Brian is a 7-year-old boy who presents to the primary care office with his mother. His mom has noticed that Brian has been coughing frequently and seems to have shortness of breath at times. She reports that Brian had a \”cold\” with a low grade fever and runny nose about 2 weeks ago and the symptoms seem to appear after the cold.
On physical examination, Brian appears in moderate respiratory distress, with suprasternal and intercostal retractions. His vital signs include a temperature of 100 Ax°F, a respiratory rate of 32 breaths per minute, heart rate of 120 beats per minute, and pulse oximetry of 95% on room air. Lung exam is notable for diffuse symmetrical expiratory wheezes. His nasal mucosa is erythematous with boggy turbinates and clear mucus. The remainder of the exam is unremarkable.
1. Based on this case, discuss the differences in the pathophysiology for asthma vs pneumonia. Include your thoughts as to the diagnosis for this case and if you would consider a covid-19 infection.
Post your initial discussion by 11:59 PM ET on Thursday. Posts are a minimum of 250 words, scholarly written, APA formatted (with some exceptions due to limitations in the D2L editor), and a minimum of 2 references (which may include the course textbook). Reply to at least one classmate\’s initial discussion post by Saturday at 11:59 PM ET. The initial discussion post and discussion response should occur on two different calendar days of each electronic week. These are not the complete instructions for participating in discussions. See the \”Grading Rubric for Online Discussions – 500 level\” found in the Course Resources module.
NSG 530: Week 5
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NSG 530: Week 5
Respiratory illnesses can have significant detrimental health effects on patients. Asthma and pneumonia are two different respiratory conditions that affect the lungs. The two diseases have different causes; however, they share some symptoms such as shortness of breath and coughing. Asthma is a common chronic health condition of the airways characterized by airflow obstruction, variable and recurring symptoms, and underlying inflammation (Ticona et al., 2021). On the other hand, pneumonia is an umbrella term for a group of illnesses caused by different organisms causing infection of the lung parenchyma.
The pathophysiology of asthma is associated with different changes in the airways. These changes include bronchoconstriction, airway edema, airway hyper-responsiveness, and airway remodeling. According to Ticona et al. (2021), inflammation has a significant role to play in the pathophysiology of asthma. The inflammation of the airways involves an interaction of various cell types and many mediators with the airways that ultimately leads to the characteristic or physiological features of the disease (Ticona et al., 2021). These physiological features include bronchial inflammation and airflow deprivation causing recurrent episodes of cough, shortness of breath, and wheezing. The process through which these interactive events happen and lead to clinical asthma is not fully understood and is still under investigation (Ticona et al., 2021). Despite the existence of various asthma phenotypes, inflammation remains a constant feature or pattern.
On the other hand, the pathophysiology of pneumonia includes systematic defense mechanisms such as humoral and complement-mediated immunity, which is consisted of diseases like common variable immunodeficiency (CVID), X-linked agammaglobulinemia (inherited), and functional asplenia (acquired) (Jain et al., 2022). Impaired cell-mediated immunity exposes individuals to infection by intracellular organisms such as viruses and others (Pneumocystis pneumonia (PJP), fungal causes).
Resistant macrophages often protect the lungs from foreign pathogens. Ironically, these macrophages often trigger inflammatory reactions that often cause clinical findings and the histopathological findings seen in pneumonia. Cytokines (TNF-a, IL-8, and IL-1) are normally triggered when macrophages engulf the pathogens (Jain et al., 2022). The reaction activates inflammatory cells like neutrophils at the site of infection. This reaction in turn leads to inflammation of the lung parenchyma and other symptoms of pneumonia. COVID_19 is believed to worsen pneumonia. According to Galiatsatos (2022), COVID-19 can cause lung complications such as pneumonia, which means it might worsen the condition. WHO (2021), stated that at the onset of the COVID-19 pandemic, patients with pneumonia were believed to be at greater risk. However, the emerging data throughout 2020 indicated a less clear association between asthma and COVID-19.
References
Galiatsatos, P. (2022). COVID-19 Lung Damage. https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/what-coronavirus-does-to-the-lungs
Jain, V., Vashisht, R., Gizem Yilmaz, & Bhardwaj, A. (2022). Pneumonia Pathology. https://www.ncbi.nlm.nih.gov/books/NBK526116/
Ticona, J. H., Zaccone, V. M., & McFarlane, I. M. (2021). Community-acquired pneumonia: A focused review. Am J Med Case Rep, 9(1), 45-52. https://doi.org/10.12691/ajmcr-9-1-12
WHO. (2021). Asthma and COVID-19: Scientific brief. https://apps.who.int/iris/bitstream/handle/10665/340860/WHO-2019-nCoV-Sci-Brief-Asthma-2021.1-eng.pdf