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Viral Pneumonia


Presentation

In the preliminary stages, viral pneumonia does not produce any serious symptoms. As the disease progresses and treatment is delayed, the condition may present itself with more severe symptoms. The following are the signs and symptoms of viral pneumonia:

Fever
  • Patients with high-grade fever, myalgias, and cough should arouse the highest suspicion.[ncbi.nlm.nih.gov]
  • All patients with neutropenic fever and normal findings at chest radiography should undergo thin-section computed tomography to determine whether parenchyma abnormalities are present.[ncbi.nlm.nih.gov]
  • The patient presented with fever, myalgia, general fatigue and dyspnea of seven days duration. Chest computed tomography showed bilateral ground-glass opacity and consolidation.[ncbi.nlm.nih.gov]
  • […] dry cough headache muscle pain prostration The symptoms advance rapidly, within 12 to 36 hours: increasing breathlessness worsening cough producing scant amount of bloody sputum high fever possibly blueness of lips During the final stage the patient[sk.lung.ca]
  • The clinical picture of these different pneumonias can be very similar, but viral infection is more common in the pediatric and geriatric populations, leukocytes are not generally elevated, fever is variable, and upper respiratory tract symptoms often[ncbi.nlm.nih.gov]
Chills
  • Symptoms Symptoms of viral pneumonia include fever, shortness of breath, shaking chills, fatigue, weakness, loss of energy, lips develop bluish, productive cough, running nose, headache and muscle ache.[symptoma.com]
  • Symptoms and Signs Viral pneumonia causes cough with fever, chills and rapid breathing. It is most common in young children, peaking between ages 2 and 3.[hon.ch]
  • Symptoms These include: Dry cough Fever Chills Shortness of breath Pain in your chest when you cough or breathe Rapid breathing If you have any of these symptoms, call your doctor.[webmd.com]
  • Sufferers may also experience muscle aches, shaking chills and exhaustion. Headache and body sweats are also common symptoms.[symptomfind.com]
Malaise
  • Presentation Pearls Diagnosis Treatment Media Patient will present as a 45-year-old male with a one week history of hacking non-productive cough, low grade fever, malaise and myalgias.[smartypance.com]
  • Clinical manifestations may include upper respiratory symptoms, conjunctivitis, and rhinitis in association with fever, nonproductive cough, and malaise.[visualdx.com]
  • However, the following symptoms can signal a bout of pneumonia: Malaise or feeling weak Cough Green or yellow sputum Pain in the chest Confusion Fever Chills Shortness of Breath Often, a person may think she is simply suffering from the cold or flu.[aplaceformom.com]
  • In healthy adults, infection is characterized by low-grade fever, malaise, and nasal symptoms. Pneumonia has been reported in young children, immunocompromised patients, and elderly persons [ 27 , 28 ].[academic.oup.com]
  • In healthy adults, infection is characterized by low-grade fever, malaise, and nasal symptoms. Pneumonia has been reported in young children, immunocompromised patients, and elderly persons [ 27, 28 ].[cid.oxfordjournals.org]
Cough
  • Cough Medicine Coughing helps your lungs get rid of the mucus and keeps it from spreading in your lungs. Your doctor may prescribe an expectorant loosen the mucus and make it easier to cough up. Cough into tissues.[healthpages.org]
  • Symptoms and signs included tachypnea, decreased feeding, cough, cyanosis, lethargy, retractions, apnea, bradycardia, seizures and depressed consciousness.[ncbi.nlm.nih.gov]
  • Patients with high-grade fever, myalgias, and cough should arouse the highest suspicion.[ncbi.nlm.nih.gov]
  • The following are the signs and symptoms of viral pneumonia: Dyspnea Fever, mild to high Coughing up mucus Running nose Headache Confusion Fatigue Loss of appetite Excessive sweat Clammy skin Sharp pain in the chest during coughing or breathing Myalgia[symptoma.com]
