Bronchopneumonia · What Is It, Contagiousness, Diagnosis, Treatment, and More

Bronchopneumonia is the most common type of pneumonia found in children. Among children under 5 years of age, it’s the leading cause of death. In fact, bronchopneumonia accounts for 85% of all respiratory system diseases in children under 2 years of age. Incidence is also very high among older adults, especially people over 65 years of age. In general, community acquired pneumonia is the most common cause of death due to an infectious disease.  

Bronchopneumonia is mostly caused by a bacterial infection, but it can also be caused by viral or fungal infections. Pathogens include Staphylococcus aureus, Klebsiella pneumoniae, Haemophilus influenzae, Streptococcus pneumoniae, Pseudomonas aeruginosa, Escherichia coli, and SARS-Cov-2. Other, less common pneumonia-causing organisms include fungi such as Aspergillus fumigatus.  

Bronchopneumonia presents with suppurative inflammation that’s localized in patches around bronchi and may affect one or more lobes of the lung. In severe cases, bronchopneumonia can lead to the formation of a lung abscess (i.e., pus-filled pocket in a focal area). In addition, the infection may spread to the pleural space, filling it with an exudate (i.e., pus-like fluid resulting from inflammation),also known as empyema. 

Yes, bronchopneumonia is a contagious infection. The pathogens that can cause bronchopneumonia are usually spread through inhalation of droplets. Normally, these are transmitted when a person coughs or sneezes, creating tiny droplets that can spread and infect others. After a person inhales these pathogen-containing droplets, they colonize the upper respiratory tract and then reach the lung alveoli through inspiration. Infection can result when the inoculum size is sufficient or the host immune system is impaired. Replication of the pathogen and its virulence factors—combined with the host immune system response—ultimately lead to inflammation and damage of the bronchi and lung parenchyma.  

Risk factors include children under 2 years of age, adults over 65 years of age, recent travel, smoking, prior antibiotic use, underlying respiratory conditions (e.g., cystic fibrosis, etc.), recent upper respiratory viral infection, HIV infection, active malignancy, and autoimmune disorders. Affected populations should take precautions to avoid infection, as they may be more susceptible to severe respiratory disease.  

The causal pathogen of bronchopneumonia is oftentimes not known at diagnosis, therefore empiric treatment should be initiated with the most suspected pathogen based on clinical characteristics seen during examination.  

Antibiotics used in the treatment of bronchopneumonia include first- and third-generation cephalosporins, as well as penicillin-based antibiotics. In severe cases in which patients may require intensive care or intubation for severe respiratory distress, there is a mortality benefit to adding stress-dosed steroids (i.e., hydrocortisone) in addition to antibiotic therapy. Antibiotic therapy is typically given for 5–10 days, depending on the severity. Additionally, treatment includes supportive therapy such as adequate hydration, rest, and home care.