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Causes of pneumonia
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Even in the present era of antibiotics, pneumonia remains a major cause of childhood death. Along with measles and diarrhoea, it forms the unholy trinity that is responsible for millions of deaths among children around the world each year.
Pneumonia is an infection of the lungs, and can be caused by bacteria, viruses and fungi. The dangerous entity is bacterial pneumonia, which progresses rapidly and may have a fatal outcome if not treated promptly and adequately. This page will restrict itself to bacterial pneumonia.
When bacteria invade the lungs, the body mounts a defense. The lung air spaces fill up with a material composed of dead bacteria, host defense cells, lung cells, and other debris. This is known as consolidation, and it renders the affected part of the lung unfit for its important function of respiration.
The healthy parts of the lungs have to work harder, and this is done by increasing the rate of respiration. When large parts of the lung are affected, the oxygen needs of the body cannot be met, and a condition called hypoxia sets in. Sometimes, the pneumonia is not extensive, but the effort of maintaining a high respiratory rate exhausts the muscles involved. This causes hypoxia, too. Prolonged hypoxia causes damage to various organs of the body, and may lead to death.
Pneumonia sets in with fever, often with chills and shivering. The fever is often very high. Cough, headache, body ache, and lethargy are accompanying features. Older children have poor appetites, infants and babies are often unable to feed at all. We must remember that fever and cough are seen in a number of conditions - tonsillitis, laryngitis, sinusitis and viral colds to name a few.
The distinguishing feature of pneumonia is a fast breathing rate. A child less than a year old with a breathing rate of 50 per minute or more, and an older child with a rate of 40 per minute or more, should be seen by a doctor immediately.
It is not always possible to reliably differentiate between the different causes of pneumonia on clinical examination, but laboratory tests can help. If the child is seriously ill, the doctor will usually start antibiotics right away, without waiting for test reports. A child with extensive pneumonia and breathing difficulty may need to be hospitalized for intravenous fluid and antibiotics, and oxygen support.
Last revision: July 15, 2007
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