Pleuropneumonia: What It Is and How Lobar Pneumonia Differs

Sometimes in a report after an X-ray or in a conversation with a doctor, the word 'pleuropneumonia' appears, and next to it — 'lobar pneumonia'. It sounds alarming, as if it were something separate and very serious. In fact, both terms refer to inflammation of the lungs, but they describe different aspects: pneumonia is a lung infection in which the alveoli fill with fluid or pus, and pleural disorders are one of the possible complications.

What pleuropneumonia and lobar pneumonia are

Pneumonia is an infection of one or both lungs in which the alveoli fill with fluid or pus. The pleura is a thin tissue that covers the lung on the outside and lines the chest cavity on the inside. Pleuropneumonia is not a separate diagnosis from the list of diseases that can be described unambiguously; more often this is the name for pneumonia in which the pleura is involved, and pleural disorders are considered complications of pneumonia, and only a doctor can clarify what is meant in your report. 'Lobar pneumonia' is the name of one of the forms of pneumonia; the specific features of the course and involvement are determined by the doctor.

How lobar pneumonia differs from ordinary pneumonia

From a clinical point of view, pneumonias can be 'typical' and 'atypical' depending on the clinical picture. The term 'pneumonia' unites a large group of diseases with different etiologies and clinical presentations. Pleural disorders, including accumulation of fluid in the pleural cavity, are considered complications of pneumonia.

Causes and how inflammation develops

Pneumonia is caused by bacteria, viruses, and fungi; bacteria are the most common cause. Among the pathogens are Streptococcus pneumoniae, Legionella pneumophila, Mycoplasma pneumoniae, Chlamydia pneumoniae, Haemophilus influenzae type b. Viral pneumonia is often milder and resolves within a few weeks, but secondary bacterial pneumonia is possible against its background. Microbes more often enter the lungs via the bronchogenic route — through inhalation, aspiration, or transfer of flora from the upper respiratory tract. The hematogenous route is less common. Inflammation begins in the respiratory bronchioles, then extends beyond them into the lung tissue.

Symptoms of lobar pneumonia

Symptoms may appear suddenly or increase over several days. Typical are cough, shortness of breath, high fever, chest pain, body aches, severe fatigue and loss of appetite, sometimes wheezing. In older people, the disease sometimes manifests not with fever but with weakness or sudden confusion. Chest pain may occur when breathing and coughing.

• cough with yellow or green sputum
• chest pain that comes and goes, or occurs when breathing and coughing
• shortness of breath
• high fever and chills
• confusion or unusual weakness in older people

How it is diagnosed

The doctor asks about symptoms and listens to the lungs with a stethoscope. Then they may order a chest X-ray and blood tests, such as a complete blood count and blood culture. In the hospital, in severe cases, sputum examination, computed tomography of the chest, pleural fluid culture, and pulse oximetry are added to assess blood oxygen saturation. Sometimes bronchoscopy is performed.

Complications and when urgent help is needed

Complications include bacteria entering the blood with the risk of septic shock, lung abscesses, pleural disorders, renal and respiratory failure. Most people recover in 2–4 weeks, but with late diagnosis the prognosis is worse. If a cough persists for up to 3 weeks, sputum appears, chest pain or shortness of breath occurs, a doctor's consultation is needed.

Pneumonia itself is not a reason to call an ambulance; 103 or 112 — if a person is gasping for air, cannot speak, the skin, lips or tongue are pale, blue or mottled, with coughing up blood, sudden confusion, or if a child cannot be woken up.

This material is for reference: it helps to understand the terms, but does not replace a doctor's consultation, who will assess your specific situation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer