
People at greatest risk for bacterial pneumonia include people recovering from surgery, people with respiratory diseases or viral infections and people who have
weakened immune systems.
If your body's defenses are weakenedby illness, old age, malnutrition, or impaired immunitythe pneumonia bacteria, which can live in healthy throats, can
multiply and work their way into the lungs. The infection can quickly spread through the bloodstream and invade the entire body.
Dozens of different types of bacteria can cause pneumonia.
The most common cause of bacterial pneumonia in adults is Streptococcus pneumoniae (pneumococcus), but there is a vaccine available for this form of
pneumonia.
Atypical pneumonia is caused by bacteria such as Legionella pneumophila, Mycoplasma pneumoniae, and Chlamydophila pneumoniae.
Pneumocystis jiroveci pneumonia is sometimes seen in people whose immune system is impaired (due to AIDS or certain medications that suppress the
immune system).
Other bacteria that can cause pneumonia include Staphylococcus aureus, Moraxella catarrhalis, Streptococcus pyogenes, Neisseria meningitidis, Klebsiella
pneumoniae, and Haemophilus influenzae.
Viral Pneumonia
Most respiratory viruses attack the upper respiratory tract, but some cause pneumonia, especially in children. Most of these pneumonias are not serious and last
a short time but others can be severe.
Viral pneumonia caused by the influenza virus may be severe and sometimes fatal. The virus invades the lungs and multiplies; however, there are almost no
physical signs of lung tissue becoming filled with fluid. This pneumonia is most serious in people who have pre-existing heart or lung disease and pregnant
women.
In extreme cases, the patient has a desperate need for air and extreme breathlessness. Viral pneumonias may be complicated by an invasion of bacteria, with all
the typical symptoms of bacterial pneumonia.
Mycoplasma Pneumonia
Mycoplasms are the smallest free-living agents of disease in humankind. They are not classified as to whether they are bacteria or viruses, but they have traits of
both.
Mycoplasms usually cause a mild form of pneumonia, but may be severe. They affect all age groups, but occur most often in older children and young adults.
Other Types of Pneumonia
Tuberculosis can cause pneumonia (tuberculosis pneumonia). It is a very serious lung infection and extremely dangerous unless treated early.
Pneumocystis carinii pneumonia (PCP) is caused by an organism believed to be a fungus. PCP may be the first sign of illness in many persons with AIDS.
PCP can be successfully treated in many cases. It may recur a few months later, but treatment can help to prevent or delay recurrence.
Other less common pneumonias may be quite serious and occur more often. Various special pneumonias are caused by the inhalation of food, liquid, gases or
dust, and by fungi.
Rickettsia (also considered an organism somewhere between viruses and bacteria) cause Rocky Mountain spotted fever, Q fever, typhus and psittacosis, diseases
that may have mild or severe effects on the lungs.
How Serious Is Pneumonia?
Pneumonia can be very serious and can cause death.
Pneumonia tends to be more serious for infants and young children, older adults (people 65 years or older), people who have other chronic health problems, and
people who have weak immune systems as a result of diseases or other factors.
If you develop pneumonia, your chances of a fast recovery are greatest if:
you are young
your pneumonia is caught early
your immune systemyour body's defense against diseaseis working well
the infection hasn't spread
you are not suffering from other illnesses
With treatment, most patients will improve within two weeks. Elderly or debilitated patients may need longer treatment.
If you have taken antibiotics, your doctor may want to make sure your chest x-ray becomes normal again after you finish the whole prescription. It may take
many weeks for your x-ray to clear up.
Possible Complications
People who may be more likely to have complications from pneumonia include:
Older adults or very young children
People whose immune system does not work well
People with other, serious medical problems such as diabetes or cirrhosis of the liver
Possible complications include:
Respiratory failure, which requires a breathing machine or ventilator
Sepsis, a condition in which there is uncontrolled inflammation in the body, which may lead to widespread organ failure
Acute respiratory distress syndrome (ARDS), a severe form of respiratory failure
Lung abscessesthese are infrequent, but serious, complications of pneumonia. They occur when pockets of pus form inside or around the lung. These
may sometimes need to be drained with surgery.
Who Gets Pneumonia?
Anyone can get pneumonia, but some people are at a higher risk than others.
Risk factors (that increase your chances of getting pneumonia) include:
Cigarette smoking
Recent viral respiratory infectiona cold, laryngitis, influenza,etc.
Difficulty swallowing (due to stroke, dementia, Parkinson's disease, or other neurological conditions)
Chronic lung disease such as COPD, bronchiectasis, or cystic fibrosis
Cerebral palsy
Other serious illnesses, such as heart disease, liver cirrhosis, or diabetes
Living in a nursing facility
Impaired consciousness (loss of brain function due to dementia, stroke, or other neurologic conditions)
Recent surgery or trauma
Having a weakened immune system due to illness, certain medications, and autoimmune disorders
Learn more about preventing pneumonia.
A
A
A
Share
Print
Lung Cancer Education Resource

