Pneumonia in Immunocompromised People – Symptoms, Diagnostic Tests, Treatment

Ability to fight infection is significantly reduced in patients with weak immune system. These patients are vulnerable to infections and thereby need extra care and prevention against diseases to stay healthy.

Like any other infection, the immunocompromised people are susceptible to lung infections which eventually lead to Pneumonia. The infectious agents that infect the people with compromised immunity vary from the ones that caused pneumonia in healthy people with good immune system.

Who are immunocompromised patients?

The immunocompromised patients may include the patients whose immunity is suppressed due to other infections. Broadly, it covers the patients with following conditions.

                    Individuals who have AIDS/HIV infection

                    Individuals with leukaemia

                    Individuals who have undergone organ transplantation including bone marrow transplant

                    Individuals who are on immunosuppressant medications for the treatment of cancer

Symptoms of Pneumonia in Immunocompromised People

The symptoms of Pneumonia in immunocompromised people are usually similar to those found in healthy people infected with pneumonia.

                    Cold and Cough: It is the most common symptom in people who are at initial stages of pneumonia. It results due to infection in the upper respiratory tract.

                    Sputum: In some cases of pneumonia the cough may appear in form of greenish or yellow mucus. The sputum may be discoloured or even bloody.

                    Fever: In most of the cases, the cough is followed by fever. The fever may be mild or high (may reach 104 F).

                    Shaking chills: Patient may experience shaking chills frequently.

                    Difficulty in breathing: The patient may experience shortness of breath on mild exercise or physical movement such as climbing stairs.

In addition to the common symptoms, the patient may also experience certain additional symptoms.

                    Severe Chest Pain: In some cases of Pneumonia, the patient may feel sharp chest pain that is even more pronounced during deep breathe or while coughing.

                    Clammy skin due to excessive sweating

                    Weakness and fatigue

                    State of Confusion in elderly people

                    Loss of appetite

                    Headache

 

                    In rare cases, patients may experience stiffness in joints and muscles

                    Swollen glands

Diagnostic Tests for Pneumonia in Immunocompromised People

The preliminary examination is done by the doctor using a stethoscope. It is placed on the patient’s chest and back for detecting the crackles or abnormal breath sounds in the lungs.

The absence of normal breath sounds suggests the presence of infection. Depending on the severity of infection, doctors may recommend the following diagnostic tests.

                    Chest X-ray to get detailed images of internal structures such as lungs

                    Sputum gram stain for detecting the presence and type of bacteria/infectious agents

                    Blood culture for identifying the type of infectious agent

                    Complete blood count for detecting the increased number of WBC 

                    Bronchoscopy involves insertion of bronchoscope into airways and respiratory tract via mouth or nose for collecting sample from inside the airways.

                    Chest CT scan is done in rare and severe cases

                    Lung biopsy is done in rare cases where a piece of lung tissue is extracted from body for examination.

Treatment for Pneumonia in Immunocompromised People

The treatment therapy involves the usage of combination antibiotics depending on the causative agent that has caused the infection.

                    Intravenous antibiotics for 5-8 days for severe cases

                    Common Drugs used for treating Pneumocystis pneumonia in immunocompromised patients.

Trimethoprim-sulfamethoxazole

Dapsone combined with trimethoprim,

Clindamycin and primaquine

Atovaquone

Intravenous pentamidine

                    The corticosteroids are prescribed for patients whose blood oxygen level reduces below a certain level.

                    Oxygen therapy is administered to those patients who have low oxygen level in their bloodstream.

                    Patients are administered with chest therapy that includes chest tapping, incentive spirometry, rhythmic inhalation and coughing.