  • They’ll loosen up the gunk in your lungs so you can cough it out. Use a humidifier or take a warm bath (more gunk-loosening). Don’t smoke. Stay home until your fever goes down and you’re not coughing anything out.[webmd.com]
Dry Cough
  • cough headache muscle pain prostration The symptoms advance rapidly, within 12 to 36 hours: increasing breathlessness worsening cough producing scant amount of bloody sputum high fever possibly blueness of lips During the final stage the patient has:[sk.lung.ca]
  • The main late symptom is a dry cough that is worse at night. In otherwise healthy individuals, viral pneumonia is usually a mild disease [3,4,5] .[ehealthstar.com]
  • Symptoms These include: Dry cough Fever Chills Shortness of breath Pain in your chest when you cough or breathe Rapid breathing If you have any of these symptoms, call your doctor.[webmd.com]
  • On the first day it feels like the flu, with symptoms like: Fever Dry cough Headache Sore throat Loss of appetite Muscle pain After a day or so your fever might get worse. You might also feel like you can’t catch your breath.[webmd.com]
Pleural Effusion
  • Swine-origin influenza A (H1N1) virus infection can be accompanied with pleural effusion; however, there are no reports about the significance of pleural effusion in H1N1 pneumonia.[ncbi.nlm.nih.gov]
  • Pleural effusions were detected in 52%.[emedicine.com]
  • Chest radiography on postoperative day 9, showed a glass-like shadow and pleural effusion in the left lung field, and the man's condition began deteriorating rapidly.[ncbi.nlm.nih.gov]
  • Three particularly noteworthy conditions are: i. metastatic infection ii. lung abscess iii. complicated pleural effusion 1.[quizlet.com]
  • Pleural effusion, hilar lymphadenopathy and pneumothorax are uncommon findings.[radiopaedia.org]
Dyspnea
  • The patient presented with fever, myalgia, general fatigue and dyspnea of seven days duration. Chest computed tomography showed bilateral ground-glass opacity and consolidation.[ncbi.nlm.nih.gov]
  • Complications include development of acute respiratory distress syndrome or secondary bacterial pneumonia, which usually occurs 2-14 days after an improving clinical course with recurrence of fever, cough, and dyspnea.[visualdx.com]
  • The following are the signs and symptoms of viral pneumonia: Dyspnea Fever, mild to high Coughing up mucus Running nose Headache Confusion Fatigue Loss of appetite Excessive sweat Clammy skin Sharp pain in the chest during coughing or breathing Myalgia[symptoma.com]
  • Dyspnea and cough are common (60%–80% of cases) but are not unique to RSV infection. The typical RSV illness begins with nasal congestion, which gradually progresses to wheezing and difficulty breathing.[academic.oup.com]
Productive Cough
  • Presentation Pearls Diagnosis Treatment Media Patient will present as a 45-year-old male with a one week history of hacking non-productive cough, low grade fever, malaise and myalgias.[smartypance.com]
  • Viruses are the most common cause of pneumonia in children, while in adults bacteria are a more common cause. [2] Signs and symptoms [ edit ] Symptoms of viral pneumonia include fever, non-productive cough, runny nose, and systemic symptoms (e.g. myalgia[en.wikipedia.org]
  • Symptoms Symptoms of viral pneumonia include fever, shortness of breath, shaking chills, fatigue, weakness, loss of energy, lips develop bluish, productive cough, running nose, headache and muscle ache.[symptoma.com]
  • If someone has had fever and a cough (especially a productive cough with yellow, green, brown sputum) after having " flu-like symptoms," he or she should contact a medical caregiver .[medicinenet.com]
  • If someone has had fever and a cough (especially a productive cough with yellow, green, brown sputum) after having " flu-like symptoms," he or she should contact a medical caregiver.[medicinenet.com]
Mild Clinical Course
