Definition:
Inflammation of the lung parenchyma (specifically the alveoli), usually caused by an infection. The alveoli fill with fluid, making gas exchange difficult and leading to respiratory symptoms.
Symptoms
Shared general features:
- Cough (productive in alveolar types, dry in interstitial)
- Fever (high in bacterial types, variable in viral)
- Dyspnea (shortness of breath)
- Chest pain (pleuritic, worsens on inspiration), sharp/stabbing chest pain.
Physical Examination
- General signs: Fever, tachypnea, tachycardia. May see hypotension in severe cases, or herpes labialis (cold sores) due to immune stress.
- Facies febrilis: Flushed face due to high fever.
On Lung Exam:
- Bronchopneumonia: ↓ Vesicular breathing, scattered crackles or rhonchi. Patchy consolidation.
- Interstitial pneumonia: Often only ↓ breath sounds or ↓ mobility of chest on affected side.
Instrumental Tests
- Lobar → solid white opacity in one lobe
- Bronchial → patchy infiltrates, base-heavy
- Interstitial → diffuse streaky or patchy lines, especially near hilum
Spirometry - Restrictive pattern (↓ FVC, ↓ FEV1, normal or ↑ FEV1/FVC).
Used especially in interstitial pneumonia
Blood gases - ↓ PaO₂ (hypoxemia); sometimes ↑ PaCO₂ in severe cases