Pneumonia

Stopping the disease

Pneumonia is a dangerous infectious disease. Infants and small children as well as elderly people or people with chronic diseases are particularly at risk.

Our experienced consultants at Schoen Clinic specialise in treating pneumonia. Targeted therapy helps to fight the pathogens and alleviate the symptoms. 

Causes & symptoms

What is pneumonia?

Pneumonia is an inflammatory disease of the alveoli and lung tissue. It is generally caused by an infection. It usually has an acute onset and heals completely, but it can also be fatal or chronic with permanent tissue remodelling and loss of lung function.

Causes: How pneumonia develops

The most common cause is infection, mainly by bacteria, viruses, fungi and parasites. More rarely, pneumonia is caused by foreign bodies or penetration of stomach contents into the bronchi after being inadvertently inhaled. Irritant gases or radiation (e.g. as part of radiotherapy) can also trigger pneumonia. Cardiovascular diseases, such as hypostatic pneumonia with heart failure or pneumonia following a pulmonary embolism, are also possible triggers. The infection usually occurs as a droplet infection. The frequency of the individual infectious agents depends on various factors.

Community-acquired pneumonia

Pneumonia can be contracted at home. These are mostly caused by bacteria. The most common pathogens are pneumococci. A viral infection is the trigger in 25 per cent of cases. However, the pathogen spectrum also depends on age, on other diseases present at the same time, on the immune status of the patient and on the living situation (e.g. nursing home).

Hospital-acquired pneumonia

This occurs in hospital patients, especially when they are in intensive care and receiving mechanical ventilation. Pre-treatment with antibiotics is also a risk factor. The germ spectrum is clearly different here: these are more often problem germs, which are insensitive to commonly prescribed antibiotics in many cases. What’s more, the pathogen spectrum is dependent on the immune defence of the patient. Pathogens that are of no importance in a healthy person (e.g. fungi or viruses) play a role for patients with a weakened immune system.

Pneumonia: Symptoms of the disorder

A distinction is made between two types of pneumonia:  
  • Bacterial pneumonia 
    Classic bacterial pneumonia usually begins suddenly with chills and high fever. Patients feel seriously ill. There is also a cough, possibly with sputum. The patients complain of shortness of breath. Flaring of the nostrils, in which the nostrils clearly move with respiration, occurs, especially in younger children. Breathing can cause chest pain, which is often triggered by a small concomitant effusion between the pulmonary pleurae. If there is a lack of oxygen, a bluish discolouration of the lips, nose, toenails or fingernails may be visible.
  • Atypical pneumonia
    Atypical pneumonia can be triggered by the pathogens of classic pneumonia. However, viruses or mycoplasma are more frequently the cause. The onset of the disease is usually slow, possibly associated with headaches and muscle pain and only mild fever. Patients complain of a dry cough, often with little or no sputum. 

Possible complications during pneumonia

  • Pathogen scattering
  • Concomitant effusion or suppuration between the pulmonary pleurae 
  • Chronic inflammation
  • Respiratory insufficiency 
  • Pulmonary embolism

Diagnostics

Pneumonia diagnosis: How we diagnose a disease

After a detailed interview (medical history), you will be physically examined by our specialists. Listening to your lungs is very important. In contrast to atypical pneumonia, classic pneumonia is often accompanied by rattling noises when examined with a stethoscope.

Imaging procedures

If pneumonia is suspected, an X-ray or computed tomography of the chest is usually taken. This may allow conclusions to be drawn about the causes and extent of pneumonia. Inflammation centres can be detected in X-rays as what are known as shadows: there is a lightening of the lung tissue here. If the findings in the X-ray image are unclear, computed tomography of the lung can lead to further conclusions.
The ultrasound examination can also provide initial indications or show complications such as effusion.

Laboratory examinations

Inflammation values in the blood are usually also taken. This includes, above all, a blood count. In classic pneumonia, the white blood cells are increased as well as the C-reactive protein, which is an inflammation marker for acute, mostly bacterial, inflammation. The white blood cells can be normal or decreased in atypical pneumonia. In one third of the cases, we can also detect the pathogen from purulent sputum or from the irrigation fluid obtained during a bronchoscopy (endoscopy of the bronchial system). In some cases (e.g. pneumococcus or legionella), an antigen detection can also be performed using urine and sputum/bronchial irrigation fluid.