diagnosing pneumonia

The 2014-2015 flu season was particularly harsh, and vaccines did not match up that well to prevalent strains of influenza virus. Whether or not the 2016 flu season is a bad one, doctors urge everyone to be vaccinated against flu, and they are more confident in the match between this year’s flu vaccines and prevalent viral activity.

Europe, however, could experience greater problems this year due to the more than 700,000 refugees who have entered Europe in 2015. Sheltering refugees as winter arrives is expected to present strong challenges, including opportunistic diseases like influenza and pneumonia. Fortunately, the traditional chest x-ray is a valuable tool in making the diagnosis when a cold or flu turns into pneumonia.

Preventing Influenza Prevents Some Cases of Pneumonia

Pneumonia is an infection in the lungs that can be caused by a number of different microorganisms. Around one-third of US pneumonia cases each year are caused by viruses, especially in young adults and children. The influenza virus is the most common cause of viral pneumonia in adults, though other viruses (like rhinovirus and respiratory syncytial virus) can also cause it.

Flu vaccines are valuable enough when they prevent the misery that influenza itself causes, but when it prevents flu, it also prevents flu complications like pneumonia. Some adults are advised to be immunized against certain types of pneumonia, but being vaccinated against influenza is an easy, cost-effective first step that almost everyone can take to help prevent flu-related pneumonia.

 Signs and Symptoms of Pneumonia

Pneumonia may be located in one or both lungs and causes several important signs and symptoms that doctors look for. Viral pneumonia symptoms are similar to influenza symptoms, with fever, aches, headache, dry cough, and weakness. It also causes shortness of breath and an increasingly productive cough. Difficulty breathing can cause lips to turn grayish-blue.

Bacterial pneumonia symptoms can develop quickly, and often include a high fever and shaking chills with chest pain that accompanies coughing or breathing deeply. Coughing produces thick, non-clear phlegm.

Mycoplasma, or “walking” pneumonia develops over weeks, with headache, fever, cough, and fatigue. People who also develop shaking chills or who cannot sleep due to coughing should see a physician for definitive diagnosis and treatment.

How Chest X-Rays Can Confirm Pneumonia

A simple chest x-ray allows radiologists to picture the lungs, and can indicate whether a patient has pneumonia. When someone has pneumonia, opacities appear where they shouldn’t, and there is no volume loss in the lung. Masses would show up on a chest x-ray as more well-defined than pneumonia. Parapneumonic effusions (excess fluid accumulations in the pleural cavity) are sometimes seen with pneumonia.

While a chest x-ray cannot indicate precisely which microorganism is responsible for pneumonia, it can provide clues. For example, pneumococcal pneumonia may give the entire lung lobe a “consolidated” appearance. Viral pneumonia may show up in the perihilar area (where blood vessels, nerves, and lymphatic vessels connect with the lungs), and may have a patchy appearance. Laboratory tests are required to confirm which organism is responsible for pneumonia.

Differentiating Pneumonia from Collapsed Lung

Some of the symptoms of pneumothorax (collapsed lung) overlap with those of pneumonia, in particular, shortness of breath and pain. Furthermore, pneumonia can cause pneumothorax, and doctors may use a chest x-ray to determine whether a person’s symptoms are caused by pneumonia or pneumothorax.

With pneumothorax, volume loss is seen in the lung, but with pneumonia lung volume is normal, or slightly increased. The shape and position of lung tissue are different in collapsed lungs than in lungs of people who have pneumonia. A chest x-ray can help radiologists rule out pneumothorax, which is treated differently than pneumonia.

Who Is at Greatest Risk from Pneumonia (and Influenza)?

Anyone can develop pneumonia at any age, but those at greatest risk for complications and death are those with weaker immune systems. This typically includes very old people and very young babies, as well as those with chronic health conditions. People receiving chemotherapy for cancer face greater risks from pneumonia than others, and people who smoke, or who are addicted to alcohol face greater than average health risks from pneumonia.

Every year pneumonia kills thousands of people and puts many more than that in the hospital. People most likely to make the fastest recovery from pneumonia are those who are young, those whose pneumonia is caught early, and those with a properly functioning immune system. Swifter recovery is also more likely if the infection has not spread and if the person with pneumonia is not suffering from other illnesses at the same time.

Vaccinating Against Pneumonia

Vaccines are available against pneumococcal pneumonia, and they’re recommended for children under age 5, adults over age 65, and other people who have risk factors, like a compromised immune system. Otherwise healthy people who are at heightened risk of pneumococcal disease can also be vaccinated against pneumonia. The flu vaccine, by preventing flu, can also prevent viral pneumonia, which can follow flu.

How Pneumonia Is Treated

When pneumonia is caused by bacteria, it is treated with antibiotics, which offer a high cure rate. Which antibiotic is used is determined based on the patient’s age, symptoms, severity, and whether the patient is hospitalized or not. Improvement in symptoms is usually noticed within two or three days.

Viral pneumonia treatment is largely a matter of symptomatic relief, so patients may take fever reducers, cough medication, and sometimes pain medication if coughing has led to significant pain. Fluids and rest are also important in the treatment of viral pneumonia.

The Value of Radiology During Influenza Season

When the common cold or influenza develops into pneumonia, the expertise of a radiologist, like Brian Auster, MD or Michael Arch, MD of SteleRAD can make the difference in obtaining a diagnosis efficiently so proper treatment can begin as soon as possible. The Board-certified owner-operator radiologists of SteleRAD have decades of combined experience assisting South Florida physician practices, hospitals, and imaging centers with every radiological subspecialty. If you are interested in how SteleRAD can be of assistance to your practice, hospital, or imaging center, we invite you to call us at 954-358-5250 or contact us at any time.