Definition

Pneumonia is an infection in the lung tissue, which can affect the alveoli (air sacs) as well as the bronchi and bronchioles, the branching air passages from the trachea or throat.

The condition occurs when viruses, bacteria, or fungi cause inflammation and infection in the lung tissue. Pneumonia that affects both the alveoli and bronchi is referred to as bronchopneumonia.

Individuals with bronchopneumonia may experience difficulty breathing due to narrowed airways and inflammation of the lung tissue. This inflammation can impede the lungs' ability to receive sufficient oxygen.

Causes

Bronchopneumonia can be caused by viruses, bacteria, or fungi, with bacterial infections being the most common. These pathogens are typically transmitted from person to person through droplets from sneezing or coughing.

The bacteria commonly responsible for bronchopneumonia include:

• Staphylococcus aureus
• Haemophilus influenzae
• Pseudomonas aeruginosa
• Escherichia coli
• Klebsiella pneumoniae
• Species of Proteus

Additionally, bronchopneumonia frequently occurs in hospital settings, where individuals with weakened immune systems are more susceptible to diseases, including lung infections. Hospital-acquired pneumonia may also be caused by bacteria that are resistant to antibiotics.

Risk factor

Some factors that increase the risk of bronchopneumonia are:

• Age: Individuals aged 65 years or older and children under 2 years old have a higher risk of developing bronchopneumonia and its complications.
• Environment: People who work or frequently visit hospitals or nursing homes have a higher risk of contracting bronchopneumonia.
• Lifestyle: Smoking, poor nutrition, and heavy alcohol use can increase the risk of bronchopneumonia.
• Medical conditions: Having certain diseases increases the risk of bronchopneumonia. These medical conditions include:
• Chronic lung diseases such as asthma or chronic obstructive pulmonary disease (COPD)
• HIV/AIDS
• Having a weakened immune system due to chemotherapy or the use of immunosuppressive drugs
• Chronic diseases such as heart disease or diabetes
• Autoimmune diseases, such as rheumatoid arthritis or lupus
• Cancer
• Chronic cough
• Difficulty swallowing
• Use of a ventilator

If you belong to any of the above risk groups, consult with a doctor about ways to prevent and manage bronchopneumonia.

Symptoms

Symptoms of bronchopneumonia can vary from mild to severe and are generally similar to other types of pneumonia. Complaints usually begin with flu-like symptoms that can worsen over several days. Other symptoms include:

• Fever
• Productive cough
• Shortness of breath
• Chest pain
• Rapid breathing
• Sweating
• Chills
• Headache
• Muscle pain
• Fatigue
• Confusion or delirium, especially in the elderly

Symptoms may be more severe in individuals with weakened immune systems or other underlying illnesses.

Symptoms in children:

Children and infants may exhibit different symptoms. Although coughing is the most common complaint in infants, they may also show signs or symptoms such as:

• Rapid heartbeat
• Low blood oxygen levels
• Retraction or pulling of chest muscles during breathing
• Irritability
• Decreased appetite
• Fever
• Shortness of breath
• Difficulty sleeping

Diagnosis

Only a doctor can diagnose bronchopneumonia. The doctor will inquire about symptoms and medical history, then perform a physical examination. Using a stethoscope, the doctor will listen for wheezing and other abnormal breath sounds.

If the lung infection is severe enough or the lungs are filled with fluid, breath sounds may be diminished.

The doctor will also conduct diagnostic tests to rule out other diseases that may cause symptoms similar to bronchopneumonia. These other diseases may include bronchitis, bronchial asthma, or lobar pneumonia.

Diagnostic tests that may be performed include:

• Chest X-ray: Typically, there will be uneven areas of infection, usually in both lungs and mostly located at the base of the lungs.
• Complete blood count: A high total white blood cell count, with elevated counts of specific types of white blood cells, may indicate a bacterial infection.
• Blood or sputum cultures: These tests determine the type of microorganism causing the infection.
• CT scan: This provides a more detailed view of lung tissue.
• Bronchoscopy: This allows for a closer look at the airways and the sampling of lung tissue while examining for infection and the condition of other parts of the lung.
• Oximetry: This is a simple test to measure the percentage of oxygen in the blood. The lower the number, the lower the oxygen levels in the body.

Management

Bronchopneumonia can be managed with simple home treatments or may require medical care by a doctor.

• Home care:

Bronchopneumonia caused by a virus usually does not require medical treatment unless it is severe. It typically improves on its own within two weeks. If caused by bacteria or fungi, it usually requires treatment.

• Medical treatment:

Doctors will prescribe antibiotics if bronchopneumonia is caused by bacteria. Most people will feel better within three to five days after taking antibiotics. Antibiotics should be completed to prevent recurrence of the infection and antibiotic resistance.

In cases of viral infections such as influenza, doctors may prescribe antiviral medication to reduce the duration of illness and the severity of symptoms.

• Hospital care

Hospital care is provided if the infection is severe and the patient meets any of the following criteria:

• Aged over 65 years
• Experiencing difficulty breathing
• Experiencing chest pain
• Rapid breathing
• Low blood pressure
• Showing signs of confusion
• Requires breathing assistance
• Suffering from chronic lung disease

Treatment in the hospital may include administration of antibiotics and fluids through intravenous lines. If oxygen levels are low, oxygen therapy is also necessary.

• For children:

Doctors will prescribe antibiotics if a child has a bacterial infection. Symptomatic treatment will also be provided to alleviate symptoms. Make sure the child gets enough fluids and rest.

Doctors will provide fever-reducing medication. Inhalers may also be prescribed to help keep the airways open. In severe cases, children may require hospitalization to receive:

• Fluid therapy through intravenous lines
• Medications
• Oxygen
• Respiratory therapy

Always consult a pediatrician before giving cough medicine to a child. Cough medicine is rarely recommended for children under 6 years old. It is also important to pay attention to your child's hygiene.

Complications

Complications of bronchopneumonia include:

• Sepsis, or infection spreading through the bloodstream
• Lung abscess, which is a collection of pus in the lung
• Accumulation of fluid in the pleural membrane or pleural effusion
• Respiratory failure
• Kidney failure
• Heart disorders such as heart failure, heart attack, and irregular heart rhythm

Prevention

Simple preventive measures can reduce the risk of illness and contracting bronchopneumonia, such as proper handwashing.

Vaccination can also prevent certain types of pneumonia. Make sure to get the annual influenza vaccination because influenza can lead to pneumonia. Bacterial pneumonia can also be prevented with the pneumococcal vaccine. This vaccine is available for adults and children.

Consult with a doctor to determine if vaccination is beneficial for you and your family. Learn more about vaccination schedules for infants and toddlers.

When to see a doctor? 

Consult a doctor if you experience the signs and symptoms of bronchopneumonia mentioned above. Prompt treatment will speed up recovery and prevent complications.