Description

Pneumonitis (noo-moe-NIE-tis) is a general term that refers to the inflammation and irritation, also called inflammation of the lung tissues. Lung infections such as pneumonia can also cause the lung tissue to become inflamed. But pneumonitis usually refers to inflamed lung tissue is not caused by an infection.

Pneumonitis is a result of a strong defense response by the body's immune system to an irritant. The common causes of pneumonia include airborne irritants at work, at home, or hobbies. Other causes include some treatments for cancer and many different medications.

Shortness of breath, and, often, a dry cough, are the most common symptoms of pneumonia. The treatment focuses on avoiding irritants and reduction of the inflammation of the lung tissue.

Symptoms

The symptoms of pneumonia can develop quickly or slowly and can become worse with time. Sometimes the symptoms can suddenly worsen or better. Also, the symptoms vary greatly among people with the disease and include:

  • Difficulty breathing.
  • A dry cough that often does not bring up any mucus.
  • Extreme tiredness.
  • Loss of appetite.
  • Fever.
  • Joint and muscle pain.
  • The pain of a headache.
  • The loss of weight.

When to call a doctor

Talk with your doctor or other health care professional if you experience symptoms such as shortness of breath and a dry cough.

If you have difficulty breathing, go to the emergency room of a hospital immediately, or, in the united states, call 911.

Causes

Pneumonitis that occurs when an irritating substance causes inflammation of the small air sacs called alveoli in the lungs. Inflamed lung tissue makes it difficult for oxygen to pass through the alveoli to the blood.

Many causes have been linked to pneumonitis. But it is not clear why some people have a strong immune system response to certain substances that cause pneumonia, while others do not. For many people, the specific substance that cause inflammation is never identified.

Some types of pneumonitis include hypersensitivity pneumonitis, drug-induced pneumonitis and radiation-induced pneumonitis.

Hypersensitivity pneumonitis

For some people, the breath of particles in the air causing a severe allergic reaction by your immune system. This reaction is irritating to the lungs, causing pneumonia. The condition is also called allergic alveolitis extrinsic.

Certain types of hypersensitivity pneumonitis have nicknames related to its cause, as the "farmer's lung," or "bird-fancier's lung" or "hot tub lung."

The causes may include:

  • The molds. Repeated exposure to molds can cause inflamed lung tissue. Breathing in the air bits of moldy hay is one of the most common causes of work-related pneumonitis. Moldy conditions in tubs of hot water can also cause pneumonitis due to the action of the bubbles causes a vapor that contains the mold. It is common for the appearance of mold in the home of humidifiers that are not cleaned frequently. Other examples of humid areas where mold can grow and be released into the air, including air conditioning, swimming pools, water-damaged carpet, and ventilation systems.
  • Birds. The exposure to the feathers of the birds, dust, or excrement is a common cause of pneumonia.
  • The dust. Exposure to the dust of metal working or hardwoods can cause pneumonitis.
  • Chemicals. Spray mists, pesticides and chemicals can irritate the lungs and cause pneumonia.
  • The fur of the Animal. The cells of the skin, the skin and the droppings of the animals are another cause of the pneumonia. This can happen when you work in close collaboration with the livestock and veterinary practices.

Drug-induced pneumonitis

Many medications can cause pneumonitis. But the exact reason why some drugs cause the inflamed lung tissue is not clear. It is possible that some medicines can irritate the cells of the lung, and then the immune system has a strong response that causes inflammation.

Examples of drugs that can cause pneumonitis, which include certain antibiotics, many of the medications used to treat cancer, and some medications that keep your heartbeat regular.

Radiation-induced pneumonitis

Some people who receive radiation therapy to the chest, such as the breast or lung cancer, you can get pneumonitis. Pneumonia can also occur after whole-body radiation therapy that is done to prepare a person for a bone marrow transplant. The symptoms usually appear in the first few months after radiation treatment ends.

Risk factors

Environment

Some of the factors that cause an increased risk of pneumonitis, including:

  • Jobs and hobbies. Agriculture increases the exposure to mold particles that can be breathed in during the harvest of grain and hay. Another risk factor is a job where the workers are around fine mist, fumes, dust and chemicals. Woodworking can increase the risk as well.
  • Birds and animal handling. Poultry workers, and of the people who breed or keep pigeons and other birds are often exposed to the droppings, feathers, and other materials that can cause pneumonitis. To be around a lot of animals can also increase the risk.
  • The use of hot tubs and humidifiers. Moldy conditions in tubs of hot water, house humidifiers that are not cleaned often, and in any other place the mold can grow which are risk factors for pneumonia.

