Pneumonitis happens when an allergic reaction occurs in the lungs after inhaling certain substances. It is also known as hypersensitivity pneumonitis.

The reaction can cause inflammation in the air sacs in one or both lungs. Without treatment, long-term damage can result in the lungs. However, quick action can reverse pneumonitis completely.

In this article, we take a look at the symptoms, causes, and treatments of pneumonitis. We also examine the differences between the condition and the more familiar pneumonia.

Symptoms

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Symptoms of pneumonitis include shortness of breath, rattling sounds in the lungs, and coughing.

The symptoms of pneumonitis can vary in intensity, frequency, and the areas of the body that they affect.

The symptoms can include the following:

  • fevers, chills, and headaches
  • muscle or joint pain
  • coughing or a rattling sound in the lungs
  • shortness of breath
  • severe weight loss
  • fatigue
  • clubbing of fingers or toes

Any fluid filling the lungs can be a deadly complication of pneumonitis if it is not caught early and treated. So people should look out for any of these symptoms if they suspect someone might be suffering from pneumonitis.

Certain complications of pneumonitis or severe flares of symptoms in the lungs can cause respiratory issues. Tissue in the lungs can become scarred, which may stop the lungs from working properly. Furthermore, the amount of oxygen reaching the bloodstream may also be reduced.

If left untreated, pneumonitis can be life-threatening, as it makes it harder for the heart to pump blood through the lungs.

Causes

Pneumonitis tends to occur when an irritating substance of any kind is introduced to the lungs. When this happens, tiny air sacs in the lungs become inflamed, making it difficult to breathe and causing other symptoms.

In most cases, the irritants that cause pneumonitis in the first place are never identified.

Lifestyle factors, such as occupation, location, gender, and age can all contribute to the risk of pneumonitis. Someone who works with harsh chemicals or irritants is more likely to develop pneumonitis than others, for example.

The causes behind pneumonitis vary and can include:

  • molds and bacteria
  • radiation treatment, usually when targeting the chest area
  • drugs and antibiotics, including some used in chemotherapy or to control the heartbeat
  • exposure to birds, bird feathers, or excrement

Risk factors

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Smoking may increase the risk of developing pneumonitis as well as many other lung conditions.

Pneumonitis has many risk factors associated with it.

Due to the ease with which it can develop, pneumonitis is often linked to some specific risk factors. These vary but largely come down to the location and living conditions of an individual.

A person who works with birds for a living, or someone who deals with harsh chemicals, can be more at risk than someone who works in an office, for example.

Risk factors include:

  • lifestyle habits, such as smoking
  • genetics
  • age, as it usually affects those between 50-55 years of age
  • environment and job, such as working around irritants or large public crowds
  • sex, as the condition may be slightly more common in women than men
  • bird-handling
  • hot tubs and humidifiers
  • certain cancer treatments

When to see a doctor

Someone should go and see their doctor, as soon as any symptoms worsen or become severe. In particular, any flu-like symptoms or signs of water in the lungs should be referred to a doctor immediately.

If the factors that are causing the pneumonitis symptoms cannot be removed, adjusted or avoided, a doctor should also be seen for different treatment options.

Pneumonitis can cause permanent damage to the lungs if it is not treated early. As a result, it is best to see a doctor before symptoms become severe or impossible to treat with self-care.

Diagnosis

Pneumonitis causes similar symptoms to many other lung conditions. As such, it may take several tests before a definitive diagnosis is made, as the doctor will need to rule out these other possibilities first.

A doctor will try to establish if the person has come into contact with any of the substances that can cause pneumonitis. To do so, they will begin by taking a medical history and carrying out a physical exam.

The doctor may also request checks, including:

  • blood tests to evaluate the levels of white blood cells in the body
  • CT or computed tomography scans or X-rays to test for fluid or inflammation in the lungs
  • a spirometry to see how well the lungs are able to breathe in and out
  • an oximetry to test how much oxygen is in the bloodstream
  • bronchoalveolar lavage where fluid is collected from the lungs and tested for white blood cells
  • lung biopsies to check the tissue in the lungs for any changes that indicate pneumonitis

To examine the lungs and collect samples of tissue or fluid, a doctor may use a device called a bronchoscopy. This thin, flexible tube can be passed down the throat into the lungs. It has a light and a camera attached to it, allowing the user to look inside the lungs.

Treatment

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Measures to prevent pneumonitis include removing or avoiding the source of irritation, and wearing a face mask that covers the mouth and nose.

Treatment for pneumonitis include:

  • Corticosteroid medication: This can reduce inflammation but has adverse effects if used long term.
  • Oxygen therapy, if the person has difficulty breathing.

In most cases, a doctor will recommend removing the irritant that caused or is causing the pneumonitis so a person is no longer exposed to the contaminant.

Avoiding the irritant is often enough to prevent the pneumonitis from reoccurring or getting worse. This may not always be possible, however, especially if the case is related to chemotherapy or radiation treatments.

To help manage the risk of developing pneumonitis, it is important to take preventive measures when dealing with irritants. This can include wearing a face mask when dealing with birds, bacteria, or mold of any kind, and avoiding chemical irritants, as much as possible.

In more severe cases of pneumonitis, a doctor might prescribe corticosteroids. These drugs work by reducing inflammation in the lungs by weakening the immune system. However, weakening the immune system leaves a person at risk of developing infections or brittle bones, so corticosteroids can be dangerous.

Doctors might also offer oxygen therapy with an oxygen mask if someone is finding it difficult to breathe. While some people only need oxygen therapy when they sleep, others may need it constantly if their case is severe.

Prevention

Unlike pneumonia, where several preventative vaccinations are available, pneumonitis is largely prevented by avoiding the irritants that can cause the condition.

Routine checking that heating, air-conditioning, and ventilation units are clean and working properly may help prevent airborne irritants from causing pneumonitis.

People should always be aware of any allergies they might have, and the possible allergens that can be found in areas they visit frequently. Any areas where allergens could be found should be avoided or visited with caution.

Pneumonitis versus pneumonia

Pneumonitis is a general term that describes inflammation in the lungs.

When it is noninfectious inflammation, doctors will refer to the problem as pneumonitis.

Pneumonia is a kind of pneumonitis as it causes inflammation. However, pneumonia is caused by an infection by bacteria, a fungus or viruses.

As a result, pneumonia can be spread from person to person while pneumonitis cannot.

Outlook

Pneumonitis can lead to severe complications if it is not treated, so people should be aware of the symptoms.

Fortunately, someone should be able to prevent the condition if they are aware of what substances could cause them to have an allergic reaction

If anyone is experiencing the symptoms of pneumonitis and notices them getting worse at any point, they should contact their doctor.