"肺炎"的搜尋報告

肺炎，是指肺部的肺泡出现發炎的症狀。肺炎可以發生在任何年齡組別的人身上，但以年幼及年長者，以及患有免疫力缺乏症或免疫系統比較差的人屬於高危患者，他們比較容易發病。而對於其他人，他們身體本身的免疫系統已有能力對抗輕微的感染。一般程況都會向病人處方抗生素來治療。若病況嚴重，可以致命。

病徵
對於肺炎的診斷，胸腔X射線中肺部出現浸潤現象是診斷肺炎的黃金標準，支持性的診斷方法則是由病患的痰液或血液進行微生物的培養。當懷疑有肺炎時，通常會進行血液檢查：完全血球計數可以顯示出嗜中性球的增生（除了某些免疫不全或嗜中性球減少症的病患之外）。若病情發展為敗血症，病患的腎功能可能有下降的情形。在離子的測定方面，通常由於肺炎的肺部組織釋出抗尿激素而導致納離子的降低。 若為院內感染或是因免疫不全所造成的肺炎，其診斷會比較困難，甚至可能需要進行肺部的斷層掃描以區分可能造成肺炎的原因（例如肺栓塞）。若病患亦有其它的症狀或不適（例如血管炎，肉狀瘤病或是肺癌等）時，斷層掃描亦具有其應用性。

診斷
社區型肺炎

流行病特徵：社區型肺炎是嚴重的疾病。在英國是第四大主要死因，在美國則是第六大死因。85%的社區型肺炎的致病體是典型的細菌，包括了肺炎鏈球菌（Streptococcus pneumonia）、流行性感冒嗜血桿菌（Haemophilus influenzae）、卡他莫拉式菌（Moraxella catarrhalis）。剩下的15%則由所謂的非典型致病體造成，包括肺炎黴漿菌（Mycoplasma pneumonia）、肺炎披衣菌（Chlamydia pneumonia）、和退伍軍人菌屬（Legionella species）。一般而言，需氧的葛蘭式陰性桿菌（如綠膿桿菌（Pseudomonas aeruginosa）、靜止桿菌（Actinectobacter）、腸桿菌（[Enterobacter））較少造成社區型肺炎。
臨床特徵：典型的特徵包括咳嗽、有膿的痰、呼吸急促、肋膜胸痛、發燒和發抖。理學檢查上，可發現較高的呼吸速度、心跳和呼吸道堅實化。在老年人，症狀會變得較模糊不清且較不具專一性。老年人可能會伴有頭痛、不安、腹瀉、意識不清、跌倒和食欲減少等。胸部X光是診斷的標準。一般而言，當病人懷疑有社區型肺炎而只有肺部的症狀，並無其他器官的關連時，通常是由典型的致病體造成。而病人有肺炎且伴隨著其他器官的症狀且實驗室檢查也有變化時，可能是由非典型致病體造成。

肺炎類型
院內感染性肺炎， 又稱為醫院肺炎，是因其他疾病或治療而住院後所得到的一種肺部感染。其被認定與社區感染性肺炎（CAP）為不同的疾病，因為病因、微生物學、治療及預後都不同。住院病患有很多造成肺炎的危險因子，包括呼吸器使用、長期營養不良、潛在心肺疾病、胃酸缺乏及免疫疾病等。此外，一般環境下無法生存的病原在醫院卻非常茂盛。這些病原包括抗藥性嗜氧格蘭氏陰性桿菌，如綠膿桿菌、腸桿菌及[[]]

院內感染性肺炎（Hospital-acquired pneumonia）

Severe acute respiratory syndrome (SARS)
Pneumocystis carinii pneumonia
Bronchiolitis obliterans organizing pneumonia
Eosinophilic pneumonia

其他種類肺炎
Pneumonia is an infectious disease by definition, and whether a patient is prone to develop pneumonia depends on the presence of pathogens but equally on the patient's immune system and other factors. 大多數的肺炎都並非傳染性，除非肺炎是由流行性感冒引起的。
Breathing problems, as often present in patients after a stroke, in Parkinson's disease, hospitalisation or surgery and mechanical ventilation can all increase the likelihood of pneumonia. Similarly, inability to clear sputum (as in cystic fibrosis) or retention of sputum (as in bronchiectasis) can lead to pneumonia.
After splenectomy (removal of the spleen), a patient is more prone to pneumonia due to the spleen's role in developing immunity against the polysaccharides on pneumococcus bacteria.

感染途徑
Vaccination with the pneumococcal polysaccharide vaccine is recommended for adults older than 65 and persons with chronic disease (except asthma). Also for Native Alaskans and certain Native Americans.

預防
一般來說，治療肺炎大多投以抗生素治療；醫生會就肺炎的類型及病人的免疫力來評估用量。 Amoxicillin is used as first-line therapy in the vast majority of community patients, sometimes with added clarithromycin. In North America, where the atypical forms of community acquired pneumonia are becoming more common, clarithromycin, azithromycin, and the fluoroquinolones have displaced the penicillin-derived drugs as first line therapy. In hospitalized patients and immune deficient patients, local guidelines generally determine which combination of (generally intravenous) antibiotics is used.

治療
The clinical state of the patient at time of presentation is a strong predictor of the clinical course. Many clinicians use the Pneumonia Severity Score to calculate whether a patient requires admission to hospital, based on the severity of symptoms, underlying disease and age

Prognosis and mortality
Before the advent of antibiotics, pneumonia was often fatal. When penicillin was discovered in the 20th century, it was the first causal therapy. Most community-acquired strains of S. pneumoniae are still penicillin-sensitive.

歷史
Many famous people throughout the years have succumbed to pneumonia and its complications. As it is a common cause of death in the chronically ill, this is not always reported in the press.

A well known and tragically sudden death due to pneumonia was that of Muppets creator Jim Henson in the early 1990s.
19th Century Sharpshooter Calamity Jane.
In 1989, Actor Jim Backus died of pneumonia, after suffering for years with Parkinson's Disease. Backus was best known for his roles as the voice of animated character, Mr. Magoo, and as Thurston Howell III on television's Gilligan's Island.
Television producer and director, Bruce Paltrow, 58, died of the disease while traveling in Rome in 2002. Paltrow was survived at the time by his wife, actress Blythe Danner, and his daughter, actress Gwyneth Paltrow.
In the late 30s, movie mogul Irving Thalberg was finally felled by pneumonia after suffering for years from heart problems. Thalberg died before even reaching his 40th birthday, and some say Louis B. Mayer, let alone Norma Shearer, never recovered from the loss of MGM's creative "boy wonder."
In 2005, John Raitt, Broadway star of the 50s and 60s in such hits as The Pajama Game and Carousel, passed away due to complications from pneumonia. His daughter is pop and blues singer, Bonnie Raitt.
Nicole DeHuff, an actress who played Teri Polo's sister in Meet the Parents, has died of causes related to pneumonia. She was 31 years and 41 days in age. The actress died Feb. 16, 2005, in Hollywood, four days after she reportedly checked into a Los Angeles hospital, was misdiagnosed and sent home with orders to take Tylenol.

Notable pneumonia sufferers


註解1： National guideline clearninghouse clinical practice guideline (USA): adult preventive health care - immunizations
註解2： Center for Disease Control, United States, regarding vaccination with the pneumococcal polysaccharide vaccine (PDF)
註解3： Halm EA, Teirstein AS. Management of community-acquired pneumonia. N Engl J Med 2002;347:2039-45. PMID 12490686.