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Understanding Pneumonia: Expert Insights from Dr. Jaspreet Singh

Overview

Pneumonia is a common and potentially life-threatening respiratory illness, especially prevalent in densely populated regions like India. Dr. Jaspreet Singh Khandpur, an experienced interventional pulmonologist and chest physician based in Thane, offers valuable insights into the causes, risk factors, symptoms, and potential complications of pneumonia. His expertise is widely sought after, particularly for high-risk cases that require advanced diagnostic and therapeutic interventions.

Dr. Singh holds an MBBS, an MD in Pulmonary Medicine, and a DNB in Respiratory Medicine. He is also a member of prestigious international organizations, including the European Respiratory Society (ERS), the Asia Pacific Society of Respirology (APSR), and the Indian Chest Society (ICS). Additionally, he is an ex-chest physician, a pulmonary critical care and sleep disorder specialist, and an interventional bronchoscopist. With a vast and diverse background, Dr. Singh is well-equipped to manage complex pulmonary conditions.

He is currently attached to several prominent hospitals in the Thane and Navi Mumbai areas, such as Titan Medicity, Kasarvadavli , Horizon Prime Hospital, Reliance Hospital, Coper Clinic, and Highline Hospital. Other hospitals he is associated with include Curie and Bethany Hospitals, among others. In addition to his hospital affiliations, Dr. Singh runs his own clinic in kolshet road, DMAT, where he specializes in bronchoscopies, thoracoscopies, and foreign body removals.

Why Pneumonia Is Prevalent in India

Dr. Singh addresses a significant aspect of pneumonia in India: tuberculosis (TB). He explains that tuberculosis (TB) is one of the most common causes of pneumonia in India. TB is a slow-progressing disease that may take one to two months to develop fully. As the country grapples with many TB cases, the spread of pneumonia becomes more common. Dr. Singh emphasizes that while pneumonia may be associated with various viral infections, the prevalence of tuberculosis makes it a significant factor in the overall incidence of pneumonia. Some other contributing factors include:

Population Density

While it is common for countries to have large populations, India’s particular challenge lies in its high population density. Dr. Singh explains that densely populated areas, where a large number of people live in close quarters, create an ideal environment for pneumonia to spread. “It’s not just the population size that matters, but the density,” he says. This means that when one person in a crowded space contracts the infection, it can easily spread to others, increasing the risk of pneumonia in these areas.

Age related factors

Dr. Singh also highlights the age factor as a major contributor to the severity of the illness. Children tend to recover quickly from initial symptoms like fever and cough, but older individuals, particularly those with pre-existing conditions such as asthma, chronic obstructive pulmonary disease (COPD), or age-related asthma, are more susceptible to severe pneumonia. These complications can lead to persistent cough, prolonged fever, and significant morbidity, sometimes requiring hospitalization.

Post COVID Impact

The COVID-19 pandemic also had a profound impact on the incidence of pneumonia in India. Dr. Singh highlights the long-term effects of COVID-19, which have added to the ongoing pneumonia burden in the country. While the immediate impact of COVID-19 was widely felt, the aftereffects, including long-term respiratory issues, are increasingly being observed in patients. This adds another layer of complexity to pneumonia-related illnesses in India, as people continue to experience health complications even after recovering from COVID-19.

Understanding Symptoms of Pneumonia and Tuberculosis

While healthcare professionals are well-equipped to identify and treat diseases like tuberculosis (TB) and pneumonia, it can be difficult for the public to recognize the symptoms of these illnesses early on. Dr. Jaspreet Singh offers valuable advice on how the average person can identify warning signs of pneumonia or tuberculosis and when to seek professional medical help.

He explains that the general public should be cautious when experiencing symptoms like:

fever
cough
chest pain
breathlessness

While it may be tempting to self-medicate with over-the-counter (OTC) drugs, this is not always advisable. “If symptoms such as a fever or a persistent cough, especially with yellow or green mucus, last for several days—around 5 to 6 days—it’s important to seek medical attention,” he advises.

