Secondary bacterial pneumonia refers to the superinfection of bacterial pneumonia when the patient is suffering from a lung infection. Secondary bacterial pneumonia is the cause of significant morbidity and mortality in hospitalized patients. Healthcare professionals like, Pulmonologist in Lahore recognize secondary pneumonia as a potentially preventable complication if timely managed. Read on to know more about secondary bacterial pneumonia, its causes and complications.
How does secondary bacterial pneumonia develop?
As the name implies, secondary pneumonia occurs in lungs that are weakened by a concurrent illness, most often a viral respiratory disease. During the emergency management of a viral respiratory illness, attention is focused solely on managing the primary disease, with little consideration for the secondary infection, which is why the mortality is high in these cases.
In viral pandemics, secondary infections and co-infections are quite common, as seen these days with COVID-19. Even in 1918, during the Spanish flu, 50 million deaths were attributed to secondary bacterial pneumonia.
While the exact mechanism of secondary bacterial pneumonia is not understood, it is postulated that the weakened immune system due to the primary viral infection, makes the body susceptible to superinfections and co-infections. Because of the virus-mediated suppression of the immune system, the opportunistic bacteria are able to colonize the regions of the lungs that are infested by the viruses. The mammalian cells are found to be more susceptible to this colonization, particularly in cells infested by viruses.
Moreover, the immune response to the primary pathogen can potentially alter the response to the secondary pathogen. These secondary infections can be acquired from the environment, or from the hospital, if the patient is admitted. Nosocomial or hospital-acquired infections are particularly hard to treat as they are multi-drug resistant.
Smokers are at higher risk of developing secondary bacterial pneumonia, as are the patients of stroke, dementia, chronic lung disease, and those taking immunosuppressants.
What are the symptoms of secondary bacterial pneumonia?
The symptoms of secondary bacterial pneumonia include: high grade fever between 102 and 105 Fahrenheit, stabbing pain in the chest and productive cough with green or yellow mucus. Some non-specific symptoms include: muscle pain, headache, rapid breathing, fatigue, pallor, sweating and loss of appetite. When confusion and dizziness develop, especially in those aged 65 and above, it is an alarming sign, warranting immediate medical attention.
In children, the symptoms are similar, with additional presentation of bluish lips and nails, flaring nostril and sinking chest.
What organisms cause secondary bacterial pneumonia?
Organisms responsible for secondary bacterial pneumonia include: strep pneumonia, proteus, Enterobacter, staph aureus, Neisseria meningitides and Hemophilus influenza. Additionally, the patient can be affected by super-added bacterial and fungal organisms.
COVID-19 and secondary bacterial pneumonia
COVID-19 is a single stranded RNA virus causing severe respiratory tract infection and putting the patient at risk of secondary bacterial pneumonia. Once the virus replicates in the respiratory system, it generates inflammatory mediators that damage the lung tissue, cause pneumonia and make the patient susceptible to secondary infection.
The presence of secondary bacterial pneumonia in COVID-19 patients complicates treatment. This is why in positive patients prophylactic antibiotics are started soon after diagnosis to prevent secondary bacterial pneumonia. Clinical reports from around the world show that complications were observed in patients who were not given antibiotics prophylactically.
What are the complications of secondary bacterial pneumonia?
Without appropriate management, secondary bacterial pneumonia has a high fatality rate. The complications of secondary bacterial pneumonia are also numerous, including, organ failure, sepsis, pleural effusion, lung abscess, difficulty breathing. The recovery time of the patient with secondary bacterial pneumonia depends on the general health of the patient. Elderly population may need a longer recovery time.
Patients who are susceptible to secondary bacterial pneumonia should get annual flu shots from Pulmonologist in Islamabad and maintain good hygiene.