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Community-acquired pneumonia (CAP)

Pneumonia is a respiratory disease characterised by inflammation of the lung due to infections.1

 

Community-acquired pneumonia (CAP) is a kind of pneumonia developed in people who have not recently been to hospitals or any other healthcare facilities (eg, nursing home, rehabilitation centres).2

Community-acquired pneumonia (CAP)

Causes

CAP may be caused by infection with viruses, bacteria or fungi. The most common germ that causes CAP is Streptococcus pneumoniae. Other causative agents include Moraxella catarrhalis, Haemophilus influenzae and Klebsiella pneumoniae.1,2 Sometimes, infections of more than one type of pathogen may trigger the disease.

 

Community-acquired pneumonia (CAP)

Risk factors

Some factors may increase your risk of developing CAP:1,2

 

Age

People aged over 65 years and young children with an immune system which is not fully developed are at risk of pneumonia.

 

Certain conditions

People with immune deficiency disease (eg, HIV/AIDS) or chronic disease (eg, chronic obstructive pulmonary disease [COPD], bronchiectasis, heart disease, liver cirrhosis, and diabetes mellitus) are at increased risk of pneumonia. Those who are undergoing chemotherapy or immunosuppressive therapy may also have a weakened immune system and are at risk of pneumonia.

 

Smoking

Smoking impairs the body’s defence system to fight against bacterial and viral infections that cause pneumonia.

 

Cold or flu

Recent cold or flu may also weaken the immune system to protect the body from infections that may lead to pneumonia.

 

How common is it?

Pneumonia is the leading cause of death in children worldwide. In 2011, approximately 1.4 million children aged 5 years or younger died of pneumonia, accounting for 18% of all deaths in this age group worldwide.3

 

In the United States, approximately 1 million cases of pneumonia in people aged over 65 are reported each year.4

 

Symptoms

During the initial stage of infection, symptoms of pneumonia are very similar to flu, especially if the pneumonia has been caused by a virus. These include:1,2

  • Fever (mild to high)
  • Dry cough or Productive cough (with the production of phlegm or mucus)
  • Shortness of breath
  • Pleuritis
  • Sweating
  • Shaking chills
  • Chest pain
  • Headache
  • Muscle pain
  • Fatigue

These symptoms vary depending on your age and health status.

 

Treatment

Patients with mild CAP usually do not require hospital admission. Your doctor will decide whether you should be admitted to hospital or can be treated at home, depending on the severity of CAP and whether you have any other chronic illnesses.2

 

Home therapy

If you are treated at home, the most common medications are as follows:1

 

Antibiotics

The choice of antibiotics depends on the bacterial trends in your area and your risk factors. If you are prescribed any antibiotics, you should finish the whole course of treatment and should not skip any doses. This increases the effectiveness of treatment and prevents the development of resistance to antibiotics.

 

Macrolides and tetracyclines are commonly used in previously healthy patients. For patients with other illnesses such as chronic heart, lung, liver or renal disease, a fluoroquinolone or β-lactam plus a macrolide may be required.

 

Antiviral

If you suffer from viral pneumonia, antiviral treatment would be necessary as antibiotics are not effective in treating this type of pneumonia.

 

Fever reducers

Your doctor may give you medications to reduce your temperature, such as aspirin, ibuprofen, naproxen or acetaminophen. (Aspirin is not suitable for children.)

 

Cough medicine

You are advised to speak to your doctor before taking any cough medicine. Coughing can help clear mucus in your airway and relieve your symptoms.

 

Hospital admission

You may need to be admitted to hospital if you have two or more of the following criteria:1,2

  • Age 65 years or older
  • Confusion
  • Rapid breathing
  • Decrease in blood pressure
  • Requiring breathing aid

 

If you are treated in the hospital, you are likely to receive:2

  • Fluids and antibiotics in your veins
  • Oxygen therapy
  • Breathing facilitation (possibly)

 

Practical tips for recovery1,2

  • Finish the course of antibiotic treatment
  • Rest
  • Drink plenty of fluids
  • Stick to your medical appointments
  • Stop smoking

 

Prevention1,2

Vaccination

Pneumonia can be a complication of seasonal flu. Seasonal flu vaccine may help protect you from both diseases. Pneumonia vaccines are also recommended for people aged 65 years or older.

 

Personal hygiene

Washing your hands frequently can prevent germs from entering your system.

 

Quit smoking

Tobacco damages your lungs’ capacity to fight against infections.

 

Stay healthy

A balanced diet and regular exercise can boost your immune system.

 

Environmental factors

Reducing indoor air pollution by maintaining a constant air flow and encouraging good hygiene in crowded homes can help prevent pneumonia.

 

References

1. Pneumonia. Mayo Clinic Web Site. Available at: http://www.mayoclinic.com/print/pneumonia/DS00135/DSECTION=all&METHOD=print . Accessed 5 June 2012.

 

2. Pneumonia. Medline Plus Web Site. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000145.htm. Accessed 5 June 2012.

 

3. World Health Organization. Pneumonia Fact sheet N°331. Geneva Switzerland: World Health Organization, October 2011. Available at http://www.who.int/mediacentre/factsheets/fs331/en/. Accessed 5 June 2012.

 

4. Pneumonia Overview. Available at http://www.healthcommunities.com/pneumonia/overview-of-pneumonia.shtml. Accessed 5 June 2012.

 

The above information is provided for your reference only.

Please consult your family doctor if you have any enquiries.

Disease Information

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