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Lung Infections

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What is acute respiratory infection?
Acute respiratory infection is an infection that may interfere with normal breathing. It can affect just your upper respiratory system, which starts at your sinuses and ends at your vocal chords, or just your lower respiratory system, which starts at your vocal chords and ends at your lungs.

This infection is particularly dangerous for children, older adults, and people with immune system disorders.

What are the symptoms of acute respiratory infection?
The symptoms you experience will be different if it’s a lower or upper respiratory infection. Symptoms can include:

congestion, either in the nasal sinuses or lungs
runny nose
cough
sore throat
body aches
fatigue
Call your doctor if you experience:

a fever over 103˚F (39˚C) and chills
difficulty breathing
dizziness
loss of consciousness
What causes acute respiratory infection?
There are several different causes of acute respiratory infection.

Causes of upper respiratory infection:

acute pharyngitis
acute ear infection
common cold
Causes of lower respiratory infection:

bronchitis
pneumonia
bronchiolitis

Who is at risk for acute respiratory infection?
It’s almost impossible to avoid viruses and bacteria, but certain risk factors increase your chances of developing acute respiratory infection.

The immune systems of children and older adults are more prone to being affected by viruses.

Children are especially at risk because of their constant contact with other kids who could be virus carriers. Children often don’t wash their hands regularly. They are also more likely to rub their eyes and put their fingers in their mouths, resulting in the spread of viruses.

People with heart disease or other lung problems are more likely to contract an acute respiratory infection. Anyone whose immune system might be weakened by another disease is at risk. Smokers also are at high risk and have more trouble recovering.

How is acute respiratory infection diagnosed?
In a respiratory exam, the doctor focuses on your breathing. They will check for fluid and inflammation in the lungs by listening for abnormal sounds in your lungs when you breathe. The doctor may peer into your nose and ears, and check your throat.

If your doctor believes the infection is in the lower respiratory tract, an X-ray or CT scan may be necessary to check the condition of the lungs.

Lung function tests have been useful as diagnostic tools. Pulse oximetry, also known as pulse ox, can check how much oxygen gets into the lungs. A doctor may also take a swab from your nose or mouth, or ask you to cough up a sample of sputum (material coughed up from the lungs) to check for the type of virus or bacteria causing the disease.

How is acute respiratory infection treated?
With many viruses, there are no known treatments. Your doctor may prescribe medications to manage your symptoms while monitoring your condition. If your doctor suspects a bacterial infection, they may prescribe antibiotics.

What are the potential complications of acute respiratory infection?
Complications of acute respiratory infection are extremely serious and can result in permanent damage and even death. They include:

respiratory arrest, which occurs when the lungs stop functioning
respiratory failure, a rise in CO2 in your blood caused by your lungs not functioning correctly
congestive heart failure
Preventing acute respiratory infection
Most causes of acute respiratory infection aren’t treatable. Therefore, prevention is the best method to ward off harmful respiratory infections.

Getting the MMR (measles, mumps, and rubella) and pertussis vaccine will substantially lower your risk of getting a respiratory infection. You may also benefit from influenza vaccination and pneumovax. Talk to your doctor about getting these.

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Emphysema

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Overview
Emphysema is a lung condition that causes shortness of breath. In people with emphysema, the air sacs in the lungs (alveoli) are damaged. Over time, the inner walls of the air sacs weaken and rupture — creating larger air spaces instead of many small ones. This reduces the surface area of the lungs and, in turn, the amount of oxygen that reaches your bloodstream.

When you exhale, the damaged alveoli don't work properly and old air becomes trapped, leaving no room for fresh, oxygen-rich air to enter.

Most people with emphysema also have chronic bronchitis. Chronic bronchitis is inflammation of the tubes that carry air to your lungs (bronchial tubes), which leads to a persistent cough.

Emphysema and chronic bronchitis are two conditions that make up chronic obstructive pulmonary disease (COPD). Smoking is the leading cause of COPD. Treatment may slow the progression of COPD, but it can't reverse the damage.

