Smokers' Lung - COPD and Pneumonia

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Are smokers with COPD predisposed to developing pneumonia?

The answer is yes. As previously mentioned, smoking increases mucus production and impairs the clearing action of the cilia in the airway. Also, the addition of bacteria, inflammatory cells, and damaged lung cells to the secretions in the airway and lung make the secretions especially thick, tenacious, and difficult to clear. Therefore, in such a stagnant and nutritious (the mucus) environment, bacteria can flourish and cause infection of the lung (pneumonia). Furthermore, even the inflammatory cells are damaged by tobacco smoke so that their ability to fight infection is diminished.

For all of these reasons, pneumonia is not only more common, but it is often also more severe in smokers with COPD (chronic obstructive pulmonary disease, that is, emphysema and/or chronic bronchitis) than in non-smokers without COPD. Moreover, the inflammatory cells that accumulate in the lung to fight off the infection can fill the alveolar spaces and thereby further limit diffusion of oxygen and carbon dioxide. Therefore, smokers with COPD, who already have impaired breathing (pulmonary function), often become much worse when there is a superimposed infection of the lung (pneumonia). Figure 7 is a microscopic section of a lung with pneumonia in a patient with COPD.

Picture of pneumonia in COPD
Picture of pneumonia in COPD

Notice that most of the alveoli are filled with inflammatory cells. Some alveoli, however, are unaffected and empty because the involvement of this lung with pneumonia is patchy.

Return to Smoker's Lung: Pathology Photo Essay

See what others are saying

Comment from: Tamm, 45-54 Female (Patient) Published: October 18

I am 47 years old. When I was 43 years old I was diagnosed with stage 2 throat cancer! I had 6 weeks radiation twice a day and that was in March! I had to wait 3 months after treatment to see if it cured the cancer and thankfully it was. Started having more problems and had PET scan. It showed 3 spots in my lungs and they did biopsies. While doing that my lung collapsed and I was on the breathing machine for 4 days before it sealed itself up. I went thought chemotherapy and radiation for that! That was in November/December. In January I was coughing up blood and it got so bad that I had to go to emergency room. They said I had pneumonia and was put in the hospital for 2 weeks on IV antibiotics and breathing treatments. It hurt to breathe, felt like I was being smothered and someone was stabbing me in my lung with a knife; not a good feeling. I was released with diagnosis of COPD on top of everything else. Thankfully I am a survivor from the cancer but on a daily basis I fight to breathe right. Daily activity is harder now. If I could go back I never would have taken and inhaled that first cigarette or worked with chemicals. Some aren't as lucky as I am and they don't make it!

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Comment from: Will, 55-64 Male (Patient) Published: October 07

I smoked from 18 to 30 then quit for my kids. Twenty years later I have a new partner and she smoked so I took that first one again and was again hooked for three years. Quit a few times for months, the last one being through a hypnotist with no withdrawal at all. But after 3 months we caved again and went for a week, but I felt so out of breath. Last weekend I just slept and suddenly felt the worst sharp pain when I breathed in. Diagnosed as my first case of pneumonia and in bed for a week. That is it for me and the smokes. This was a wakeup call!

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