Host Factors Contributing To Secondary Bacterial Pneumonia
The tryptophan-catabolizing enzyme indoleamine 2,3-dioxygenase has been shown to enhance IL-10 levels in a mouse model for post-influenza pneumococcal pneumonia . Inhibition of IDO, which is expressed during the recovery phase of influenza infection, reduced bacterial loads during secondary, but not primary, pneumococcal infection. Despite a clear reduction in bacterial loads as well as markedly reduced levels of IL-10 and TNF-, it did not have an impact on survival. It is unlikely, therefore, that IDO predisposes for bacterial pneumonia by means of enhancing IL-10 production. Recent observations in our laboratory indicate that local IDO activity induces apoptosis of neutrophils during bacterial infection of the airways . IDO-mediated apoptosis, which has been extensively studied for T lymphocytes, is particularly mediated by metabolites such as kynurenine and 3-hydroxy anthranilic acid, rather than depletion of tryptophan. Tryptophan metabolites have been implicated in monocyte and macrophage apoptosis as well . Together, these data indicate that IDO functions as a natural mechanism to remove inflammatory cells. This mechanism to resolve inflammation prevents excessive damage to the airways after viral infection, but increases the susceptibility to secondary bacterial pneumonia.
Can I Prevent Pneumonia
The routine vaccinations that most people receive as kids help prevent certain types of pneumonia and other infections. If you have a chronic illness, such as sickle cell disease, you may have received extra vaccinations and disease-preventing antibiotics to help prevent pneumonia and other infections caused by bacteria.
People should get a pneumococcal vaccination if they have diseases that affect their immune system , are 65 years or older, or are in other high-risk groups. Depending on the bugs that are likely to affect them, these people also may get antibiotics to prevent pneumonia, as well as antiviral medicine to prevent or lessen the effects of viral pneumonia.
Doctors recommend that everyone 6 months and older get an annual flu shot. That’s because someone with the flu could then come down with pneumonia. Call your doctor’s office or check your local health department to see when these vaccines are available.
Because pneumonia is often caused by germs, a good way to prevent it is to keep your distance from anyone you know who has pneumonia or other respiratory infections. Use separate drinking glasses and eating utensils wash your hands often with warm, soapy water and avoid touching used tissues and paper towels.
You also can stay strong and help avoid some of the illnesses that might lead to pneumonia by eating as healthily as possible, getting a minimum of 8 to 10 hours of sleep a night, and not smoking.
Both Bacteria And Viruses Can Cause Pneumonia But One Is Much Worse For The Heart
11 November 18
CHICAGO Pneumonia caused by bacterial infections poses a much greater threat to the heart than pneumonia caused by viral infections, a new study suggests.
Patients in the study who were diagnosed with bacterial pneumonia had a higher risk of heart attack, stroke or death, compared with patients diagnosed with viral pneumonia, the researchers found.
The findings were presented here today at the American Heart Association’s Scientific Sessions annual meeting. The study has not yet been published in a peer-reviewed journal.
Both bacteria and viruses can cause pneumonia, an infection characterized by inflammation in the air sacs of the lungs.
In the study, the researchers looked at data from 2007 to 2014 on around 4,800 patients at a Utah hospital who had been diagnosed with pneumonia and hospitalized. Around 80 percent of the patients had been diagnosed with bacterial pneumonia. The researchers then looked at data on those patients for the 90 days following their diagnosis, noting which patients experienced heart attack, stroke, heart failure or death.
The researchers found that 34 percent of the patients with bacterial pneumonia had a major heart complication within that 90-day window, compared with 26 percent of the patients diagnosed with viral pneumonia.
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Trouble In Breathing Due To Inflammed Air Sacs Or Alveoli
You may experience a steady drop in your breathing rate or an unexplained rise in your breathing counts. One may also notice that there is sudden trouble which one may notice every time he/she breathes. This condition is also known as laboured breathing. The patient may notice that the breathing rate post-COVID recovery has drastically changed. It is either rapid or shallow. One can also find him/herself becoming breathless even while resting, Dr. Mukherjee told TheHealthSite.com.
