The Differences And Similarities Of Pneumonia And Essay

This essay has a total of 2360 words and 15 pages.

The Differences And Similarities Of Pneumonia And Tuberculosis

The Differences and Similarities of Pneumonia and Tuberculosis


Pneumonia and tuberculosis have been plaguing the citizens of the world
for centuries causing millions of deaths. This occurred until the creation and
use of antibiotics become more widely available. These two respiratory
infections have many differences, which include their etiology, incidence and
prevalence, and many similarities in their objective and subject indicators,
medical interventions, course, rehabilitation and effects.

To explore the relationship between pneumonia and tuberculosis we will
examine a case study. Joan is a 35 year old women who was feeling fine up till
a few weeks ago when she develop a sore throat. Since her sore throat she had
been experiencing chest pain, a loss of appetite, coughing and a low fever so
she went to visit her doctor. Her doctor admitted her to the hospital with
bacterial pneumonia and after three days of unsuccessful treatment it was
discovered that she actually had active tuberculosis. This misdiagnosis shows
the similarities between the two diseases and how easily they can be confused.

Pneumonia

Pneumonia is a serious infection or inflammation of the lungs with
exudation and consolidation. Pneumonia can be one of two types: lobar pneumonia
or bronchial pneumonia. Lobar pneumonia affects one lobe of a lung while
bronchial pneumonia affects the areas closest to the bronchi (O'Toole, 1992).
In the United States over three million people are infected with pneumonia each
year; five percent of which die.

Etiology

There are over 30 causes for pneumonia however there are 4 main causes
which are bacterial, viral, mycoplasma and fungal (American Lung Association,
1996). Bacterial pneumonia attacks everyone from young to old, however
"alcoholics, the debilitated, post-operative patients, people with respiratory
disease or viral infections and people who have weakened immune systems are at
greater risk" (American Lung Association, 1996). The Pneumococcusis bacteria,
which is classified as Streptococcus pneumoniae, causes bacterial pneumonia and
can be prevented by a vaccine. In 20 - 30% of the cases the infection spreads
to the blood stream (MedicineNet, 1997) which can lead to secondary infections.


Viral pneumonia accounts for half of all pneumonia cases (American Lung
Association, 1996) unfortunately there is no effective treatment because
antibiotics do not affect viruses. Many viral pneumonia cases are a result of
an influenza infection and commonly affect children, however they are not
usually serious and last only a short time (American Lung Association, 1996).
The "virus invades the lungs and multiplies, but there are almost no physical
signs of lung tissue becoming filled with fluid. It finds many of its victims
among those who have pre-existing heart or lung disease or are pregnant"
(American Lung Association, 1996). In the more severe cases it can be
complicated with the invasion of bacteria that may result in symptoms of
bacterial pneumonia (American Lung Association, 1996).

During World War II mycoplasma were identified as the "smallest free-
living agents of disease in humankind, unclassified as to whether bacteria or
viruses, but having characteristics of both" (American Lung Association, 1996).
Mycoplasma pneumonia is "often a slowly developing infection" (MedicineNet,
1997) that often affects older children and young adults (American Lung
Association, 1996).

The other main cause of pneumonia is fungal pneumonia. This is caused
by a fungus that causes pneumocystic carinii pneumonia (PCP) and is often "the
first sign of illness in many persons with AIDS and … can be successfully
treated in many cases" (American Lung Association, 1996).

In Joan's case bacterial pneumonia was suspected because her immune
system was weakened by her sore throat and her signs and symptoms correlated
with pneumonia.

Tuberculosis (TB)

Tuberculosis was discovered 100 years ago but still kills three million
people annually (Schlossberg, 1994, p.1). Cases range from race and ethnicity.
In 1990 the non-Hispanic Blacks had 9, 634 cases while the American Indians and
Alaskan Natives had 371 cases (Galantino and Bishop, 1994). It is caused by
bacteria called either Mycobacterium tuberculosis or Tubercle bacillus.
Tuberculosis can infect any part of the body but is most often found in the
lungs where it causes a lung infection or pneumonia.

Etiology

There has been a resurgence of TB due to a number of factors that include:

1. the HIV / AIDS epidemic, 2. the increased number of immigrants, 3. the
increase in poverty, injection drug use and homelessness, 4. poor compliance
with treatment regiments and; 5. the increased number of residents in long term
facilities (Cook & Dresser, 1995).

The tuberculosis bacteria is spread through the air however transmission will
only occur after prolonged exposure. For example you only have a 50% chance to
become infected if you spend eight hours a day for six months with someone who
has active TB (Cook & Dresser, 1995).

The tuberculosis bacteria enters the air when a TB patient coughs,
sneezes or talks and is then inhaled. The infection can lie dormant in a
person's system for years causing them no problems however when their immune
system is weakened it gives the infection a chance to break free.

Types of TB Treatments

Types of treatment will depend on whether the patient has inactive or
active tuberculosis. To diagnose active TB the doctor will look at the patients'
symptoms, and outcomes of the skin test, sputum tests, and chest x-rays. A
person has active tuberculosis when their immune system is weakened and they
start to exhibit the signs and symptoms of the disease. They also have positive
skin tests, sputum tests and chest x-rays. When this occurs the treatment is
more intense. The disease is treated with at least two different types of
antibiotics in order to cure the infection. Within a few weeks the antibiotics
will build the body's resistance and slow the poisons of the TB germ to prevent
the patient from being contagious. An example of treatment would be short-
course chemotherapy, which is the use of isoniazid (INH), rifampin, and
pyrazinamide in combination for at least six months (Cook & Dresser, 1995). The
drugs need to be taken for six to twelve months or there may be a reoccurrence.
Failure to take the antibiotics consistently will result in a multi-drug
resistant TB (MDR TB) which "is much harder to treat because the drugs do not
kill the germs. MDR TB can be spread to others, just like regular TB" (American
Lung Association, 1996).

Inactive tuberculosis is when a person is infected with the tuberculosis
bacteria, but their immune system is able to fight the infection, therefore only
showing a positive skin test and a negative x-ray and sputum test. The patient
may be infected but they are not contagious which means the doctor will start a
preventative treatment program. This program includes the use of the drug
isoniazid for six to twelve months to prevent the TB from becoming active in the
future.

Once the treatment for Joan's pneumonia was unsuccessful it was
rediagnosed because she remembered her exposure to TB when her grandfather
contracted it when she was seven years old. She has been unaware that she has
been caring the infection in a dormant state for 28 years. Due to her sore
throat, which weakened her immune system, her TB became active therefore she was
given a new treatment plan. This plan included the use of isoniazid, rifampin,
and pyrazinamide.

Objective and Subjective Indicators

Tuberculosis and pneumonia have similar objective and subjective
indicators because they both cause infection of the lungs. Because of theses
similarities in the indicators Joan's case was easily misdiagnosed without the
information of the TB exposure.

The subjective indicators are chest pain, headaches, loss of appetite,
nausea, stiffness of joints or muscles, shortness of breath, tiredness and
weakness. The patient has to be able to tell the doctor these symptoms in order
for the correct diagnosis to be made because of the overlap between the two
diseases.

The objective indicators include coughing, chills, fever, night sweats
and blood-streaked or brownish sputum. These signs will be observable by the
doctor.

Medical Interventions

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