World Pneumonia Day marks today on November 12th
by Vasco Barreto, internist and member of SPMI
When winter and low temperatures approach, there is an increase in the number of cases of influenza and other respiratory infections. In some patients, like the elderly or people with chronic diseases, it may develop into more severe situations, including pneumonia.
Pneumonia is an infection of the lung tissue, more precisely the lung parenchyma, which degrades the gas exchange at the level of alveolar and respiratory bronchioles, causing respiratory need.
This disease develops, in most cases, by inhalation of bacteria and other microorganisms present in the larynx and oral cavity. In rare cases, it may also develop through contact with other patients, by transmitting infected particles or drops, as well as in a hospital setting where there are several microorganisms, some of which are resistant to antibiotics.
More commonly in the elderly and children, pneumonia affects other risk groups, such as chronic patients (with chronic obstructive pulmonary disease, diabetes, HIV infection, renal failure, immunosuppression, etc.), smokers, alcoholics and drug addicts.
The most common symptoms are difficulty breathing, breathlessness, chest pain, fever (mostly elevated), chills, coughing with the ability to spread and headache and in muscles. Usually these complications occur quickly, with the opportunity to manifest simultaneously.
This is where it is important to perform an early diagnosis because all of the aforementioned symptoms are common to other respiratory diseases. Except in very severe cases, the patient should begin by addressing primary health care where a doctor is able to determine whether treatment can be initiated only because of symptoms and physical examination or on thoracic radiography, which usually forces the patient to go to the hospital.
As regards the treatment of pneumonia, it focuses on the administration of antibiotics and the control of symptoms as well as general measures such as rest, proper feeding and proper fluid intake. Depending on the severity of the patient's condition, it is determined whether he will be treated on an outpatient basis or if he will be admitted.
Even with the majority register of cases treated on an outpatient basis, pneumonia continues to be an important cause of hospitalization in our country. This is due to the severity of the clinical picture or vulnerability of patients who often see their chronic diseases decompensated.
Pneumonia can and should be prevented by adopting a healthy lifestyle (including healthy diet, exercise, smoking cessation and reduced alcohol consumption) and very important through vaccination, which includes pneumococcal vaccine and influenza vaccine. In the hospital environment, respect for the rules for infection control is crucial (hand hygiene, use of protective equipment, respect for signs in the departments).
There is still much resistance from the Portuguese population to seasonal vaccination against influenza. It is therefore important to work to raise awareness, especially in risk groups, of this potentially fatal disease and the importance of vaccination. Only this year, the National Health Service has 1.4 million doses of vaccines to administer, in addition to vaccines that can be purchased at prescription drug stores.
Adopting the aforementioned preventive behaviors is already a major step in reducing the number of cases of pneumonia, something that the Portuguese Society for Internal Medicine wants to continue to invest in or promote initiatives directed at the population or in the constant education of internists and other healthcare professionals.