Top Stories
More about Lung Disease
Enterovirus - What You Need to KnowSeptember 12, 2014
CVS Steps Up in the Fight Against TobaccoSeptember 3, 2014
LUNG FORCE Lung Cancer Call-In Day 9/4/14September 2, 2014
More

American Lung Association
55 W. Wacker Drive, Suite 1150, Chicago, IL 60601
T: 1-800-LUNGUSA | F: 202-452-1805 | Contact Us
http://www.lung.org/lung-disease/pneumonia/understanding-pneumonia.html
Patent Ductus Arteriosus (PDA)
?
Updated:May 6,2014
What is it?
An unclosed hole in the aorta.
Before a baby is born, the fetus's blood does not need to go to the lungs to get
oxygenated. The ductus arteriosus is a hole that allows the blood to skip the
circulation to the lungs. However, when the baby is born, the blood must receive
oxygen in the lungs and this hole is supposed to close. If the ductus arteriosus is
still open (or patent) the blood may skip this necessary step of circulation. The
open hole is called the patent ductus arteriosus.


More information for...
Parents of children with PDA
What causes it?
The ductus arteriosus is a normal fetal artery connecting the main body artery
(aorta) and the main lung artery (pulmonary artery). The ductus allows blood to
detour away from the lungs before birth.
Every baby is born with a ductus arteriosus. After birth, the opening is no longer
needed and it usually narrows and closes within the first few days.
Sometimes, the ductus doesn't close after birth. Failure of the ductus to close is
common in premature infants but rare in full-term babies. In most children, the
cause of PDA isn't known. Some children can have other heart defects along with
the PDA.
How does it affect the heart?
Normally the heart's left side only pumps blood to the body, and the right side only
pumps blood to the lungs. In a child with PDA, extra blood gets pumped from the
body artery (aorta) into the lung (pulmonary) arteries. If the PDA is large, the extra
blood being pumped into the lung arteries makes the heart and lungs work harder
and the lungs can become congested.
How does the PDA affect my child?
If the PDA is small, it won't cause symptoms because the heart and lungs don't
have to work harder. The only abnormal finding may be a distinctive type of
murmur (noise heard with a stethoscope).
If the PDA is large, the child may breathe faster and harder than normal. Infants
may have trouble feeding and growing at a normal rate. Symptoms may not occur
until several weeks after birth. High pressure may occur in the blood vessels in the
lungs because more blood than normal is being pumped there. Over time this may
cause permanent damage to the lung blood vessels.
What can be done about the PDA?
If the PDA (ductus) is small, it doesn't make the heart and lungs work harder.
Surgery and other treatments may not be needed. Small PDAs often close on their
own within the first few months of life.
Most children can have the PDA closed by inserting catheters (long thin tubes) into
the blood vessels in the leg to reach the heart and the PDA, and a coil or other
device can be inserted through the catheters into the PDA like a plug. The figure
below on the left shows one example of how a catheterization is used to close the
ductus. If surgery is needed, an incision is made in the left side of the chest,
between the ribs. The ductus is closed by tying it with suture (thread-like material)
or by permanently placing a small metal clip around the ductus to squeeze it
closed. If there's no other heart defect, this restores the child's circulation to
normal. In premature newborn babies, medicine can often help the ductus close.
After the first few weeks of life, medicine won't work as well to close the ductus
and surgery may be required.

What activities can my child do?
If the PDA is small, or if it has been closed with catheterization or surgery, your
child may not need any special precautions regarding physical activity and may be
able to participate in normal activities without increased risk.
As far as follow up in the future, depending on the type of PDA closure, your
child's pediatric cardiologist may examine it periodically to look for uncommon
problems. The long-term outlook is excellent, and usually no medicines and no
additional surgery or catheterization are needed.
Download and print a PDF version of this information
Congenital Heart Defect ID Card

Persistencia del ductus arterioso (PDA)
Soplo normal o funcional del corazn
Adults with PDA
What causes it?

