What are chronic lung infections?
Chronic lung infections are those which do not resolve quickly or at all after antibiotic treatment. The most common causes are from chronic obstructive pulmonary disease (COPD), cystic fibrosis, and bronchiectasis, all of which involve inability to clear secretions. All persistent lung infections alternate periods of stability with periods of exacerbation (changes in cough, dyspnea, sputum, or fatigue).
Chronic lung infections are usually due to some compromise in this dynamic action of ventilation–age, immunocompromise, or the dysfunction and tissue destruction of chronic obstructive pulmonary disease (COPD).
Causes of Chronic Lung Infections
Depending on specific illnesses or the degree of debilitation, the respiratory changes that can begin lengthy (chronic) lung infections include:
- Loss of elastic recoil in the chest wall resulting in air trapping and increase in lung capacity and residual volume
- Diminished respiratory muscle strength and endurance
- Loss of alveoli
- Reduction in oxygen and carbon dioxide exchange
- Inability to increase rate of respiratory effort
- Decreased cough or gag reflex (leading to ineffective clearance or aspiration pneumonia
- Decreased ability of cilia to move mucous and bacterial debris upward
The above risks are compounded extensively in closed settings of cloistered immun0compromised persons, such as in nursing homes and facilities and other institutions. Hospital acquired pneumonia is more likely to be drug resistant. Comorbidity is the strongest independent predictor of mortality in patients with chronic lung infections.
Smoking results in most of the respiratory changes cited above. The upward elevator movement of cilia to move inhaled particles, bacteria, etc. out of the pulmonary system become inert. Smoking also is the prime cause of COPD. The destruction of alveoli, decreasing the surface area used for respiration, decreases such that any infection is already synergistic for compromise in gaseous exchange.
A serious complication of stroke is the loss of a gag or swallowing reflex. This creates a scenario in which food and drink meant for the esophagus can get into the lung, providing a suitable growth medium for bacterial.
Those who are immunocompromised (e.g., HIV) are who are pharmacologically immunocompromised (systemic corticosteroid use) may be ineffective in the first lines of defense due to limitations of the innate immune system.
Chronic Lung Infections
- Pneumonia from COPD, aspiration
- Bronchiectasis-related pneumonia (inability to clear secretions)
- Cystic fibrosis-related pneumonia