Symptoms
You can have emphysema for many years without noticing any signs or symptoms. The main symptom of emphysema is shortness of breath, which usually begins gradually.

You may start avoiding activities that cause you to be short of breath, so the symptom doesn't become a problem until it starts interfering with daily tasks. Emphysema eventually causes shortness of breath even while you're at rest.

When to see a doctor
See your doctor if you've had unexplained shortness of breath for several months, especially if it's getting worse or it's interfering with your daily activities. Don't ignore it by telling yourself it's because you're aging or out of shape. Seek immediate medical attention if:

You're so short of breath, you can't climb stairs
Your lips or fingernails turn blue or gray with exertion
You're not mentally alert
Causes
The main cause of emphysema is long-term exposure to airborne irritants, including:

Tobacco smoke
Marijuana smoke
Air pollution
Chemical fumes and dust
Rarely, emphysema is caused by an inherited deficiency of a protein that protects the elastic structures in the lungs. It's called alpha-1-antitrypsin deficiency emphysema.

Risk factors
Factors that increase your risk of developing emphysema include:

Smoking. Emphysema is most likely to develop in cigarette smokers, but cigar and pipe smokers also are susceptible. The risk for all types of smokers increases with the number of years and amount of tobacco smoked.
Age. Although the lung damage that occurs in emphysema develops gradually, most people with tobacco-related emphysema begin to experience symptoms of the disease between the ages of 40 and 60.
Exposure to secondhand smoke. Secondhand smoke, also known as passive or environmental tobacco smoke, is smoke that you inadvertently inhale from someone else's cigarette, pipe or cigar. Being around secondhand smoke increases your risk of emphysema.
Occupational exposure to fumes or dust. If you breathe fumes from certain chemicals or dust from grain, cotton, wood or mining products, you're more likely to develop emphysema. This risk is even greater if you smoke.
Exposure to indoor and outdoor pollution. Breathing indoor pollutants, such as fumes from heating fuel, as well as outdoor pollutants — car exhaust, for instance — increases your risk of emphysema.
Complications
People who have emphysema are also more likely to develop:

Collapsed lung (pneumothorax). A collapsed lung can be life-threatening in people who have severe emphysema, because the function of their lungs is already so compromised. This is uncommon but serious when it occurs.
Heart problems. Emphysema can increase the pressure in the arteries that connect the heart and lungs. This can cause a condition called cor pulmonale, in which a section of the heart expands and weakens.
Large holes in the lungs (bullae). Some people with emphysema develop empty spaces in the lungs called bullae. They can be as large as half the lung. In addition to reducing the amount of space available for the lung to expand, giant bullae can increase your risk of pneumothorax.

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Breathing Difficulty

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There is an old proverb that states, "Life is in the breath. He who half breathes half lives."

If you have allergies, asthma, or other breathing problems, this proverb may sound very familiar. But a greater understanding of your breathing problems, along with an accurate medical diagnosis and effective treatment, can help you regain control. It doesn't matter what type of breathing problem you have. Daily control is vital to living an active, productive life.

What Causes Breathing Problems?
There are many causes of breathing problems. Some people have difficulty breathing when they get a cold. Others have trouble breathing because of occasional bouts of acute sinusitis. Sinusitis can make it difficult to breathe through your nose for a week or two until the inflammation subsides and the congested sinuses begin to drain.

Many breathing problems are chronic or long-term. These common breathing problems include chronic sinusitis, allergies, and asthma. These problems can cause a host of symptoms such as nasal congestion, runny nose, itchy or watery eyes, chest congestion, cough, wheezing, labored breathing, and shallow breathing.

The nasal passage is a pathway for viruses and allergens to enter your lungs. So the nose and sinuses are often associated with many lung disorders. A sinus or nasal passage inflammation may trigger reflexes and cause asthma attacks. And the No. 1 trigger for asthma is allergies.