The treatment of cancer

Some medicines used to treat cancer can cause pneumonitis. So can the radiation therapy to the lungs and the chest. The combination of the two increases the risk of pneumonitis even more.

Genes

Genes may play a role in having an extra strong immune response to substances. If you have family members who have a strong allergic reaction to substances, they may have an increased risk of an allergic reaction as well.

Complications

If pneumonitis is not detected or not treated, they may gradually develop lung damage that can not be reversed.

In healthy lungs, air sacs and relax the muscles with each breath. The ongoing inflammation of the thin tissue that lines each air sac leads to the formation of scars and makes the air sacs less flexible. They become stiff as a dry sponge. This is called pulmonary fibrosis. In severe cases, pulmonary fibrosis can cause high blood pressure in the lungs, right-sided heart failure, respiratory failure or death.

Diagnosis

To diagnose pneumonia, your doctor or other health care professional to review your medical history and family history. Talk about your symptoms and review of the medications you take and previous treatments, such as cancer treatment that you have had. It is also likely that you will be asked about any continuous or repeated contact with the dust, chemicals, birds and the mold of the sources, especially through the house, work, or hobbies.

The health care provider will perform a physical examination and uses a stethoscope to listen to your lungs while you breathe.

One option to help diagnose hypersensitivity pneumonitis is to avoid the suspicion of an environmental substance for several weeks to see if symptoms improve.

To say pneumonitis of other diseases of the lungs, it is likely that you have one or more tests.

Blood tests

Certain blood tests may be useful for the localization of a diagnosis. For example, a blood test may be able to tell you if you have an infection. Blood test to see if you have the antibodies that suggest that exposure to an allergen. Another blood test, called an arterial blood gas, you can measure the oxygen and carbon dioxide levels in the sample.

Imaging tests

  • X-ray of the chest. Images of the lungs can give you an idea of where and how severe the inflammation is. X-rays can also rule out other conditions that are causing your symptoms, such as pneumonia. Sometimes an x-ray may not show any change.
  • The computed tomography (CT). A ct scan combines X-ray images taken from different angles to create images of the internal structures of the body. A ct scan gives much more detail of the changes in the lungs of a chest x-ray may show. CT may also be useful in the search of how much lung damage has occurred.

Pulmonary function tests

Pulmonary function tests are done to find out how well your lungs are working:

  • Spirometry. In this test, you breathe quickly and with force through a tube connected to a machine. The machine measures the amount of air that the lungs can hold and how fast air moves in and out of the lungs.
  • The volume of the test lung. This test measures the amount of air the lungs hold at different times when breathing in and out.
  • Lung diffusion test. This test shows how well the body moves oxygen and carbon dioxide between the lungs and the blood.
  • Pulse oximetry. This simple test uses a small device placed on one of the fingers to measure the amount of oxygen in the blood. The percentage of oxygen in the blood is called the oxygen saturation. Your health care professional may recommend a six-minute walk test with a check of oxygen saturation.

Imaging and pulmonary function tests can also be used to check your condition over time and see how the treatments are working.

Bronchoscopy

Bronchoscopy is a procedure to examine the lungs and air passages. A thin tube called a bronchoscope is passed through the nose or the mouth, the throat and in the lungs.

Your doctor can empty a section of lung with a solution of salt water to collect the cells in the lung and other materials. This washing procedure is known as a wash.

Your doctor can also take small samples of tissue from the lungs. The tissue samples are often too small to make the correct diagnosis. But this form of biopsy can also be used to rule out other conditions.

Surgical lung biopsy

Your doctor may want to examine larger samples of tissue from several sites in the lungs that cannot be reached by bronchoscopy. A surgical procedure to collect these samples may be required. Although a surgical biopsy is invasive and carries a risk of complications, it may be the only way to make the correct diagnosis. This procedure can be done as a minimally invasive surgery.

Treatment

The treatment may depend on the cause of the pneumonia.