Dr. Singh emphasises that these symptoms should prompt a visit to a doctor, particularly if the illness persists or worsens. To drive his point home,

Dr. Singh offers an analogy: “If your car breaks down and you don’t know how to fix it, you take it to a garage. Similarly, when your body shows signs of illness, you should take it to a medical center or clinic instead of trying to diagnose or treat it yourself.”

A healthcare professional should evaluate the symptoms thoroughly, as conditions like pneumonia, tuberculosis, asthma, or bronchitis can sometimes present with similar symptoms.

The Importance of Proper Diagnosis

Dr. Singh stresses the importance of proper diagnosis and guidance from a medical professional. He notes that some patients initially treated for pneumonia with antibiotics may later find that their condition was asthma or bronchitis, which requires a different approach. On the other hand, patients initially diagnosed with asthma or bronchitis may, in some cases, turn out to have tuberculosis or another type of pneumonia.

This highlights the need for a thorough evaluation by a doctor, particularly a chest physician, who can accurately assess symptoms and determine the appropriate course of treatment. Dr. Singh emphasizes that deciding when to administer antibiotics is critical, noting that making an accurate diagnosis from the outset is essential to avoid unnecessary treatments.

Avoiding Over-the-Counter Medications

Dr. Singh also advises against over-relying on over-the-counter medications. While it may seem convenient to use OTC drugs to manage symptoms, they may not address the root cause of the illness.

“Understanding the symptoms and acting upon them appropriately by consulting a medical professional is key,” he says.

Understanding the Risk Factors and Causes of Pneumonia

Pneumonia is a serious respiratory illness with a variety of causes, but certain risk factors make some individuals more susceptible to developing the condition. Dr. Jaspreet Singh outlines the key factors that increase the likelihood of pneumonia, highlighting the significance of age, comorbidities, lifestyle choices, and environmental factors.

1. Age: The Primary Risk Factor

Dr. Singh emphasizes that old age is one of the most significant risk factors for pneumonia. As individuals age, their ability to expel mucus and secretions from the lungs decreases, which can lead to the accumulation of these secretions. While younger individuals can often cough up and expel mucus or secretions throughout the day, older adults may experience a buildup in the lungs, which can significantly increase the risk of respiratory infections, including pneumonia. The elderly also tend to have a weaker immune response, which further predisposes them to complications from infections.

2. Lifestyle Factors: Smoking and Poor Diet

In addition to age, certain lifestyle factors play a crucial role in increasing the risk of pneumonia. Smoking is a major contributor, as it damages lung tissue and weakens the immune system making it harder for the body to fight off infections. Dr. Singh also highlights the importance of diet, emphasizing that poor nutrition can weaken the immune system and make the body more vulnerable to pneumonia.

“It’s not just about exercise; it’s about following a healthy diet—eating regular meals like breakfast, lunch, and dinner,” he advises. Proper nutrition is essential for maintaining strong immunity and preventing respiratory illnesses.

3. Environmental Factors: Pollution and Occupation

Environmental exposure also plays a significant role in the development of pneumonia. Dr. Singh notes that people who live or work in areas with high levels of air pollution or exposure to smoke are at a higher risk. He shares an interesting observation, explaining that people working in places like hotels, where food is prepared in poorly ventilated spaces, may be exposed to harmful pollutants that can damage the lungs over time. This, in turn, compromises the lungs’ immunity and increases susceptibility to pneumonia.

4. The Role of Immunity and Exposure to Infectious Agents

Dr. Singh explains that while tuberculosis bacteria and other pathogens are present in the environment, the risk of infection increases when a person’s immune system is weak.

“Bacteria are everywhere, but if your immunity is low, and if you are not eating well, you are more likely to contract pneumonia,” he says.

People living in densely populated areas, where infectious diseases like cough and cold spread quickly, are also at an increased risk of developing pneumonia.

5. Other Comorbidities

Dr. Singh highlights additional comorbidities that can elevate the risk of pneumonia, including

diabetes
hypertension
obesity
cardiac diseases

In cases of diabetes, for example, the increased secretion can facilitate the growth of bacteria, leading to infections that cause pneumonia, often resulting in yellow or green mucus.

