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Pneumonitis refers to the inflammation of lung tissue, a condition that encompasses a variety of causes beyond infections, such as pneumonia, which also leads to lung tissue inflammation but is specifically caused by infections. The term “pneumonitis” is more commonly applied to noninfectious sources of lung inflammation, often stemming from exposure to airborne irritants linked to one’s hobbies or workplace. Additionally, this condition can be triggered by certain medications and some forms of cancer treatment, leading to not only breathing difficulties but also a range of other physical symptoms.
The inflammation caused by pneumonitis comes in multiple types of inflammation. Among them are:
- Acute: The onset of inflammation is sudden, and it diminishes quickly.
- Subacute: The progression of inflammation is slow and steady.
- Chronic: Long-term and persistent inflammation develops from inflammation.
The following types of pneumonitis includes:
- Acute interstitial pneumonitis: Your symptoms worsen swiftly as acute interstitial pneumonitis occurs suddenly.
- Chemical pneumonitis: When someone breathes in chemicals found in products used at home or at work, such as chemicals used in imaging tests, chlorine gas, insecticides, gasoline, and smoke, they might develop chemical pneumonitis.
- Hypersensitivity pneumonitis: When you breathe in (inhale) allergens such as dust, mold, bacteria, or microscopic scales from animal skin, hair, or feathers (dander), you may develop hypersensitivity pneumonitis.
- Radiation pneumonitis: Radiation pneumonitis may develop following cancer treatment with radiation therapy.
The primary indicators of pneumonitis often involve difficulty breathing, often coupled with a persistent dry cough lacking mucus production. Receiving a diagnosis typically requires specialized testing. The primary objectives of treatment are to diminish inflammation and steer clear of irritants.
Symptoms
The primary signal of pneumonitis is typically shortness of breath, often accompanied by a dry cough. Over time, untreated pneumonitis can progress to chronic pneumonitis, potentially leading to lung scarring (fibrosis) if left undetected or untreated.
Chronic pneumonitis signs and symptoms include:
- Bluish discoloration or cyanosis
- Chest pain.
- Dry cough
- Fatigue
- Loss of appetite
- Shortness of breath or dyspnea.
- Unintentional weight loss
Anytime you have trouble breathing, regardless of the reason, seek medical attention.
Causes
Pneumonitis, an inflammation of the tiny air sacs in the lungs known as alveoli, can be triggered by a variety of irritants, ranging from chemotherapy drugs to airborne fungi. Despite the array of potential causes, the specific agent responsible for this inflammation often remains unidentified. This condition hampers the ability of oxygen to pass through the alveoli and enter the bloodstream, leading to difficulties in respiratory function.
Pneumonitis can have a wide range of potential causes. Common causes include:
- Animal: Allergens found in animal fur, feathers, and skin have the potential to cause inflammation. One typical way to get pneumonitis is by being around feathers or bird excrement.
- Bacteria and molds: Lung inflammation can result from exposure to certain molds and bacteria on a regular basis. Certain types of mold-related pneumonitis have been dubbed “hot tub lung” or “farmer’s lung.” Examples of molds are the ones that develop on sugar cane, hay, straw, cereals, and cheese.
- Medications: Pneumonitis may be brought on by a number of medicines, including some antibiotics, certain chemotherapy agents, and therapies that regulate heart rate. Aspirin overuse can result in pneumonitis.
- Radiation treatments: Pneumonitis can occur in certain patients receiving chest radiation treatment, such as those treating lung or breast cancer. In order to get ready for a bone marrow transplant, whole-body radiation treatment might sometimes result in pneumonia.
Risk factors
The following may increase the risk of pneumonitis.
- Work or hobbies: The following occupations and hobbies have increased risks of pneumonitis:
- Farming: Workers in a number of agricultural occupations are exposed to pesticides and aerosolized mists. One of the most frequent ways that moldy hay causes occupational pneumonitis is by airborne particle inhalation. When hay and grain are being harvested, mold particles might also be inhaled.
- Bird handling: Individuals who deal with poultry and those who raise or breed pigeons are frequently in contact with feathers, excrement, and other elements that can lead to pneumonitis.
