The following are the most important diseases or complications that may be contributed to by pneumonia (pneumonia):
Respiratory system (J00-J99)
- Acute respiratory failure (“virus-induced respiratory failure”); lethality (mortality related to the total number of people suffering from the disease) up to 50%.
- Lung abscess (accumulation of pus in the lungs) – sputum (sputum) stink putrid and is blood tinged
- Pulmonary fibrosis (connective tissue remodeling of the lungs) – may result from chronic interstitial pneumonia.
- Pleurisy (pleurisy).
- Pleuraempyem (accumulation of pus in the pleural cavity).
- Pleural effusion (fluid between the two sheets of the pleura/lung and pleura), parapneumonic (“around the lung”).
- Pneumonia, chronic
- Pneumothorax – collapse of the lung caused by an accumulation of air between the visceral pleura (lung pleura) and the parietal pleura (chest pleura).
- Respiratory insufficiency (disorder of gas exchange of the lungs).
- Respiratory partial insufficiency: arterial hypoxemia with reduction of partial pressure of oxygen below a threshold of 65-70 mmHg with normal to reduced carbon dioxide.
- Respiratory global insufficiency: here is in addition to respiratory partial insufficiency hypercapnia (increase in carbon dioxide partial pressure > 45 mmHg).
- Other sepsis (“blood poisoning”
Cardiovascular system (I00-I99)
- Apoplexy* (stroke)
- Endocarditis (meningitis of the heart)
- Heart failure (cardiac insufficiency) – in 11.9% of CAP (community-acquired pneumonia) patients and in 7.4% of controls
- Cardiovascular disease (coronary heart disease/coronary artery disease, apoplexy/stroke) – risk increased by a factor of 6 in the first year; by a factor of 2.47 and 2.12 in the second and third years; ≥ 5 years: increased by a factor of 1.87
- Coronary artery disease* (CAD; coronary artery disease).
- Myocardial infarction* (heart attack)
- Pericarditis (inflammation of the pericardium)
- Sudden cardiac death (PHT) – relative increase in risk in CAP patients:
- <65 years of age: 1.98-fold.
- > 65 years of age: 1.55-fold
- Right heart failure (RHV) due to afterload increase.
Infectious and parasitic diseases (A00-B99).
- Sepsis (blood poisoning; in invasive pneumococcal disease).
Musculoskeletal system and connective tissue (M00-M99).
- Osteomyelitis (bone marrow inflammation).
Psyche – nervous system (F00-F99; G00-G99)
Symptoms and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99).
- Systemic inflammatory response syndrome [SIRS] – life-threatening acute injury to the lungs; often with multiorgan failure.
* 30 days after hospital admission, a 4.07-fold increased risk; after 90 days, a 2.94-fold increased risk; and after 9 to 10 years, a 1.86-fold increased risk
Risk of need for intensive medical therapy for community-acquired pneumonia
Severe course of CAP, ie, acute emergency and immediate intensified management in a monitoring or intensive care unit. This is defined by the following criteria:
- All patients with >2 minor criteria (see below) or.
- With a major criterion (= invasive ventilation or systemic hypotension with vasopressor therapy).
Minor criteria are:
- Severe acute respiratory failure (PaO2 ≤ 55 mmHg or ≤ 7 kPa on room air).
- Respiratory rate ≥ 30/min
- Multilobar infiltrates on chest radiography.
- New-onset disturbance of consciousness
- Systemic hypotension with need for aggressive volume therapy.
- Acute renal failure (nitrogen content of urea ≥20 mg/dl).
- Leukopenia (leukocytes <4,000 cells/mm3).
- Thrombocytopenia (platelets < 100,000 cells/mm3)
- Hypothermia (body temperature < 36 °C)
Prognostic factors
- Increased mortality (death rate) in diabetics (2.47-fold increased mortality rate; type 1 diabetes five- to six-fold increased mortality rate, type 2 diabetics of both sexes 20% increased mortality rate)
- Respiratory rate (norm: 12-18/min) on admission to hospital is an independent risk factor for hospital mortality in community-acquired pneumonia. Both decreased and increased respiratory rates on admission are associated with significantly increased hospital mortality. Other independent risk factors include age, admission from a nursing facility or rehabilitation facility, chronic bedriddenness, disorientation, pulse amplitude, and systolic blood pressure.