Inflammation is an essential component of many lung diseases. Lung inflammation can refer to irritation and infection of the lung.
- Pleurisy: The pleural sacs become inflamed that condition called pleurisy.
- Pneumonia: The lung tissue itself becomes infected, usually due to bacteria. It is one of the main reasons for lung inflammation.
Lung inflammation can lead to the formation of a lung abscess, a pus-filled cavity surrounded by inflammation, or an empyema, a collection of pus in the pleural space. Both these complications are very serious conditions that need antibiotic treatment, and maybe even surgery to remove the abscess or drain the pus. Another extreme consequence of pneumonia is acute respiratory distress syndrome, which can be fatal. The lung’s air sacs fill with fluid, and the respiratory failure ensures. This complication has a high fatality rate and requires a patient to be in an intensive care unit, receiving aggressive treatment including receiving extra oxygen with the help of a ventilator and antibiotics
Pneumonitis (noo-moe-NIE-tis) is a general term that refers to inflammation of lung tissue. Technically, pneumonia is a type of pneumonitis because the infection causes inflammation. Pneumonitis, however, is usually used by doctors to refer to noninfectious causes of lung inflammation.
Common causes of pneumonitis include airborne irritants at your job or from your hobbies. In addition, some types of cancer treatments and dozens of drugs can cause pneumonitis.
Difficulty breathing — often accompanied by a dry (nonproductive) cough — is the most common symptom of pneumonitis. Specialized tests are necessary to make a diagnosis. Treatment focuses on avoiding irritants and reducing inflammation.
Symptoms
The most common symptom of pneumonitis is shortness of breath, which may be accompanied by a dry cough. If pneumonitis is undetected or left untreated, you may gradually develop chronic pneumonitis, which can result in scarring (fibrosis) in the lungs.
Signs and symptoms of chronic pneumonitis include:
- Shortness of breath
- Cough
- Fatigue
- Loss of appetite
- Unintentional weight loss
Causes
Bronchioles and alveoli in the lungs
Pneumonitis occurs when an irritating substance causes the tiny air sacs (alveoli) in your lungs to become inflamed. This inflammation makes it difficult for oxygen to pass through the alveoli into the bloodstream.
Many irritants, ranging from airborne molds to chemotherapy drugs, have been linked to pneumonitis. But for most people, the specific substance causing the inflammation is never identified.
Pneumonitis causes may include:
- A variety of drugs can cause pneumonitis, including some antibiotics, several types of chemotherapy drugs and medications that keep your heartbeat regular. An overdose of aspirin can cause pneumonitis.
- Molds and bacteria.Repeated exposure to some molds and bacteria can cause the lungs to become inflamed. Specific varieties of mold-related pneumonitis have received nicknames, such as “farmer’s lung” or “hot tub lung.”
- Exposure to feathers or bird excrement is a common cause of pneumonitis.
- Radiation treatments.Some people who undergo radiation therapy to the chest, such as for breast or lung cancer, may develop pneumonitis. Pneumonitis also can occur after whole-body radiation therapy, which is needed to prepare a person for a bone marrow transplant.
Diagnosis
During the physical exam, your doctor will use a stethoscope to listen carefully to your lungs while you breathe. To distinguish pneumonitis from other lung disorders, you’ll likely have one or more of the following tests.
Blood tests
Certain blood tests can be useful for pinpointing a diagnosis.
Imaging tests
Imaging tests are useful because in most cases, pneumonia affects only a small, localized portion of your lungs, while the effects of noninfectious pneumonitis are often spread throughout all five lobes of your lungs.
- Chest X-ray.This painless test causes a small amount of radiation to pass through your chest to produce images of your lungs. X-rays take only a few minutes to perform.
- Computerized tomography (CT).CT scans combine X-ray images taken from many different angles into detailed cross-sectional images. This painless test involves lying on a narrow table that slides into a large, doughnut-shaped machine. CT scans typically take less than 15 minutes to perform. Computerized tomography gives much greater detail of changes in your lungs than what a chest X-ray can provide.
Pulmonary function tests
A test called spirometry measures the amount of air that you’re able to inhale and exhale in a specific period of time. Your doctor may also measure how efficiently your lungs transfer gases from the air into the bloodstream during exercise.
Another way to assess how well your lungs are working is to measure the oxygen in your blood with an oximeter — a device that painlessly clamps on your finger.
Spirometer
A spirometer is a diagnostic device that measures the amount of air you’re able to breathe in and out and the time it takes you to exhale completely after you take a deep breath.
Bronchoscopy
A bronchoscopy is a procedure that uses a flexible tube threaded down your throat to view your airways and collect samples from your lungs.
During bronchoscopy, your doctor may flush a section of your lung with a saltwater solution to collect lung cells and other materials. This flushing procedure is known as a lavage. Your doctor may also insert a tiny tool through the scope to remove a small sample of cells from the lung tissue for testing.
Surgical lung biopsy
In some cases, your doctor may want to examine larger samples of tissue from several locations in your lungs that cannot be reached via bronchoscopy. A surgical procedure to obtain these samples may be necessary.
Treatment
If you have hypersensitivity or chemical pneumonitis, your doctor will recommend eliminating exposure to the allergen or chemical irritating your lungs. This step should help lessen your symptoms.
In severe cases of pneumonitis, treatment may also include:
- These drugs work by suppressing your immune system, reducing inflammation in your lungs. Corticosteroids are usually taken as a pill. However, long-term corticosteroid use also increases your risk of developing infections and is associated with the thinning of bones (osteoporosis).
- Oxygen therapy.If you’re having a lot of trouble breathing, you may need oxygen therapy through a mask or plastic tubing with prongs that fit into your nostrils. Some people need oxygen therapy constantly, while others might need it only during exercise or sleep
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