What Increases Your Risk Factors For Walking Pneumonia
Like pneumonia, the risk for developing walking pneumonia is higher if you are:
- over age of 65 years old
- 2 years old or younger
Since walking pneumonia tends to be mild, some people with the illness choose not to get a formal diagnosis. But other serious diseases can cause symptoms that look like walking pneumonia. If symptoms continue to worsen after a few days, consider checking in with a healthcare professional for a diagnosis and treatment.
Treatment for walking pneumonia depends on whats causing the disease. Walking pneumonia from bacteria can be treated with antibiotics. A healthcare professional may use antiviral medications to treat cases caused by viruses.
For very mild cases of walking pneumonia, treatment may simply involve managing symptoms at home and resting.
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Differentiating Viral From Bacterial Pneumonia
Carl Heneghan, Annette Pluddemann and Kamal R. Mahtani
On behalf of the Oxford COVID-19 Evidence Service TeamCentre for Evidence-Based Medicine, Nuffield Department of Primary Care Health SciencesUniversity of Oxford
VERDICTA severe complication of COVID-19 is viral pneumonia. Distinguishing viral pneumonia from bacterial pneumonia is difficult in the community. In some cases, they could co-exist, increasing the chance of a more unfortunate outcome. However, there may be important clues in the history and the examination that can help differentiate the two. Recent guidance from NICE will support clinicians in this process.
BACKGROUNDCommunity-acquired pneumonia can be caused by viruses, bacteria and fungi .
Viral pneumonia is a common complication of influenza-like illnesses and is a complication of SARS-COV-2. Viral pneumonia may clear up on its own however, when severe, it can be life-threatening. Viruses are generally not as common a cause of CAP as some bacteria. However, as well as being a primary pathogen, viruses can be a co-pathogen with bacteria, particularly in those with severe illness requiring admission to ICU and in ventilator-associated pneumonia.
Coronavirus has also been shown to occur with CAP. In a 2010 case-control study conducted in Israel , coronaviruses were identified in 24 patients with CAP, compared with 17 in control subjects.
Those more at risk include:
Differentiating viral and bacterial pneumonia
How Do You Get Pneumonia
You may get pneumonia:
- After you breathe infected air particles into your lungs.
- After you breathe certain bacteria from your nose and throat into your lungs.
- During or after a viral upper respiratory infection, such as a cold or influenza .
- As a complication of a viral illness, such as measles or chickenpox.
- If you breathe large amounts of food, gastric juices from the stomach, or vomit into the lungs . This can happen when you have had a medical condition that affects your ability to swallow, such as a seizure or a stroke.
A healthy person’s nose and throat often contain bacteria or viruses that cause pneumonia. Pneumonia can develop when these organisms spread to your lungs while your lungs are more likely to be infected. Examples of times when this can happen are during or soon after a cold or if you have a long-term illness, such as chronic obstructive pulmonary disease .
You can get pneumonia in your daily life, such as at school or work or when you are in a hospital or nursing home . Treatment may differ in healthcare-associated pneumonia, because bacteria causing the infection in hospitals may be different from those causing it in the community. This topic focuses on community-associated pneumonia.
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What Are The Symptoms
Viral pneumonia usually moves in steadily over a few days. On the first day it feels like the flu, with symptoms like:
- Muscle pain
After a day or so your fever might get worse. You might also feel like you canât catch your breath. If your lungs are invaded with bacteria, you might also get some of the same symptoms as bacterial pneumonia, like:
- A wet, gunky cough that produces green, yellow, or bloody mucus
- Chills that make you shake
- Confusion, especially if youâre older
Studies Of The Urt Microbiome During Respiratory Viral Infection
Respiratory viruses enter the human body through the URT and are the most common type of acute infections of the respiratory tract. One possible mechanism by which influenza and other viral infections might predispose infected hosts to secondary bacterial pneumonia is by altering the microbial composition of the upper respiratory tract, fostering enhanced growth of pathogens, and facilitating the subsequent entry of large bacterial loads into the LRT . This section will examine recent literature on how acute respiratory viral infections have changed the URT microbiome.