More than 50 million people have hay fever or other allergies. And 17 million adults have asthma. Oftentimes, asthma and allergies occur together. When they do, they can make life miserable if left untreated.

Millions of People have breathing problems because of chronic obstructive pulmonary disease, or COPD, which includes emphysema and chronic bronchitis. Breathing problems may also stem from other serious problems such as lung cancer, tuberculosis, pneumonia, and lung disease related to HIV/AIDS.

Which Tests Are Used to Diagnose Breathing Problems?
Doctors diagnose breathing problems by performing a physical exam, taking a patient history and family health history, and using different tests. For instance, pulmonary function tests, also known as lung function tests, are frequently used to assess lung function in people with asthma. These tests include spirometry and a test known as methacholine challenge.

Spirometry is a simple breathing test. It measures how much air you can blow out of your lungs and how fast you can blow it. This breathing test is used to determine the amount of airway obstruction. A methacholine challenge test may be performed to help establish a diagnosis of asthma. Your doctor will know which test is best for your situation.

In some cases, the doctor may take an X-ray to see the structures inside your chest, including the heart, lungs, and bones. A chest X-ray is a good test to diagnose pneumonia. It can't, though, identify most breathing problems by itself. For some people with breathing problems, a CT scan of the chest is needed. This scan looks for any problems in the lungs. A CT scan uses X-rays and a computer to create detailed images.

If you suffer with chronic sinusitis, your doctor may order a special sinus CT scan. This scan will be used to evaluate your sinuses. Once the problem is diagnosed, your doctor may prescribe effective treatment to help resolve the breathing difficulty.

Can Allergy Tests Determine the Cause of Breathing Problems?
Allergy tests may help your doctor identify the cause of your breathing problems. There are several types of allergy tests your doctor might use. One of them is the prick technique. In this test, the doctor first puts a tiny drop of allergen on your skin. Then the doctor makes a puncture with a needle directly in the drop of allergen extract. If you are allergic to the specific allergen, your body will react to it by turning red at the site. You may also experience itching and swelling at the site of the allergen placement.

Another type of skin test involves your doctor injecting the allergen extract directly under the skin using a syringe. Other allergy tests include:

allergy blood tests (called a RAST or radioallergosorbent test)
a challenge test, in which the doctor introduces tiny amounts of the suspected allergen by inhaled, oral, or other routes
These tests are used less frequently than the skin testing.

After performing allergy tests, your doctor may know what's triggering your breathing problems. Then the doctor will be able to treat your allergy symptoms more effectively.

How Are Breathing Problems Treated?
Substances that cause breathing problems are known as triggers. Avoidance of triggers is the No. 1 way to control allergies and asthma. As an example, wearing a dust mask when doing housework or yard work may cut down on your exposure to allergy triggers. Avoiding a furry pet, washing bed linens at least once a week, staying indoors during peak pollen times, and changing the filter on your air conditioner frequently may also help prevent serious problems if you have allergies.

Medications are also important in treating breathing problems. Allergy drugs such as antihistamines and decongestants may make it easier to breathe for some people with allergies. These medications can be delivered orally or through nasal sprays.

In addition, inhaled steroids may give relief to some with chronic allergies and sinusitis. These drugs work to reduce inflammation in the airways. Allergy shots are yet another way to reduce sensitivity to allergens and may give relief to some breathing problems.

Asthma is treated with inhaled or oral drugs that help open airways and reduce the primary inflammation in the airways. These asthma medications help ease or even prevent airway obstruction and excessive mucus production. People with asthma must control inflammation in order to keep the airways open and reduce sensitivity to asthma triggers. Asthma triggers may include:

Viral infections (cold or flu)
Pollen
Pet dander
Mold spores
Dust mites
Cockroaches
Irritating pollutants in the air
Fragrances and fumes
Smoke
Food allergies
Even exercise and cold weather can be an asthma trigger in some people.


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