No obvious cough but still have pneumonia? Experts: Beware of "silent pneumonia" | Hot Topics

Recently, some parents reported that their children had no obvious coughing symptoms, but when they went to the hospital for a CT scan, they were found to have pneumonia. In this regard, an expert said: "Among the mycoplasma pneumonia infections, there are indeed some children who do not have obvious coughs or even fevers. These children have no obvious abnormalities in their lungs, but imaging examinations have shown pneumonia. This type of children accounts for about 10%-15%."

Why does a mild cough develop into pneumonia? Does a similar situation occur in adults and the elderly? What factors are related to coughing? How to prevent "silent pneumonia"?

People with low immunity

Are you more likely to suffer from "silent pneumonia"?

Ma Yanliang, chief physician of the Department of Respiratory and Critical Care Medicine at Peking University People's Hospital, said that in recent years, people have had more opportunities to undergo CT (computed tomography) scans, either due to physical examinations or other physical problems. Many people have found some patchy shadows in their lungs and have been diagnosed with pneumonia.

"Compared with children, this silent pneumonia is more common in the elderly or people with relatively poor immune function," Ma Yanliang reminded.

Coughing and pneumonia are related to each other, but why do people develop pneumonia when their cough is not obvious? Ma Yanliang inferred two reasons.

The first reason is related to the pathogen that the patient is infected with. Some viruses may not cause pneumonia-related symptoms. If the patient has always been healthy and the virus he is infected with is not strong, then the patient can recover on his own.

The second reason is related to the patient's own resistance. If the patient is an elderly person or a person with underlying diseases, and takes some hormone-based immune preparations due to underlying diseases such as tumors or diabetes, then the patient's pneumonia symptoms will not be obvious. In this case, if the patient does not treat the lung infection in time, the condition will gradually worsen in the later stage, and respiratory failure may occur, and even develop into serious lesions such as lung abscess.

Why do people cough?

In daily life, people often cough, but there are many reasons for coughing.
Ma Yanliang said that simple coughing cannot be considered a disease. For example, people may occasionally choke when eating too fast, which is actually a cough, but this cough is a reflex of the body to protect the lungs, not a disease.

In addition, there are different situations in which cough manifests as a disease.

The first case is upper respiratory tract infection. "Upper respiratory tract infection causes pharyngitis and runny nose, and this infection is often followed by coughing," said Ma Yanliang.

The second situation is lung diseases. In addition to pneumonia, various lung diseases such as bronchitis, asthma, and chronic obstructive pulmonary disease can also cause coughing.

The third situation is diseases outside the lungs. Ma Yanliang gave an example, some older people are prone to gastroesophageal reflux when eating. At this time, stomach acid will irritate the throat and cause coughing. In addition, people with poor heart function may also have coughing symptoms.

In general, cough receptors are distributed in many parts of the human body. Among them, the most common cause of cough is respiratory infection, followed by airway diseases such as asthma, chronic obstructive pulmonary disease, and gastroesophageal reflux.

Is it necessary to identify the pathogen when coughing symptoms occur?

It is difficult to distinguish the infectious pathogens based on symptoms alone. Ma Yanliang gave an example, Mycoplasma pneumoniae is the pathogen that causes mycoplasma pneumonia, and the incidence rate is particularly high among children in grades three and four. However, if children with mycoplasma pneumonia are also infected with respiratory syncytial virus or the new coronavirus, then in the case of multiple pathogens, it is difficult to determine the infectious pathogen based on symptoms alone.

In addition to observing the symptoms of the disease, Ma Yanliang said that people can observe the transmission chain of their own disease, and observing the symptoms of the virus spreader is the most direct way.

In addition, with the continuous advancement of testing methods today, people can purchase simple test kits for self-testing, or go to the hospital for nucleic acid testing.

Testing for infected pathogens is to prescribe the right medicine for the disease. "In fact, people who are healthy and have normal immunity do not need to find out the virus they are infected with every time," Ma Yanliang said frankly. "They have good immunity and can recover on their own when the symptoms are mild. There is no need to take special medicine for this." For people with poor immunity, testing for pathogens is to prescribe the right medicine for the disease and help patients avoid worsening symptoms.

Ma Yanliang suggested that paying attention to the notifications released by my country's National Health Commission and promptly understanding the trends of epidemiological changes will help with prevention and selection of targeted therapeutic drugs.