Figure 3. Changes in the human upper respiratory tract microbiome following viral exposure. Given that bacterial pneumonia frequently arises as a result of aspirated bacterial pathogens, a potential mechanism by which viral infections might increase the risk of secondary bacterial infections is through increased colonization of the upper respiratory tract by bacterial pathogens. In human subjects, live attenuated influenza vaccine and human rhinovirus have been shown to disrupt the local host bacterial community, with increased relative abundance of potential pathogens , such as Staphylococcal and Neisseria species. The major changes in the upper respiratory tract microbiome are highlighted here.
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The Difference Between Viral Pneumonia And Bacterial Pneumonia
Treatment is the biggest difference between bacterial and viral pneumonia. Bacterial pneumonia is treated with antibiotic therapy, while viral pneumonia will usually get better on its own. In some cases, viral pneumonia can lead to a secondary bacterial pneumonia. At that point, your doctor may prescribe antibiotic therapy. Your doctor will be able to tell if it has become bacterial pneumonia by a change in your symptoms or signs.
Viral Factors Implicated In Severity Of Infection
Neuraminidase enables the release of newly formed progeny virions by hydrolysing the sialic acid and detaching it from the HA the virion becomes liberated from the host cell . To be truly effective the NA must be complementary and share the same receptor specificity as HA, so if the viral HA binds to 2-3 sialic acid then the NA should hydrolyse 2-3 sialic acid .
The production of viral toxins that impact host cell integrity is another important factor in the development of co/secondary bacterial infection. Influenza A virus can produce a viral cytotoxin PB1-F2 which plays a role in increasing inflammation and therefore host cell damage and bacterial adherence, increasing mortality and morbidity . It also helps reduce bacterial clearance, increasing the occurrence and severity of co/secondary bacterial infection, by causing cell death in host monocytes .
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Spreading Pneumonia To Others
If your pneumonia is caused by a virus or bacteria, you may spread the infection to other people while you are contagious. How long you are contagious depends on what is causing the pneumonia and whether you get treatment. You may be contagious for several days to a week.
If you get antibiotics, you usually cannot spread the infection to others after a day of treatment.
Who Is Most At Risk For Getting Pneumonia
People who have an increased risk of pneumonia include:
- People over the age of 65 and infants under age 2. The weakening immune system of older people makes them less able to fight off illnesses. Similarly, the immune system of infants is still developing and not at full-strength, making them more susceptible to infection.
- People with a health-caused weakened immune system. Examples include:
- People who are receiving chemotherapy
- Transplanted organ recipients
- People who have HIV/AIDS
- People with autoimmune disease and who are taking medications that suppress the immune system.
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Diagnosis Of Bacterial And Viral Infections
If you believe you have an infection other than the common cold, which is usually not life-threatening, consult your healthcare provider to make the proper diagnosis and treatment plan.
A healthcare provider will use your report of symptoms, medical history, and a physical examination to begin the diagnosis of a respiratory infection. Depending on possible exposures, they may refer you to testing for bacteria or viruses.
Tests that are frequently performed to diagnose respiratory bacterial infections include:
- Rapid strep test: A throat swab is analyzed for strep throat.
- Throat culture: A swab is taken and sent to the lab for culture.
- Sputum culture: Phlegm is collected and sent to the lab for culture.
- Blood culture: Blood is drawn into special bottles and incubated in the lab.
To see if you have a viral respiratory infection, commonly used laboratory tests that are used include:
- Nasal, cheek, or throat swab: This may be used for detection of viral antigens or for viral culture for influenza or COVID-19.
- Blood tests: Blood may be drawn to test for viral antigens or antibodies.
