The Differences and Similarities of Pneumonia and Tuberculosis

Pneumonia and tuberculosis have been plaguing the citizens of the world
for centuries causing millions of deaths. This occurred until the creation and
use of antibiotics become more widely available. These two respiratory
infections have many differences, which include their etiology, incidence and
prevalence, and many similarities in their objective and subject indicators,
medical interventions, course, rehabilitation and effects.

To explore the relationship between pneumonia and tuberculosis we will
examine a case study. Joan is a 35 year old women who was feeling fine up till
a few weeks ago when she develop a sore throat. Since her sore throat she had
been experiencing chest pain, a loss of appetite, coughing and a low fever so
she went to visit her doctor. Her doctor admitted her to the hospital with
bacterial pneumonia and after three days of unsuccessful treatment it was
discovered that she actually had active tuberculosis. This misdiagnosis shows
the similarities between the two diseases and how easily they can be confused.


Pneumonia is a serious infection or inflammation of the lungs with
exudation and consolidation. Pneumonia can be one of two types: lobar pneumonia
or bronchial pneumonia. Lobar pneumonia affects one lobe of a lung while
bronchial pneumonia affects the areas closest to the bronchi (O\'Toole, 1992).
In the United States over three million people are infected with pneumonia each
year; five percent of which die.


There are over 30 causes for pneumonia however there are 4 main causes
which are bacterial, viral, mycoplasma and fungal (American Lung Association,
1996). Bacterial pneumonia attacks everyone from young to old, however
"alcoholics, the debilitated, post-operative patients, people with respiratory
disease or viral infections and people who have weakened immune systems are at
greater risk" (American Lung Association, 1996). The Pneumococcusis bacteria,
which is classified as Streptococcus pneumoniae, causes bacterial pneumonia and
can be prevented by a vaccine. In 20 - 30% of the cases the infection spreads
to the blood stream (MedicineNet, 1997) which can lead to secondary infections.

Viral pneumonia accounts for half of all pneumonia cases (American Lung
Association, 1996) unfortunately there is no effective treatment because
antibiotics do not affect viruses. Many viral pneumonia cases are a result of
an influenza infection and commonly affect children, however they are not
usually serious and last only a short time (American Lung Association, 1996).
The "virus invades the lungs and multiplies, but there are almost no physical
signs of lung tissue becoming filled with fluid. It finds many of its victims
among those who have pre-existing heart or lung disease or are pregnant"
(American Lung Association, 1996). In the more severe cases it can be
complicated with the invasion of bacteria that may result in symptoms of
bacterial pneumonia (American Lung Association, 1996).

During World War II mycoplasma were identified as the "smallest free-
living agents of disease in humankind, unclassified as to whether bacteria or
viruses, but having characteristics of both" (American Lung Association, 1996).
Mycoplasma pneumonia is "often a slowly developing infection" (MedicineNet,
1997) that often affects older children and young adults (American Lung
Association, 1996).

The other main cause of pneumonia is fungal pneumonia. This is caused
by a fungus that causes pneumocystic carinii pneumonia (PCP) and is often "the
first sign of illness in many persons with AIDS and can be successfully
treated in many cases" (American Lung Association, 1996).

In Joan\'s case bacterial pneumonia was suspected because her immune
system was weakened by her sore throat and her signs and symptoms correlated
with pneumonia.

Tuberculosis (TB)

Tuberculosis was discovered 100 years ago but still kills three million
people annually (Schlossberg, 1994, p.1). Cases range from race and ethnicity.
In 1990 the non-Hispanic Blacks had 9, 634 cases while the American Indians and
Alaskan Natives had 371 cases (Galantino and Bishop, 1994). It is caused by
bacteria called either Mycobacterium tuberculosis or Tubercle bacillus.
Tuberculosis can infect any part of the body but is most often found in the
lungs where it causes a lung infection or pneumonia.


There has been a resurgence of TB due to a number of factors that include:

1. the HIV / AIDS epidemic, 2. the increased number of immigrants, 3. the
increase in poverty, injection drug use and homelessness, 4. poor compliance
with treatment regiments and; 5. the increased number of residents in long term
facilities (Cook & Dresser, 1995).

The tuberculosis bacteria is spread through the air however transmission will
only occur after prolonged exposure. For example you only have a 50% chance to
become infected if you spend eight hours a day for six months with someone who
has active TB (Cook & Dresser, 1995).

The tuberculosis bacteria enters