  • In addition, the need for treatment with both oxygen (P CONCLUSION: This result suggested that pleural effusion in H1N1 pneumonia could develop without bacterial co-infection and had mild clinical course. Copyright 2011 Wiley Periodicals, Inc.[ncbi.nlm.nih.gov]
Abdominal Pain
  • Children with pneumonia may complain of chest pain or abdominal pain, and they often wheeze or make a grunt when they breathe.[hon.ch]
  • With pneumonia, a person may have difficulty breathing and have a cough and fever; occasionally, chest or abdominal pain and vomiting are symptoms, too. Pneumonia is often caused by viruses, such as the influenza virus (flu) and adenovirus.[m.kidshealth.org]
  • The common symptoms of bacterial pneumonia include: high fever (over 103 F) and chills cough with sputum that may be green or contain blood or bloody streaks rapid breathing shortness of breath chest pain that is worse when you breathe in abdominal pain[healthpages.org]
  • […] is in the lower part of the lungs near the abdomen, a person might have a fever and abdominal pain or vomiting but no breathing problems.[kidshealth.org]
Chest Pain
  • The symptoms include: cough, cold, fever and chest pain. Treatment comprises of rest, pain killers, fluids, humidifiers and in some cases antiviral medications.[epainassist.com]
  • pain, shortness of breath, loss of appetite.[dailymail.co.uk]
  • Children with pneumonia may complain of chest pain or abdominal pain, and they often wheeze or make a grunt when they breathe.[hon.ch]
  • Medical attention is required in case of difficulty breathing, chest pain, severe cough with blood and vomiting.[ic.steadyhealth.com]
Myalgia
  • Patients with high-grade fever, myalgias, and cough should arouse the highest suspicion.[ncbi.nlm.nih.gov]
  • The patient presented with fever, myalgia, general fatigue and dyspnea of seven days duration. Chest computed tomography showed bilateral ground-glass opacity and consolidation.[ncbi.nlm.nih.gov]
  • Presentation Pearls Diagnosis Treatment Media Patient will present as a 45-year-old male with a one week history of hacking non-productive cough, low grade fever, malaise and myalgias.[smartypance.com]
  • Viruses are the most common cause of pneumonia in children, while in adults bacteria are a more common cause. [2] Signs and symptoms [ edit ] Symptoms of viral pneumonia include fever, non-productive cough, runny nose, and systemic symptoms (e.g. myalgia[en.wikipedia.org]
  • The following are the signs and symptoms of viral pneumonia: Dyspnea Fever, mild to high Coughing up mucus Running nose Headache Confusion Fatigue Loss of appetite Excessive sweat Clammy skin Sharp pain in the chest during coughing or breathing Myalgia[symptoma.com]
Headache
  • Both types cause cough, fatigue, headache , fever, and other symptoms. However, bacterial and viral pneumonia also have many differences. For example, the symptoms of bacterial pneumonia usually come on rapidly and tend to be more severe.[bacteria.emedtv.com]
  • […] are almost no physical signs of lung tissue becoming filled with fluid Pregnant women or people with pre-existing heart or pulmonary illness are most susceptible Symptoms The initial symptoms of virus pneumonia are those of influenza: fever dry cough headache[sk.lung.ca]
  • Symptoms Symptoms of viral pneumonia include fever, shortness of breath, shaking chills, fatigue, weakness, loss of energy, lips develop bluish, productive cough, running nose, headache and muscle ache.[symptoma.com]
  • Symptoms and Signs Viral pneumonia often develops as a complication of acute bronchitis, sinusitis or flu, so early symptoms can involve symptoms of those diseases: a runny nose, itchy or sore throat , headache or muscle pain.[ehealthstar.com]
  • Viruses are the most common cause of pneumonia in children, while in adults bacteria are a more common cause. [2] Signs and symptoms [ edit ] Symptoms of viral pneumonia include fever, non-productive cough, runny nose, and systemic symptoms (e.g. myalgia, headache[en.wikipedia.org]