Flu Is The Most Common Cause Of Viral Pneumonia In Adults
Now that we know we are in the midst of a flu epidemic, it is important to be aware of the risk of pneumonia. The flu virus is the most common cause of viral pneumonia in adults and many people can develop pneumonia as their weakened immune systems are fighting flu. This particular pneumonia can be severe and sometimes fatal and is most serious in people who have pre-existing heart or lung disease, or in women who are pregnant.
The viral pneumonia that can develop from the flu virus is only one of dozens of kinds of pneumonia, however. There are many causes of pneumonia, both from viruses and bacteria, as well as from mycoplasma and fungi.
According to the CDC, nearly one million people a year nationwide are hospitalized with pneumonia, which can lead to respiratory failure, sepsis and lung abscess. About 500,000 people die from pneumonia each year.
Many deaths are preventable through vaccination, awareness, healthy behaviors, and early treatment.
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When Would I Need To Be Hospitalized For Pneumonia
If your case of pneumonia is more severe, you may need tostay in the hospital for treatment. Hospital treatments may include:
- Fluids, antibiotics and other medicines given through an IV
- Breathing treatments and exercises to help loosen mucus
People most likely to be hospitalized are those who are most frail and/or at increased risk, including:
- Babies and young children
- People with weakened immune systems
- People with health conditions that affect the heart and lungs
It may take six to eight weeks to return to a normal level of functioning and well-being if youve been hospitalized with pneumonia.
Common Viral Infections And Their Symptoms
The severity of viral infections can also vary widely and depends on the type of virus involved. Common viral respiratory infections and their symptoms include:
- The common cold:Typically caused by rhinoviruses and some coronaviruses. The common cold is usually mild and can include coughing, sore throat, sneezing, runny and stuffy nose.
- Influenza :The flu is commonly caused by type A and B influenza strains. Symptoms are typically more severe than the common cold and can include coughing, fever , muscle aches, shortness of breath, and more.
- COVID-19: Caused by the SARS-CoV-2 virus, symptoms include fever, dry cough, sore throat, runny nose, shortness of breath, loss of sense of smell and taste, fatigue, and more.
- Viral pneumonia: This viral lung infection can be caused by viruses including coronaviruses, adenoviruses, influenza virus, parainfluenza virus, varicella-zoster virus, and respiratory syncytial virus . Symptoms include cough, difficulty breathing, increased breathing rate, and fever.
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When To See A Healthcare Provider
If, based on the symptoms, you believe you may have the flu, call your healthcare provider right away. Antiviral medications such as Tamiflu can lessen the severity and duration of the flu if started within the first 48 hours of symptom onset.
Your healthcare provider may want you to come in to confirm the influenza virus with a rapid in-office test or may prescribe an antiviral solely based on your symptoms and flu activity in your area.
You should also contact your healthcare provider if symptoms continue to worsen after a week, or if you develop a fever or productive cough after you have started to feel better. This could indicate a secondary infection, such as bronchitis or pneumonia.
Other symptoms that require a call to your healthcare provider include severe muscle pain, weakness, or unsteadiness, and any worsening of chronic medical conditions.
Summary Of A Multifactorial Process
The full details of the mechanisms of synergism between influenza virus and pneumococcus remain to be elucidated. There is ample evidence that influenza virus alters the host in a way that predisposes to adherence, invasion, and induction of disease by pneumococcus. Access to receptors is a key factor and may be facilitated by the virus through epithelial damage, by exposure or up-regulation of existing receptors, or by provoking the regeneration response of epithelia following cytotoxic damage. Alteration of the immune response either by diminishing the ability of the host to clear pneumococcus or by amplification of the inflammatory cascade likely contributes to the severity of the resulting infection. Although the precise contributions of the many virulence factors expressed by these important pathogens are not completely understood, it is clear that the process is multifactorial and complex. It is likely that differences in these virulence factors between strains of the virus or the bacterium account in part for differences in the spectrum and severity of disease in humans. The insight gained into the pathogenesis of the interaction between influenza virus and pneumococcus may serve as a starting point towards the elucidation of the mechanisms underlying the many other polymicrobial interactions that contribute to disease in humans and animals.
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