The world day of pneumonia marks today on November 12
by Vasco Barreto, internist and member of SPMI
As winter approaches and low temperatures, the number of cases of influenza and other respiratory infections increases. In some patients, such as the elderly or those with chronic diseases, it can progress to more serious situations, including pneumonia.
Pneumonia is an infection of pulmonary tissue, more precisely the pulmonary parenchyma, which hinders the exchange of gases in the level of respiratory alveoli and bronchial, causing respiratory disturbances.
This disease develops, in most cases, by inhalation of bacteria and other microorganisms present in the pharynx and the oral cavity. More rarely, it can also be developed by contact with other patients, through the transmission of particles or droplets infected, as well as in a hospital where there is a multiplicity of microorganisms, a part that is resistant to antibiotics.
More common in the elderly and children, pneumonia affects other risk groups, such as chronic patients (with chronic obstructive pulmonary disease, diabetes, HIV infection, kidney failure, immunosuppression, etc.), smokers, alcoholics and drug addicts.
Their most frequent symptoms are the difficulty of breathing or lack of air, pain in the chest area, fever (in most cases elevated), chills, cough with the possibility of spread and headache and in the muscles. Normally, these complications arise rapidly, with the possibility of manifesting itself at the same time.
Here is where it is important to make a timely diagnosis, since all the symptoms mentioned are common to other respiratory diseases. Except in very serious cases, the patient must begin to address primary health care, where doctors are in a position to decide whether treatment can be started only on the basis of symptoms and physical examination or chest radiography, which normally forces the patient to go to the hospital.
With regard to the treatment of pneumonia, it focuses on the administration of antibiotics and the control of symptoms, as well as on general measures such as rest, adequate nutrition and correct ingestion of liquids. Depending on the severity of the patient's condition, decide whether it will be treated in an ambulatory way or admitted.
Even with the majority register of cases treated as ambulatory, pneumonia continues to be one of the main causes of hospitalization in our country. This is due to the seriousness of the clinical image or the fragility of the patients, who usually see their chronic diseases decompensated.
Pneumonia can and should be avoided by adopting a healthy lifestyle (including healthy eating, exercise, cessation of smoking and reduced alcohol consumption), and very important through vaccination, which includes pneumococcal vaccine and flu vaccine. In the hospital setting, respect for the rules of control of infection is essential (hand hygiene, use of protection equipment, with respect to signs present in the rooms).
There is still a lot of resistance from the Portuguese population to seasonal flu vaccination. Therefore, it is essential to work to sensitize, especially to 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, as well as vaccines that can be purchased at prescription drug stores.
Adopting the preventative behaviors mentioned above is already a great step towards reducing the number of cases of pneumonia, something that the Portuguese Internal Medicine Society wants to continue betting, either in the promotion of initiatives aimed at the population or in the constant training of internists and other professionals of health