Tag Archives: Pneumonia

Immune System: Is It A Guard Dog Or Wolf?

Without an immune system, we wouldn’t be here. Even the simplest creature, like bacteria, have types of defensive systems.

However, as we learned with Covid, the immune system can become mistimed, and be a detriment. Covid retards the innate immune system, and unleashes it later on when it no longer serves a useful purpose and actually damages tissue. In certain illnesses, like the common cold, most of the symptoms are actually CAUSED by the immune system.

in the case of allergies, symptoms are caused by the operation of our th2 immune system against a harmless entity, like pollen. With organ transplantation, our immune system recognizes the transplant as foreign; it has no reasoning capacity to realize that the transplanted tissue is necessary for us to live, and  to proceeds to reject the transplant.

In the case of the previous post, hydrocortisone, the prototypical shotgun that tamps down the immune system, benefited severe pneumonia.

With public health, immunizations, and a clean environment, infection is no longer the big killer is once was. Our immune system, designed to defend against a much more infectious world, is currently a real source of danger and disease.

Just like our coagulation system, once critical to stop the more frequent blood flowing in a violent world, Is now a bigger danger than ever because of our development of atherosclerotic blood vessel disease as we live longer.

Anticoagulants and anti-immunity treatments, some of them very expensive, are finding increased utility.

Please press the magnifying glass on the green field, and type in “immune system”. There are a number of previous posts of a more specific and detailed nature.

— Dr. C

Reviews: Hydrocortisone Use In Severe Pneumonia

NEJM Group (May 25, 2023) – Glucocorticoids can help mitigate the adverse consequences of pneumonia, but whether they can reduce mortality in severe community-acquired pneumonia is unknown. New research findings are summarized in a short video.


Among patients with severe community-acquired pneumonia being treated in the ICU, those who received hydrocortisone had a lower risk of death by day 28 than those who received placebo.

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Lung Infections: Signs & Symptoms Of Pneumonia

Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.

Mayo Clinic – Pneumonia can range in seriousness from mild to life-threatening. It is most serious for infants and young children, people older than age 65, and people with health problems or weakened immune systems.


The signs and symptoms of pneumonia vary from mild to severe, depending on factors such as the type of germ causing the infection, and your age and overall health. Mild signs and symptoms often are similar to those of a cold or flu, but they last longer.

Signs and symptoms of pneumonia may include:

  • Chest pain when you breathe or cough
  • Confusion or changes in mental awareness (in adults age 65 and older)
  • Cough, which may produce phlegm
  • Fatigue
  • Fever, sweating and shaking chills
  • Lower than normal body temperature (in adults older than age 65 and people with weak immune systems)
  • Nausea, vomiting or diarrhea
  • Shortness of breath

Newborns and infants may not show any sign of the infection. Or they may vomit, have a fever and cough, appear restless or tired and without energy, or have difficulty breathing and eating.

When to see a doctor

See your doctor if you have difficulty breathing, chest pain, persistent fever of 102 F (39 C) or higher, or persistent cough, especially if you’re coughing up pus.

It’s especially important that people in these high-risk groups see a doctor:

  • Adults older than age 65
  • Children younger than age 2 with signs and symptoms
  • People with an underlying health condition or weakened immune system
  • People receiving chemotherapy or taking medication that suppresses the immune system

For some older adults and people with heart failure or chronic lung problems, pneumonia can quickly become a life-threatening condition.


Respiratory Infections: What Is Acute Pneumonia?

Pneumonia is a common acute respiratory infection that affects the alveoli and distal airways; it is a major health problem and associated with high morbidity and short-term and long-term mortality in all age groups worldwide. Pneumonia is broadly divided into community-acquired pneumonia or hospital-acquired pneumonia.

A large variety of microorganisms can cause pneumonia, including bacteria, respiratory viruses and fungi, and there are great geographical variations in their prevalence. Pneumonia occurs more commonly in susceptible individuals, including children of <5 years of age and older adults with prior chronic conditions. Development of the disease largely depends on the host immune response, with pathogen characteristics having a less prominent role. Individuals with pneumonia often present with respiratory and systemic symptoms, and diagnosis is based on both clinical presentation and radiological findings.

It is crucial to identify the causative pathogens, as delayed and inadequate antimicrobial therapy can lead to poor outcomes. New antibiotic and non-antibiotic therapies, in addition to rapid and accurate diagnostic tests that can detect pathogens and antibiotic resistance will improve the management of pneumonia.


Infographic: Diagnosis & Treatment Of Pneumonia

Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.

Pneumonia can range in seriousness from mild to life-threatening. It is most serious for infants and young children, people older than age 65, and people with health problems or weakened immune systems.

Bronchitis Or Pneumonia: What Is The Difference?


Pneumocystis is found in the respiratory tract of most mammals and Man. Pneumonia from this organism was extremely rare or unknown before the advent of AIDS.

When the lymphocyte count of a person with AIDS drops below 500, or especially 200, pneumocystis pneumonia is a frequent complication. Symptoms include cough, fever, rapid breathing, and shortness of breath.. The chest x-ray typically shows a “ground glass” appearance, caused by fluid inside the air sacs and throughout the lung. Treatment is usually with trimethoprim sulfa.