Workup

To begin with, a thorough lung examination is done to diagnose the condition. If a wheezing sound is heard from the lungs then further confirmatory tests are carried out.

  • Chest x-ray would demonstrate bilateral lung involvement, if virus is the cause of pneumonia.
  • CT scan of the chest
  • Specific viral serologic tests [9]
  • Blood tests to get complete blood count
  • Sputum culture
  • Blood cultures to identify the type of virus involved
  • Nasal swab test

When the above mentioned diagnostic procedures draw a non–specific conclusion, then open lung biopsy is the only available method for detecting the disease.

Pulmonary Infiltrate
  • Our case suggests that 1 viral pulmonary infection should be considered as a possible cause in postoperative cardiac patients with unexplained progressive pulmonary infiltrates, and 2 DNA amplification using PCR is rapid--it can be completed within 1[ncbi.nlm.nih.gov]
  • In a series of 42 patients with HSV pneumonia, all radiographs showed abnormalities: pulmonary infiltrates (93%), pleural effusions (29%), and atelectasis (12%).[emedicine.com]
Pleural Effusion
  • Swine-origin influenza A (H1N1) virus infection can be accompanied with pleural effusion; however, there are no reports about the significance of pleural effusion in H1N1 pneumonia.[ncbi.nlm.nih.gov]
  • Pleural effusions were detected in 52%.[emedicine.com]
  • Chest radiography on postoperative day 9, showed a glass-like shadow and pleural effusion in the left lung field, and the man's condition began deteriorating rapidly.[ncbi.nlm.nih.gov]
  • Three particularly noteworthy conditions are: i. metastatic infection ii. lung abscess iii. complicated pleural effusion 1.[quizlet.com]
  • Pleural effusion, hilar lymphadenopathy and pneumothorax are uncommon findings.[radiopaedia.org]
Pleural Rub
  • If early in process: pleural rub. 1. Synthetic monoclonal antibody against RSV. 2. Effective in the prevention of RSV infection 3. Used in the out-patient setting 4. Given IM monthly during the RSV season. When is Palivizumab indicated? 5.[quizlet.com]

Treatment

As the disease is caused through viral agents, antibiotics would be of no help to treat infection. Instead, anti-viral agents are prescribed to rid the body from the viruses.The various types of anti-viral medications include rimantadine, zanamivir, amantadine, cidofovir, foscarnet, ribavirin, ganciclovir, acyclovir and oseltamivir. The other modes of treatment involved to ease the symptoms include:

  • Administration of fluids
  • Oxygen for helping the individuals breathe
  • Corticosteroid medications
  • Management of symptoms using humidified air

In case of serious infections, the individuals may require a hospital stay.

Prognosis

Prognosis of viral pneumonia depends on the type and extent of severity of the disease. Individuals who have developed mild pneumonia tend to get better with treatment within 1 to 3 weeks. However, those develop acute bronchitis require hospitalization and suffer from serious complications.

Complications

Infections are the most serious complication of viral pneumonia. It can lead to the following conditions:

In many cases, affected individuals suffer from infections after an attack of viral pneumonia which in turn can lead to development of severe complications.

Etiology

Infections due to viruses are the obvious cause of viral pneumonia. The following are the common types of viral agents that are known to cause pneumonia:

Children with a weak immune system or those with heart and lung diseases are more prone to contract viral pneumonia.

Epidemiology

Viral pneumonia is a common problem affecting more commonly the children and the immune-compromised population [3]. According to the statistical reports provided by National Center for Health Statistics, viral pneumonia is ranked 8th as the leading cause of death in the United States. It has also been estimated that as high as 200 million individuals (100 million children + 100 million adults) fall prey to viral pneumonia each year.

Elderly patients are more prone to viral pneumonia because of inefficient mucus expectoration due to decreased respiratory muscle strength [4].

Sex distribution
Age distribution

Pathophysiology

For an infection to take place, the causative agent must enter the human system. In this case, viruses are the agents that gain entry into the respiratory system through inhalation either via the mouth or nose. The viruses then multiply in the epithelial lining of the lungs causing inflammation which in turn blocks the oxygen flow giving rise to breathing problems.

The extent of damage depends on the type of virus that has attacked the system. It is very common for viral pneumonia to coexist with a bacterial pneumonia making diagnosis difficult by clinical means only [5]. Certain types only damage the bronchial cells while other types may directly affect the immune system [6]. Pulmonary alveolar damage in viral pneumonia may result in bloody effusion due to diffuse alveolar damage [7].

Prevention

There are several preventive measures that need to be followed to keep pneumonia viruses at bay:

  • Hands should be washed after blowing nose, before preparing and eating food, after diapering baby and after using washroom.
  • It is also necessary to vaccinate children against pneumonia. This acts as a preventive measure against pneumonia virus. In addition, the elderly population and individuals with chronic disease conditions should also receive vaccination.
  • The drug palivizumab and ribavirin is given to children under the age of 2 years to protect them against respiratory syncytial virus [10].
  • Children must receive the flu vaccine every year to protect them against the influenza virus.
  • Individuals with a suppressed immune system are required to avoid crowded places and adopt safety measures when meeting people suffering from cough and cold.