- Hot tubs and humidifiers: Pneumonitis can be brought on by moldy hot tub environments because the bubbling movement creates an inhalable mist. Humidifiers in homes are another typical source of mold. Mold and bacteria can grow in an unclean environment and infiltrate you through the mist.
- Cancer treatment: Both radiation treatment to the lungs and some chemotherapy medications can result in pneumonitis. The chance of developing irreversible lung disease is increased by the two together.
Diagnosis
A healthcare provider may carry out the following procedures to assist diagnose pneumonitis.
- Physical examination: Your healthcare provider will examine your symptoms, review your medical history, and they will listen closely to your lungs when you breathe during the physical examination using a stethoscope. You’ll probably get one or more of the following tests to rule out pneumonia from other lung conditions.
- Blood tests: Specific blood tests are helpful in making a diagnosis. A small blood sample from an arm vein will be drawn by the healthcare provider using a tiny needle. After that, a lab will get your sample to determine whether your blood responds to any particular allergies.
- Imaging tests: Imaging tests are helpful because, whereas noninfectious pneumonitis frequently affects all five lobes of the lung, pneumonia typically only affects a small, localized part of the lung.
- Chest X-ray: In order to create images of your lungs, a little quantity of radiation must flow through your chest during this painless procedure. X-rays may be completed in a matter of minutes.
- Computerized tomography (CT): CT scans provide comprehensive cross-sectional images by combining X-ray images from various angles. Lying on a small table that slips inside a big, doughnut-shaped machine is the painless test. CT scans may be completed in less than 15 minutes on average. Compared to a chest X-ray, computerized tomography provides far more detailed information about changes in your lungs.
- Spirometry tests: Spirometry is a test that determines how much air you can breathe in and out in a predetermined length of time. The effectiveness of your lungs’ ability to transport gases from the air into your bloodstream during exercise may also be measured by your healthcare provider.
- Spirometer: The capacity of your lungs to hold air and the rate at which you can exhale are measured with a spirometer.
- Pulse oximeter: Using an oximeter, a device that gently clamps on your finger, you may test the amount of oxygen in your blood and determine how well your lungs are functioning.
- Bronchoscopy: A flexible tube is inserted down your throat during a bronchoscopy operation to inspect your airways and take lung samples.
Your healthcare provider may use a saltwater solution to flood a portion of your lung during a bronchoscopy in order to gather materials and lung cells. A lavage is the term for this flushing process. In order to take a little sample of lung tissue cells for testing, your healthcare provider could also use a tiny instrument that is inserted via the scope.
- Surgical lung biopsy: Larger tissue samples from many areas of your lungs that cannot be accessed with a bronchoscopy may occasionally be examined by your healthcare provider. To get these samples, a surgical operation could be required.
Treatment
If you’re diagnosed with hypersensitivity or chemical pneumonitis, your healthcare provider will recommend avoiding contact with the allergen or chemical exacerbating your lung condition. Following this advice should lead to a reduction in your symptoms. Preventing worsening of pneumonitis is paramount for effective treatment. Additionally, your healthcare provider may recommend the following medications or treatments:
- Medication:
- Corticosteroids: These medications function by inhibiting your immune system, which lowers lung inflammation. Typically, corticosteroids are administered as pills. On the other hand, prolonged use of corticosteroids raises your risk of infection and is linked to osteoporosis, a condition that thins the bones.
- Antifibrotic: Antifibrotic medications assist in reducing lung scarring. Your healthcare provider could recommend nintedanib or pirfenidone.
- Oxygen therapy: In cases where breathing difficulties are significant, oxygen therapy may be necessary, administered through a mask or plastic tubing inserted into the nostrils. While some individuals may require continuous oxygen treatment, others may only need it during periods of exertion or while sleeping.
- Pulmonary rehabilitation: Together with your healthcare provider, you will design an exercise regimen during pulmonary rehabilitation to help strengthen your lungs.
- Lung transplant: Your healthcare provider could advise replacing one or both of your lungs with the healthy lungs of a donor if you have severe pneumonitis that develops into pulmonary fibrosis.