Hypersensitivity pneumonitis

If you have pneumonitis caused by chemical irritation or an allergic reaction, your healthcare provider will probably recommend that you stop the exposure that irritates the lungs. This step should help to ease your symptoms.

Ways of reducing exposure include:

  • Avoid the triggering of the substance, if known. This can even mean the choice of a job or a hobby if your condition is severe.
  • Use protective equipment. Face protection that filters particles, such as pollen mask or dust respirator, can decrease the exposure.
  • Improve the ventilation. A better flow of air in the area with the substance, the cause of your symptoms can reduce their exposure.
  • To limit the growth of mold and mildew. The cleanliness of the mold might grow, such as hot tubs, cooling systems and humidifiers, you can avoid exposure. Remove water-damaged carpet, furniture, and drywall.

Corticosteroid medicines work to calm your immune system's reaction to an irritation. This can make your lungs less inflamed. Corticosteroids are usually taken as a pill for a limited time. Long-term use of corticosteroids increases the risk of developing infections and is associated with the thinning of the bones called osteoporosis. Other medications that decrease the immune system response can be used.

Sometimes, corticosteroids, the use of an inhaler can help. You breathe these medicines in their lungs. Medications that reduce inflammation in the airways for easier breathing.

Bronchodilators are drugs that also usually come in inhalers. These medicines relax the muscles around the airways. This may help to relieve the cough and make breathing easier.

Drug-induced pneumonitis

The treatment for pneumonia caused by the drug depends on the severity of the symptoms. If the symptoms are mild, you may not need any treatment. If your symptoms are severe, treatment with mainly corticosteroids, but sometimes other medicines that lower your immune system's reaction, it can help. Sometimes, your healthcare provider may decide to stop or change medications that cause inflammation.

Radiation-induced pneumonitis

If the symptoms are mild, you may not need treatment of pneumonitis radiation. Severe symptoms are usually treated with corticosteroids.

Options of treatment for any cause of pneumonia

When the pneumonia is severe, treatment may also include:

  • Oxygen therapy. If you are having a lot of trouble breathing, you may need oxygen therapy through a mask or through a plastic tube with prongs that fit on your nose. You can use oxygen when you sleep, or exercise. But some people need oxygen all the time. The realization of a small tank of oxygen or the use of a portable oxygen concentrator can help you to be more mobile.
  • Pulmonary rehabilitation. Pulmonary rehabilitation can help manage your symptoms and improve your ability to do everyday tasks.
  • Lung transplant. Severe lung damage can require a lung transplant.

Lifestyle and home remedies

A diagnosis of pneumonitis may mean that you will have to make changes in your lifestyle to protect your health. You'll have to avoid known triggers as much as possible.

Do not smoke. Smoking can harm lung worst. If you need help quitting, talk to your health professional.

If your job duties expose you to substances that irritate the lungs, talk with your healthcare provider and employer on how to protect yourself. If a hobby that is causing the problem, you may need to find a different form of the hobby.

Preparing for your appointment

You can start by seeing your family health care provider. Then, you may be referred to a physician with experience in the lung conditions that is called a pulmonologist.

What you can do

Before your appointment, make a list that includes:

  • Symptoms, including when they started, and if anything it seems worse or better.
  • All the jobs and some of the exhibitions that can be part of their work activities.
  • Hobbies that regularly you may be exposed to substances that can irritate the lungs.
  • The medical problems that you have had and their treatments.
  • Medical problems of their parents or siblings.
  • All the drugs, vitamins, herbs, and supplements you are taking or have taken in the past few years. Include the dose.
  • Questions to ask your health care professional.

Questions may include:

  • What is likely causing my symptoms?
  • What kinds of tests do I need?
  • What treatment do you recommend it?
  • I have other health conditions. How will my pneumonitis affect them?
  • Are there any restrictions that I need to follow?

Feel free to ask questions during your appointment.

What to expect from your doctor

Your health care professional may ask questions such as:

  • Do you now or have you ever smoked tobacco?
  • What types of jobs or hobbies have you had?
  • Make your breathing symptoms get worse or better in relation to their work or hobby schedules?
  • Do you have a hot tub or a humidifier in the home?
  • It is never about the pigeons or birds pets?

Be prepared to answer questions that you have time to talk about what is most important to you.

Symptoms and treatment of Pneumonitis