Summary

Viral pneumonia is the infection of the lungs caused due to viral agents. Viruses are second most common cause of pneumonia in children and adults [1]. Such a condition is usually mild and does not cause any serious complications unless it affects the geriatric and the immunecompromised population. In such individuals, viral pneumonia may present serious complications such as severe hypoxemia and respiratory failure.

Recent research reports point towards the fact that viruses account for more than 50% cases of acquired pneumonia. The rest of the cases are caused either by bacteria or parasites.

Patient Information

Definition

Viral pneumonia is characterized by infection of the lungs due to viruses. It is a less serious condition than bacterial pneumonia, but can present life threatening complications in elderly population, immune compromised individuals and pregnant women.

Cause

Several types of viruses such as respiratory syncytial virus, influenza, parainfluenza, rotavirus, adenovirus, measles virus, rubella virus and cytomegalovirus are known to cause viral pneumonia.

Symptoms

Symptoms of viral pneumonia include fever, shortness of breath, shaking chills, fatigue, weakness, loss of energy, lips develop bluish, productive cough, running nose, headache and muscle ache.

Diagnosis

Preliminary physical examination of the lungs if reveal a wheezing sound indicate viral pneumonia. In addition, X-ray and CT scan of the chest, followed by blood test and blood cultures also form an important part of the diagnosis of the condition. In rare cases open lung biopsy may also be required when all other procedures fail to diagnose the condition.

Treatment

Individuals with viral pneumonia are given anti-viral agents for treating the infections. In serious conditions, hospitalization would be required to manage the symptoms. Humidified air, fluid replacement, oxygen and corticosteroid medications form the basis of the treatment regime.

References

Article

  1. Shields AF, Hackman RC, Fife KH, Corey L, Meyers JD. Adenovirus infections in patients undergoing bone-marrow transplantation. N Engl J Med. Feb 28 1985; 312(9):529-33.
  2. van den Hoogen BG, de Jong JC, Groen J, Kuiken T, de Groot R, Fouchier RA, et al. A newly discovered human pneumovirus isolated from young children with respiratory tract disease. Nat Med. Jun 2001; 7(6):719-24.
  3. Jennings LC, Anderson TP, Beynon KA, Chua A, Laing RT, Werno AM, et al. Incidence and characteristics of viral community-acquired pneumonia in adults. Thorax. Jan 2008; 63(1):42-8.
  4. Falsey AR, Walsh EE. Viral pneumonia in older adults. Clin Infect Dis. Feb 15 2006; 42(4):518-24.
  5. Korppi M, Don M, Valent F, Canciani M. The value of clinical features in differentiating between viral, pneumococcal and atypical bacterial pneumonia in children. Acta Paediatr. Jul 2008; 97(7):943-7.
  6. Legg JP, Hussain IR, Warner JA, Johnston SL, Warner JO. Type 1 and type 2 cytokine imbalance in acute respiratory syncytial virus bronchiolitis. Am J Respir Crit Care Med. Sep 15 2003; 168(6):633-9.
  7. Levy MM, Baylor MS, Bernard GR, Fowler R, Franks TJ, Hayden FG, et al. Clinical issues and research in respiratory failure from severe acute respiratory syndrome. Am J Respir Crit Care Med. Mar 1 2005; 171(5):518-26.
  8. Falsey AR, Erdman D, Anderson LJ, Walsh EE. Human metapneumovirus infections in young and elderly adults. J Infect Dis. Mar 1 2003; 187(5):785-90.
  9. Metzgar D, Osuna M, Kajon AE, Hawksworth AW, Irvine M, Russell KL. Abrupt emergence of diverse species B adenoviruses at US military recruit training centers. J Infect Dis. Nov 15 2007; 196(10):1465-73.
  10. Wald TG, Miller BA, Shult P, Drinka P, Langer L, Gravenstein S. Can respiratory syncytial virus and influenza A be distinguished clinically in institutionalized older persons? J Am Geriatr Soc. Feb 1995; 43(2):170-4.

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Last updated: 2018-06-22 09:24