Immunosuppressive therapy is often given for organ transplants and auto immune diseases these days. Patients and doctors should be on the lookout for pneumocystis symptoms in this situation. Even long-term corticosteroids can produce enough immunosuppression to allow pneumocystis to invade the body.

Pneumocystis Jeroveci is the causative organism, and used to be called pneumocystis Carini. Doctors suspect this disease when an immuno-suppressed patient, especially AIDS , has a dry cough, with pneumonia and  a very low oxygen concentration, more severe than expected.  Fluid taken from the lung shows several  organisms in little sacks or cysts.

Treatment is with sulfonamids, if they are tolerated. Cortisone must be given not the same time to prevent a severe reaction from absorption of the dead organisms. Pneumocystis is a yeast-like fungus and is also discussed under opportunistic fungal infections.

The following article will give you more information.

—Dr. C.

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Hip fracture is an iconic bugaboo of old age. It is a chronic condition in the sense that its complications, such as Depression, blood clots and pneumonia often extend long beyond the healing process.

Predisposing factors include old age and associated risk factors like osteoporosis, sarcopenia (loss of muscle mass and strength), poor vision, poor balance and hazards in the home.

FALLING is the usual agency that produces the fracture. At the risk of being ostracized, I will point out that thousands of injuries sustained by walking or tripping over dogs (and cats) occur every year.

In my small “hilltop” group of friends, there was 1 fatality, 1 shoulder fracture-dislocation, 1 hip fracture, and 0 acknowledgements of animal causation. Members of the family are immune to blame.

Treatment of hip fracture involves surgery with pins, or the more cost-effective Hip replacement. PREVENTION is critical. Osteoporosis must be prevented by exercise, Calcium, vitamin D, and avoidance of certain medication like Corticosteroids.

Balance should be developed by exercises. Vision problems, such as cataracts,should be corrected. Muscle mass should be preserved by diet and exercise, and the home cleared of throw-rugs and obstacles removed.

Just yesterday, a friend wearing socks (reducing friction?) fell down some stairs after stepping over a dog-gate. She is scheduled to have her elbow pinned. Have I mentioned SLEEP, DIET and EXERCISE RECENTLY?

–Dr. C.


From a Wall Street Journal article (May 21, 2020):

Breathing properly can allow us to live longer and healthier lives. Breathing poorly, by contrast, can exacerbate and sometimes cause a laundry list of chronic diseases: asthma, anxiety, attention deficit hyperactivity disorder, hypertension and more. Poor breathing habits can even change the physical structure of our skeletons, depleting essential minerals and weakening our bones.

Most of us misunderstand breathing. We see it as passive, something that we just do. Breathe, live; stop breathing, die. But breathing is not that simple and binary. How we breathe matters, too.

Last year, I wanted to see just how dramatically breathing habits—good and bad ones—could affect my own brain and body. I’d learned that up to 50% of us are chronic mouth breathers, a problem well described by an ancient Tao text: “The breath inhaled through the mouth is called ‘Ni Ch’i, adverse breath,’ which is extremely harmful.”

Scientists have known for decades that inhaling through this pathway saps the body of moisture, irritates the lungs and loosens the soft tissues at the back of the mouth. Mouth breathing has also been linked with neurological disorders, periodontal disease and increased risk of respiratory infection. But nobody knew how quickly this damage came on.

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Breathing is something we don’t think about. It comfortably transcends the merely habitual, and there is a complex of controllers in the brain to Drive breathing should we be unable or forget to breathe voluntarily.
Breathing has it’s own poets and cults, one of which is MINDFULNESS MEDITATION, which uses our BREATHING as the focus of our consciousness, to get us outside ourselves.

With DEEP breathing,  I noticed an INCREASED pO2, as registered on my Pulse Oximeter.

In the 1960’s asthma was not so well controlled as now. The mechanics of breathing were more important, so we taught our Patients how to breathe properly.

There are 2 sets of muscles we use to EXPAND our lungs, the DIAPHRAGM at the bottom of the chest, and the chest muscles themselves, the INTERCOSTALS. We refer to diaphragmatic breathing as “stomach” breathing, because the stomach bulges out as the descending diaphragm compresses the abdominal contents.

We refer to intercostal breathing as “chest” breathing because the chest expands when the inspiratory intercostals contract.

Diaphragmatic breathing is more efficient, and we encourage our asthmatic patients to Use their more efficient diaphragm to prevent them from tiring as they struggle to get their air out through their narrated airways.

You can squeeze a little extra air out of your lungs by contracting your abdominal muscles.

So to take a DEEP BREATH, see that your stomach rises and your chest expands with the breath IN, and that you squeeze both your abdomen and your chest with the breath out.

Your AIR SACS expand, your lungs are flushed with fresh air, and you blood oxygen, and BRAIN OXYGEN INCREASES with a deep breath in. The “stale air” is cleared by a full breath out.

When you are quietly breathing, letting that vital process take place automatically, notice that a deep breath, or “sigh”, occurs about once every 2 minutes. This is nature’s way to help lung surfactant PREVENT LUNG COLLAPSE and PNEUMONIA.

It is HEALTHFUL to PAY ATTENTION to your BREATHING occasionally! If uninclined to breathe deeply yourself, take a brisk walk up a hill, and let Nature do it for you.

—Dr. C.