In addition to these pre-existing lung diseases such as asthma, COPD (Chronic Obstructive Pulmonary Disease), and interstitial lung disease also contribute to the severity of pneumonia.

Dr. Singh explains that these conditions damage the lung’s structure and function, increasing susceptibility to infections. Additionally, individuals with frequent hospital admissions are at a higher risk of acquiring pneumonia, especially due to hospital-associated pathogens that can complicate their condition.

Complications of Pneumonia

Pneumonia, if left untreated or inadequately managed, can lead to serious complications. Dr. Jaspreet Singh highlights the critical importance of early diagnosis and treatment to prevent these potentially life-threatening issues. He also emphasizes the need for proper follow-up care to ensure patients receive timely interventions and avoid long-term health problems.

Early Intervention and the Importance of Timely Diagnosis

Dr. Singh underscores that when a patient is diagnosed with pneumonia, it is essential to monitor their progress closely. He advises that if a patient is not improving within a few days, further diagnostic steps, such as a CT scan or sputum examination, should be taken to identify the underlying cause of persistent symptoms. Often, pneumonia can be caused by a bacterial or fungal infection, and if symptoms do not improve with initial treatment, additional investigations are necessary to adjust the treatment plan accordingly.

“The key is reducing follow-up time and maintaining two-way communication with the patient,” Dr. Singh explains.

If symptoms like a persistent cough do not resolve after a few days of treatment, the doctor should be notified immediately for further evaluation. This proactive approach can prevent unnecessary delays in treatment and reduce the risk of complications.

Potential Complications of Untreated Pneumonia

When pneumonia is left untreated or inadequately managed, it can escalate into more severe complications. Dr. Singh lists several critical issues that can arise from untreated pneumonia, including:

Desaturation: This refers to a drop in oxygen levels in the blood, which can lead to difficulty breathing.
Sepsis: A systemic infection that can spread throughout the body, leading to severe illness.
Hypotension: Low blood pressure, which can complicate the patient’s condition.
Electrolyte Imbalances: Pneumonia can cause conditions like hypokalemia (low potassium) and hyponatremia (low sodium).
Hypoglycemia: In diabetic patients, untreated pneumonia can lead to dangerously low blood sugar levels.

In more severe cases, patients may require non-invasive ventilation (NIV) support or even a ventilator if their condition worsens significantly.

Dr. Singh explains that managing these severe complications is extremely challenging, likening it to “bringing the patient back from hell.” This is why early diagnosis and prompt treatment are critical to prevent pneumonia from progressing to such critical stages.

Long-term complications: Post-Pneumonia and post TB care

Even after the acute phase of pneumonia is treated, patients can experience long-term complications. Dr. Singh highlights that many individuals continue to suffer from chronic symptoms, including persistent cough and wheezing, months after the infection has cleared. This is particularly evident in cases of post-COVID, post-TB, or any post-infective condition that affects the lungs.

When part of the lung is damaged by an infection, the other parts of the lung may compensate by hyperinflating, which can lead to chronic respiratory issues like bronchitis or asthma. Patients may experience frequent coughing, chest pain, and difficulty breathing. Dr. Singh stresses that in such cases, antibiotics should not be the first line of treatment unless there is a clear indication of a bacterial infection. Instead, medications such as inhalers, nebulizers, or antiallergics may help manage the symptoms. This approach can reduce the recurrence of these symptoms and provide long-term relief.

Conclusion

Pneumonia remains a major health challenge in India, largely due to factors such as population density, poor air quality, and a high incidence of tuberculosis. Early diagnosis, prompt treatment, and managing risk factors like age, smoking, and diabetes are essential for preventing complications. Dr. Singh’s insights serve as a reminder that recognizing the symptoms early and seeking medical help can significantly reduce the severity of pneumonia and improve outcomes for patients.

We thank Dr. Jaspreet Singh Khandpur for sharing his time and valuable expertise. His detailed insights have significantly enhanced our understanding of pneumonia and its far-reaching implications.