It is a widespread respiratory disease during the cold seasons, although it can strike at any time of the year.

It is caused by a bacterial or viral infection, generating symptoms such as high fever, coughing with phlegm, shortness of breath, wheezing, chest pain and diaphoresis.

There are at-risk groups – typically children, the elderly and those with low immune defences – for whom generally well-tolerated pathogens, which in healthy people commonly induce flu-like syndromes or bronchitis, can cause more extensive infections such as bronchopneumonia.

Regardless of the specific causes of bronchopneumonia, symptoms may include:

  • cough with or without phlegm
  • high fever (even between 39 and 40°C)
  • chest pain
  • dyspnoea
  • tachypnoea
  • rapid breathing
  • sweating
  • shivering
  • headaches
  • muscle aches
  • sense of fatigue
  • loss of appetite
  • confusion or delirium (especially in the case of elderly people)

In order to avoid serious complications, it is advisable to consult your doctor, especially if you experience intense chest pain, tachypnoea and confusion.

If not properly treated, or in the case of a late diagnosis, bronchopneumonia can cause complications, the most feared of which is so-called ‘sepsis’ (or septicaemia).

This is a serious clinical condition, as a result of the activation of a very high immune response after pathogens have been passed into the bloodstream.

Sepsis typically involves high fever, accelerated heart rate, pallor, rapid breathing, lower than normal blood pressure, confusion, chills and loss of consciousness.

Other possible complications of bronchopneumonia are:

  • pleurisy, which is an inflammation affecting the pleura, i.e. the protective membrane that covers the lungs and the cavities in which they reside.
  • respiratory insufficiency (which occurs when the respiratory system fails to maintain a proper level of oxygenation in the blood or elimination of carbon dioxide)
  • cardiovascular problems
  • pulmonary abscess, i.e. a cavity containing pus, located in the lungs; usually this lesion is surrounded by a more or less extensive inflammatory area.

Bronchopneumonia: the causes

Depending on the cause of its development, bronchopneumonia can be distinguished into

  • infectious (approximately 90% of cases), which in turn can be classified into bacterial, viral and fungal
  • non-infectious
  • Pleurisy leads to complaints such as respiratory insufficiency, cardiovascular problems and lung abscess.

Regardless of theIndependent of the cause, during a bronchopneumonia an inflammation develops that affects the bronchial tree up to the pulmonary alveoli.

In bronchopneumonia, we have an inflammation of the lobular type

The inflammation of the lung parenchyma can be

  • lobular, if it affects the bronchi and lung lobules (small portions of the lung parenchyma).
  • lobar, if it affects larger portions of lung parenchyma (typically due to pneumococcus).
  • Interstitial oedema may be observed that evolves into alveolar oedema (with worsening of symptoms).

The alveoli may become completely obliterated with the development of respiratory failure and acidosis.

Infectious bronchitis can be bacterial, viral and fungal

The main bacteria responsible for bronchopneumonia are:

  • Streptococcus Pneumoniae (or pneumococcus)
  • Staphylococcus Aureus
  • Haemophilus Influenzae
  • Klebsiella pneumoniae
  • Moraxella Catharralis
  • Mycobacterium Tubercolosis (responsible for tuberculosis)
  • Pseudomonas Aeruginosa
  • Pneumocystis Carinii (typical of HIV immunocompromised persons)

As for viral infectious bronchopneumonia, the main suspected viruses are influenza viruses and the respiratory syncytial virus (which mainly affects children under 2 years of age).

There are also rarer forms of a fungal or protozoal nature, caused by:

  • Candida Albicans
  • Aspergillus
  • Cryptosporidium

Non-infectious bronchopneumonia is a rarer form, accounting for only 10% of all cases of bronchopneumonia, and is caused by environmental, physical or chemical agents.

It generally occurs from the inhalation of foreign bodies that reach the lung through the bronchial tree.

We speak in such cases of ab-ingestis pneumonia.

It frequently develops in children or the elderly with severe swallowing disorder.

Foreign bodies are typically

  • food, such as peas, peanuts, peanuts or other seeds; sometimes the cause is vomit that comes up from the oesophagus and enters the respiratory tract (this may occur, for example, in bedridden persons)
  • non-food, i.e. toy fragments, batteries, coins and other plastic or metal objects
  • acids or other irritating chemicals
  • inhalation of poisonous or toxic gases
  • airway surgery
  • allergens; this is referred to as hypersensitivity pneumonitis, triggered by an allergic reaction.

Bronchopneumonia most frequently affects certain types of individuals, such as

  • children under the age of 2, especially viral bronchopneumonia
  • people over 65 years of age
  • those suffering from lung diseases such as cystic fibrosis, asthma or chronic obstructive pulmonary disease (COPD)
  • individuals with AIDS (or HIV)
  • individuals with a weakened immune system, for example as a result of chemotherapy or taking immunosuppressive drugs
  • smokers
  • individuals with a history of severe alcoholism
  • people with serious swallowing difficulties
  • people with malnutrition problems

Treating bronchopneumonia

Treatment for bronchopneumonia varies depending on the cause.

If the source is viral, doctors usually recommend a rest period of about one to two weeks.

Drug therapy is only resorted to in the event of severe symptoms or when the disease shows no sign of improving.

If the origin of the bronchopneumonia is bacterial, doctors usually prescribe antibiotic therapy, as this is the only solution for eliminating the infectious agent.

In such cases, in order to avoid a recurrence, it is essential that the patient completes the prescribed antibiotic treatment.

On medical indication, a course of aerosol therapy may be useful.

Regardless of the underlying cause of bronchopneumonia, there are some good rules to follow to alleviate symptoms

  • maintain a good level of hydration by drinking plenty of water and taking hot drinks
  • resort to paracetamol to combat fever

In more serious cases of bronchopneumonia, hospitalisation is necessary. In such circumstances, doctors may have to resort to assisted ventilation and intravenous medication.

Generally, bronchopneumonia that is diagnosed early and treated correctly has a positive prognosis.

If, on the other hand, detected late or treated inappropriately, it can lead to complications, even serious ones.

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