Pulmonologists are specially trained in diagnosis [by history taking and physical examination], evaluation [diagnostic tests (blood, urine, sputum, Chest X-Ray and CTs, PFTs and bronchoscopy, etc)] and management [treatment, holistic care, rehabilitation, and prognosis] of diseases of the respiratory system such as:
CHEST INFECTIONS :
Due to bacteria [gram positive, gram negative or anaerobic], viruses [H1N1], tubercular bacilli [TB]): pneumonias-community acquired [CAP] or health care-associated pneumonias [HAP], bronchiectasis, opportunistic infections in an immunocompromised patient [transplant, HIV, diabetic, patient on steroids] due to fungi [aspergillus, candida], cryptococcus, parasites [protozoa, helminths and other zoonotic infections], Nocardia, pneumocystis, non tubercular mycobacteria, rare virus], bronchitis, aspiration pneumonia, lung abscess, empyema.
OBSTRUCTIVE LUNG DISEASES :
Due to obstruction in airways that limit or block the flow of air in or out of the lungs: Allergic rhinitis and Asthma, Allergic Broncho Pulmonary Aspergillosis [ABPA], Emphysema, Acute bronchitis, Chronic bronchitis, Chronic obstructive Pulmonary Disease, [COPD], Bronchiolitis, Bullous diseases of lungs.
DISEASES CAUSING ABNORMAL GAS EXCHANGE IN LUNGS :
Due to fluid, blood, and other material deposition in alveoli (gas exchange units of lungs): Alveolar hemorrhage syndromes, Acute Respiratory Distress Syndrome [ARDS], aspiration pneumonitis, pulmonary alveolar proteinosis, alveolar microlithiasis, pulmonary amyloidosis, ANCA associated pulmonary vasculitides, pulmonary edema.
CONGENITAL AND DEVELOPMENTAL DISORDERS :
Of lung due to birth defects: lung aplasia, hypoplasia, agenesis, cystic fibrosis.
RESTRICTIVE LUNG DISEASES :
Due to stiffness and scarring [lung fibrosis] of the interstitium [the space between the alveoli (gas exchange units of the lung)] due to immunologic process: Interstitial Lung Disease (ILD) [UIP, IPF, NSIP, DIP, LIP, BOOP], hypersensitivity pneumonitis, Sarcoidosis, radiation pneumonitis, eosinophilic pneumonia, ILD’s related to connective tissue disease (CTD), Pulmonary Langerhans’s cell histiocytosis, lymphangioleiomyomatosis, Drug-induced lung diseases.
LUNG CANCER :
Nonsmall cell lung carcinoma [NSCLC], small cell lung carcinoma [SCLC], solitary pulmonary nodule [SPN], lymphoproliferative [lymphomas] or hematologic [leukemias] malignancies affecting lung and pleura, metastasis to lungs from other primary malignancies [spread of tumor cells to lungs].
DISEASES OF PLEURA (LINING OF LUNGS) :
Pleurisy or pleural effusion (water collection outside the lung either due to infection or cancer), empyema (pus of lung lining), Pneumothorax (rupture of lung lining), Mesothelioma (cancer of the lining of lungs).
OCCUPATIONAL AND ENVIRONMENTAL LUNG DISEASES :
(Pneumoconiosis): Due to exposure to dust (organic or inorganic), toxins or fumes (asbestos, beryllium, coal dust, silica dust, indoor and outdoor air pollution).
LUNG DISORDERS FROM UNUSUAL ATMOSPHERIC PRESSURE :
Mountaineers (high altitudes) where the air has less atmospheric pressure (oxygen), or Divers (deep water) where there is more atmospheric pressure causing higher nitrogen levels in the blood.
DISORDERS OF PULMONARY CIRCULATION :
Diseases related to abnormalities of blood flow to lungs: Pulmonary arterial hypertension (PAH), corpulmonale, acute or chronic pulmonary thromboembolism, pulmonary arteriovenous malformations.
DISEASES OF MEDIASTINUM :
[diseases of space containing airways (windpipe), food pipe, heart vessels, lymph nodes]: oesophageal perforation [rupture of food pipe], tracheobronchial perforation [rupture of windpipe], and superior vena caval syndrome [compression of heart vessels], congenital lesions of the mediastinum [bronchogenic cysts, estrogenic cysts, neurenteric cysts, thymic cysts, pericardial cysts, thoracic duct cysts], acquired lesions of the mediastinum [acute or chronic mediastinitis [infection], pneumomediastinum (air in mediastinum), enlarged lymph nodes and tumors in the mediastinum.
DISEASES OF THORACIC CAGE (CHEST WALL) AND DIAPHRAGM :
(membrane separating lungs from the abdomen): Neuromuscular weakness (nerve or muscle neurological diseases causing chest wall muscle weakness or diaphragmatic palsy), congenital chest wall and diaphragmatic disorders (kyphoscoliosis, eventration of diaphragm, diaphragmatic hernias, and obesity).
SLEEP-RELATED BREATHING DISORDERS :
Like obstructive sleep apnea [OSA], obesity hypoventilation syndrome.
RESPIRATORY FAILURE :
Acute or chronic type 1 or type 2 respiratory failure, acute lung injury, Acute Respiratory Distress Syndrome [ARDS]
What is pneumonia?
Pneumonia is an infection of the lungs that causes coughing, fever, and trouble breathing (figure 1). It is a serious illness, especially in young children, people older than 65, and people with other health problems. Pneumonia is usually caused by bacteria but can also be caused by viruses or other germs.
- Fever (temperature higher than 100.4°F or 38°C)
- Trouble breathing
- Pain when you take a deep breath
- A fast heartbeat
- Shaking chills
Should I see a doctor or nurse if I think I have pneumonia?
Yes, see a doctor or nurse as soon as possible. Pneumonia can be mild. But it can also be very serious, especially if you do not get it treated quickly. It’s especially important to see your doctor or nurse right away if:
- Your cough keeps getting worse
- You start having trouble breathing when doing everyday tasks or when resting
- You have chest pain when you breathe in
- You feel suddenly worse after getting better from a cold or the flu
- You have a weakened immune system, for example, because you have an HIV infection, had an organ transplant or stem cell (bone marrow) transplant, or take medicines that suppress the immune system
- You already have a serious lung disease, such as chronic obstructive pulmonary disease or emphysema
- You are 65 years of age or older
If your doctor or nurse thinks you might have pneumonia, he or she will probably take an X-ray of your chest. Taking a chest X-ray is the best way to tell if you have pneumonia.
How is pneumonia treated?
Pneumonia that is caused by bacteria is treated with antibiotics. These medicines kill the germs that cause pneumonia. Most people can take antibiotic pills at home, but some people need to be treated in the hospital. Make sure to take all of your antibiotics, even if you feel better before you finish them.