The ductus arteriosus is a normal fetal artery connecting the main body artery
(aorta) and the main lung artery (pulmonary artery). The ductus allows blood to
detour away from the lungs before birth.
Every baby is born with a ductus arteriosus. After birth, the opening is no longer
needed and it usually narrows and closes within the first few days of life.
Sometimes the ductus doesn't close after birth. Failure of the ductus to close is
common in premature infants but rare in full-term babies, and the cause is usually
not known. Some patients can have other heart defects along with the PDA.
How does it affect the heart?

Normally the heart's left side only pumps blood to the body, and the right side only
pumps blood to the lungs. In a person with PDA, extra blood gets pumped from the
body artery (aorta) into the lung (pulmonary) arteries. If the PDA is large, the extra
blood being pumped into the lung arteries makes the heart and lungs work harder
and the lungs can become congested.
How does the PDA affect me?

If the PDA is small, it won't cause symptoms or problems because the blood flow
and pressure in the heart and lungs aren't changed appreciably from normal. The
only abnormal finding may be a distinctive type of murmur (noise heard with a
stethoscope), sometimes called a "machinery" murmur.
If the PDA is large, breathlessness may be due to reduced heart function or
problems related to high pressures in the lungs. High pressure may occur in the
lung vessels because more blood than normal is being pumped there. Over time
this may cause permanent damage to the lung blood vessels (pulmonary
hypertension).

What if the defect is still present? Should it be repaired in adulthood?

If the PDA is small, it doesn't have to be closed because it doesn't make the heart
and lungs work harder.
Patients with a moderate- or large-sized PDA may develop problems related to the
increased blood flow to the lungs. These patients may have improvement if the
PDA is closed. Closing the PDA can now usually be performed by catheter coil
placement or other device insertion to plug the abnormal communication (referred
to as interventional or therapeutic catheterization.)
Surgery may be the best treatment option for some patients. The surgeon doesn't
have to open the heart to fix the PDA. An incision is made in the left side of the
chest, between the ribs. The PDA is closed by tying it with suture (thread-like
material) or by permanently placing a small metal clip around the PDA to squeeze
it closed. Occasionally in the adult, a surgical patch is used. If there's no other heart
defect, this restores the circulation to normal.

If I still have a PDA, what activities can I do?
If the PDA is small, or if the PDA has been closed with catheterization or surgery,
you may not need any special restrictions and may be able to participate in normal
activities without increased risk.
Patients with moderate or large PDAs and patients with pulmonary hypertension
may need to restrict activity. They should discuss this with their cardiologist.
Ongoing Care: What will I need in the future?

Depending on the type of PDA closure, your cardiologist may examine it
periodically to look for uncommon problems. The long-term outlook is excellent,
and usually no medicines and no additional surgery or catheterization are needed.
Medical Follow-up
Patients with a small PDA need periodic follow-up with a cardiologist. Patients
with a PDA that's been successfully closed rarely require long-term cardiology
follow-up unless there's additional cardiac disease. Only rarely will they need to
take medicine after surgical or device closure. Your cardiologist can monitor you
with noninvasive tests if needed.
Activity Restrictions
Most patients with a small unrepaired PDA or a repaired PDA don't need any
special precautions and can participate in normal activities without increased risk.
After surgery or catheter closure, your cardiologist may advise some limitations on
your physical activity for a short time even if there's no pulmonary hypertension.
Exercise restriction is recommended for patients with pulmonary hypertension
related to PDA.
Endocarditis Prevention
Endocarditis prophylaxis is generally not needed more than six months after PDA
device closure. However, endocarditis prophylaxis is recommended for PDA
patients with a history of endocarditis, for those with prosthetic valve material and
for unrepaired PDA with associated pulmonary hypertension and cyanosis. See the
section on endocarditis for more information.
Pregnancy
Unless there's pulmonary hypertension or signs of heart failure, pregnancy is low
risk in patients with PDA.
Will You Need More Surgery?
Once a PDA has been closed, it's unlikely that more surgery will be needed.
Rarely, a patient may have a residual hole. Whether it will need to be closed
depends on its size.
Download and print a PDF version of this information
http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/Patent-Ductus-Arteriosus-
PDA_UCM_307032_Article.jsp